Aboriginal and Torres Strait Islander Health & the 715 Check

Aboriginal and Torres Strait Islander peoples are a diverse population, most now living in metropolitan areas rather than remote or regional settings. Preventive care needs individual assessment of age, health and lifestyle risk rather than a single template. Medicare funds a dedicated health assessment item to structure it, and several vaccines carry different recommendations for this population.

The 715 health assessment

The Aboriginal and Torres Strait Islander Peoples Health Assessment (MBS item 715) is a comprehensive assessment claimable once every 9 months, fee $254.10 (100% rebate). It must include:

• Recognising the patient’s health priorities.
• Taking the patient’s medical history and undertaking any relevant physical examination.
• Undertaking or arranging any required investigations.
• Assessing the patient using the information gathered.
• Initiating any necessary interventions and referrals.
• Developing and documenting a management plan, including follow-up, based on the assessment and the patient’s own priorities.
• Offering the patient a written report with recommendations, and adding a record to the patient’s notes.

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 — the same delegation arrangement as the other MBS health-assessment items. See Preventive Activities & Health Assessments by Age for how item 715 sits alongside the 45–49, 75+, intellectual-disability and refugee health-assessment items.

Clinical content: the National Guide

Item 715 defines the billing structure, not the clinical content. The RACGP/NACCHO National Guide to a Preventive Health Assessment for Aboriginal and Torres Strait Islander People is the practical resource for what to actually check — a topic-by-topic guide (immunisation, child health, eye/ear/oral health, rheumatic heart disease, STIs and blood-borne viruses, respiratory health, cardiovascular disease, type 2 diabetes, chronic kidney disease, cancer prevention, mental health) rather than a single generic template.

Work through the relevant chapters across the assessment rather than trying to cover everything in one sitting. Spreading a comprehensive check over 2–3 consultations is often more realistic; use the “priorities” step to decide what to tackle first.

Immunisation differences

Several vaccines have different recommendations for Aboriginal and Torres Strait Islander people, funded on the National Immunisation Program at different ages or in different geographic areas than the general schedule:

• BCG — neonates in areas of high tuberculosis incidence in the NT, Queensland and northern South Australia.
• Hepatitis A — children in the NT, Queensland, SA and WA (2 doses before age 5, first dose in the second year of life).
• Hepatitis B — all non-vaccinated, non-immune adults.
• Influenza — all people aged ≥6 months, annually.
• Pneumococcal — all adults aged ≥25 (general population funding starts later).
• Respiratory syncytial virus (RSV) — adults aged ≥60.

See National Immunisation Schedule for the general adult schedule these sit alongside, and Adult & At-Risk Immunisation, Catch-Up Schedules for assessing vaccination status and completing catch-up — check the current NIP schedule before relying on a specific age cutoff, since these thresholds shift as vaccines are added or reviewed.

Access and continuity

State-run hospital outpatient and after-hours GP-type services can prescribe PBS medicines, but historically sit outside the Closing the Gap PBS Co-payment concession available through mainstream general practice and Aboriginal Community Controlled Health Services — a patient can get a subsidised script from their regular GP but pay full price for the same medicine from a hospital service after hours. Ask which service a patient usually uses, and flag this gap explicitly rather than assuming PBS-subsidised access is uniform across every point of care.

Aboriginal Community Controlled Health Services and Aboriginal Medical Services are usually better placed than a mainstream practice to provide culturally safe care and outreach, particularly in regional and remote areas. Know the local service, and refer or share care rather than defaulting to mainstream-only follow-up.

Practical points

• Confirm Indigenous status is recorded in the practice record — it’s what makes items 715 and the vaccine variations above billable/appropriate, and a patient who isn’t asked or doesn’t have it recorded can miss both.
• A 715 assessment doesn’t have to be exhaustive in one visit — use the priorities the patient identifies to decide what’s covered now versus at a planned follow-up.
• Recall systems help — Aboriginal and Torres Strait Islander patients are eligible for the 715 assessment every 9 months, materially more often than the general population’s annual or once-only items; a practice recall/register makes this achievable in a busy list.

Safety-netting

Preventive care doesn’t replace symptomatic assessment — investigate new symptoms on their own merits.

When a finding needs action before the next scheduled review (an abnormal result, a missed vaccine, a referral not yet actioned), document a clear follow-up plan and confirm the patient knows how to make contact if it isn’t progressing.