Preventive Activities & Health Assessments by Age

Most prevention in Australian general practice happens opportunistically, folded into a consultation booked for something else. Systematic recall — actively calling patients in — is reserved for a smaller set of high-value targets: childhood immunisation, and screening for cervical, breast, colorectal and bowel cancer and diabetes.

Alongside this, Medicare funds a growing family of structured health assessment items for specific population groups: Aboriginal and Torres Strait Islander people, refugees, people with an intellectual disability, those aged 45–49 with a risk factor, and those aged 75 and over. A health assessment item is not a substitute for opportunistic prevention — it’s a dedicated, funded slot to do it systematically for patients most likely to benefit.

Time-tiered health assessment items (701–707)

These items — 701/703/705/707 for a GP, the parallel 224/225/226/227 for a prescribed medical practitioner — are billed by time spent, not by which population group is being assessed:

Service	Duration	GP item	PMP item
Brief health assessment	≤30 minutes	701	224
Standard health assessment	≥30 to <45 minutes	703	225
Long health assessment	≥45 to <60 minutes	705	226
Prolonged health assessment	>60 minutes	707	227

They’re only payable for a defined eligible cohort, each with its own additional requirements — a GP can’t bill 701–707 for a health assessment on an otherwise-well 50-year-old. The shared core across every cohort is information collection (history, relevant examination and investigations), an overall assessment, initiating any indicated interventions or referrals, and giving the patient advice and information. A practice nurse or Aboriginal and Torres Strait Islander health worker/practitioner can assist with information collection and delivering advice under the GP’s supervision, but the assessment itself remains a personal GP attendance.

A health assessment item cannot include a screening service — a test or examination not otherwise clinically indicated for that patient. It sits alongside opportunistic and systematic screening, not instead of it.

The funded cohorts:

• People aged 45–49 (inclusive) with a chronic-disease risk factor — lifestyle (smoking, inactivity, poor nutrition, alcohol), biomedical (high cholesterol, high blood pressure, impaired glucose metabolism, excess weight) or family history. Claimable once only.
• People aged 40–49 at high risk of type 2 diabetes, as determined by the Australian Type 2 Diabetes Risk Assessment Tool (completed within the prior 3 months) — a Type 2 Diabetes Risk Evaluation, reviewing the risk factors behind the high-risk score and initiating any indicated intervention. Claimable once every 3 years.
• People aged 75 and over — the Older Person’s Health Assessment (below). Annual.
• Residents of residential aged care facilities — a comprehensive medical assessment.
• People with an intellectual disability — annual.
• Refugees and other humanitarian entrants — once only.
• Children aged 3 — the 3-year-old health check (below), part of the Thriving Kids reforms, billed via the time-tiered 701–707 items.

None of these can be claimed if the same item, or item 228, 92004 or 92011, was already billed for that patient in the preceding period specific to that cohort — check the record before offering one.

A separate standard consultation on the same visit isn’t billable alongside a health assessment unless it’s clinically necessary and clearly a distinct service.

Three-Year-Old Health Check (Thriving Kids)

The check bills through the time-tiered health assessment items 701–707 (by consultation time) — the older dedicated child health-check item (711) has been retired.

A Medicare-funded 3-year-old health check is being introduced from November 2026 as part of Thriving Kids. Patients are eligible from the day they turn 3 years of age until the day before they turn 4 years of age.

Mandatory components to qualify for the MBS item numbers are a relevant child and family history, a basic physical examination, monitoring development and formulating needs, and providing advice/support and facilitating any necessary supports and/or referrals. The final step is adding a copy of the health assessment to the child’s health record and offering a copy to the child’s parent or carer.

At the check:

• Screen for risk factors for developmental delay — prematurity, low birthweight, birth complications, poor maternal health during pregnancy, prenatal exposure to alcohol or drugs, infections, genetic characteristics, trauma, maltreatment, exposure to toxins, lead poisoning and low socioeconomic status.
• Parental concern alone is a valid trigger for further assessment — elicit concerns actively.
• The RACGP Red Book recommends case finding for children at risk of developmental delay, assessing parental concern and checking for red flags across the social, emotional, communication, cognition/fine motor/self-care and gross motor domains.

