Health assessments

Rules about billing Medicare Benefits Schedule (MBS) health assessment items and how to apply them.

Read the relevant item descriptions, fact sheets and explanatory notes on the MBS Online website.

A health assessment looks at your patient’s health, physical, psychological and social function.

There are Medicare Benefits Schedule (MBS) items covering health assessments for specific target groups.

Health assessments aren’t available to hospital in-patients. They also aren’t available to aged care residents except for either:

  • comprehensive medical assessments
  • Aboriginal and Torres Strait Islander patients.

When billing and claiming health assessments you should consider all of the following:

  • time taken to complete the assessment
  • complexity of your patient’s needs
  • specific requirements for each target group.

The following table provides service descriptions, item numbers and the time required for each MBS item.

Item numbersItem nameItem descriptionTime required
224, 701Brief health assessmentA simple health assessment30 minutes or less
225, 703Standard health assessmentAn assessment for when the patient needs more than a brief assessment, but doesn’t have complex health issuesMore than 30 but less than 45 minutes
226, 705Long health assessmentAn extensive assessment for when the patient has complex health issuesAt least 45 but less than 60 minutes
227, 707Prolonged health assessmentA complex assessment of a patient with significant, long-term health needs managed through a comprehensive preventative healthcare management plan60 or more minutes
228, 715Indigenous health assessmentA health assessment for Aboriginal and Torres Strait Islander patientsNo time requirements
177, 699Heart health assessmentA health assessment for patients with cardiovascular disease or at risk of developing cardiovascular diseaseAt least 20 minutes

Claiming limits

In some cases, you can do a subsequent health assessment in the same 12-month period. You can do them if your patient is eligible for another health assessment under a different target group.

To help us assess your claim, you need to tell us which target groups the health assessment claim is for.

If you don’t specify that the subsequent health assessment was for a different target group, we’ll reject your claim.

Heart health checks

You can bill a heart health check for your patient once every 12 months if your patient meets the criteria for these items.

Find out more about items 699 and 177 for these criteria on MBS Online.

You can’t bill a heart health check item for your patient if, in the last 12 months, they had another health assessment under:

Page last updated: 15 June 2024.
QC 74110