Physical examination:

• Measure height and weight to assess growth using published centile charts, including BMI for age.
• Eyesight — ocular motility and alignment (corneal light reflection, cover test); any children with concerns can be referred for an optometry assessment.
• Hearing — if there are concerns on history, perform otoscopy and refer for audiometry.
• Oral health — refer for dental assessment if there are concerns.

Consider early referral for:

• Developmental regression or red flags for developmental delay.
• Suspicion of autism.
• Significant hearing or vision problems.
• Major psychosocial risk factors.
• Significant parental concern, even in the absence of abnormal screening tests.

Follow-up:

• Arrange follow-up for any family where a concern has been identified — regular GP support and monitoring is therapeutic and may be all that is required.
• For children with a significant concern, chronic condition management plan reviews (MBS item 967) and practice nurse follow-ups (MBS item 10997) can facilitate care with 3- to 6-monthly reviews.

Older Person’s Health Assessment (75+)

Available annually to patients aged 75 and over who are not a hospital inpatient or an aged-care resident, this is the assessment most GPs will use most often. It must cover:

• Blood pressure, pulse rate and rhythm.
• Medication review.
• Continence.
• Immunisation status — see National Immunisation Schedule.
• Physical function, including activities of daily living, and whether the patient has fallen in the last 3 months — see Falls in Older People.
• Psychological function, including cognition and mood.
• Social function, including the availability and adequacy of paid and unpaid help, and whether the patient cares for someone else.

Offer the patient (or their carer, with the patient’s agreement) a written report with recommendations, and add a record of the assessment to the notes. The RACGP Silver Book (aged-care clinical guidance) and the National Immunisation Program Schedule are the reference points suggested for conducting it to current standard.

Aboriginal and Torres Strait Islander Health Assessment (715)

A comprehensive health assessment for a patient of Aboriginal or Torres Strait Islander descent, claimable once every 9 months (fee $254.10, 100% rebate). It must include:

• Recognising the patient’s health priorities.
• History, relevant physical examination, and arranging any indicated investigations.
• Assessing the patient using the information gathered, and initiating any necessary interventions and referrals.
• A documented management plan covering follow-up, based on the assessment and the patient’s own priorities.
• Offering a written report with recommendations, and adding a record to the patient’s notes.

The detailed clinical content is set out in the RACGP National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people — use it, not a generic template, to structure the assessment itself. See Aboriginal and Torres Strait Islander Health & the 715 Check for a practical walkthrough of item 715 and the funded vaccine differences.

Other cohorts

• Refugees and humanitarian entrants — once only, covering the same core elements (history, examination, investigations, plan, report), tailored to catch-up immunisation (see Adult & At-Risk Immunisation, Catch-Up Schedules), infectious disease screening and psychosocial needs typical of this group.
• People with an intellectual disability — annual, same core structure; can be co-claimed with the 45–49 or diabetes-risk assessment in the same patient if both are genuinely indicated and distinct.
• Residential aged care residents — a comprehensive medical assessment, distinct from the 75+ item (a patient who is an aged-care resident is not eligible for the standard Older Person’s Health Assessment).

Where the clinical detail lives

This page is the entry point for the health-assessment funding structure; the clinical detail for each preventive activity is owned by its own topic page:

• Immunisation (childhood schedule, adult/catch-up, travel) — National Immunisation Schedule.
• Cancer screening (cervical, breast, bowel, prostate) and cardiovascular/osteoporosis risk assessment — Screening.
• Falls risk in patients 65+ — Falls in Older People.
• Smoking cessation — Smoking Cessation.

Practical points

• Check eligibility and recency before offering — most of these items have a “not in the preceding X months/years” rule; claiming outside it doesn’t attract a rebate.
• A health assessment is not a Chronic Disease Management Plan (GPMP/TCA) — the two are billed separately and serve different purposes, though findings from one often lead into the other.
• Delegate what can be delegated. A practice nurse or Aboriginal and Torres Strait Islander health worker/practitioner can do the information-collection legwork under supervision, making the GP’s own time in the consult go further.
• Keep records for at least 2 years — a statutory retention requirement for any documented health-assessment-related record, and Medicare compliance audits do check this.

Safety-netting

A health assessment does not substitute for symptomatic assessment. A patient presenting with a new symptom needs it worked up on its own merits, not deferred to a scheduled health check.

Flag findings that need action before the next scheduled review — an abnormal medication interaction, a new fall, a positive cognitive screen — rather than letting them wait for the next annual assessment.