New MBS items allow GPs to assess patients' risk of CAD
New MBS items allow GPs to assess patients' risk of CAD
With the new 'Heart Health Check' item numbers, the Government hopes to reduce the number of deaths each year from heart disease.
What are the changes?
From 1 April 2019, two new interim items (699 and 177) were introduced to allow GPs and medical practitioners (other than a specialist of consultant physicians) to conduct a heart health check that lasts at least 20 minutes, in consulting rooms.
Eligible patients will now be able to receive a Medicare rebate for having a specific heart health check conducted by a GP.
Why are the changes being made?
Heart disease and stroke are responsible for almost 30 per cent of all deaths and 15 per cent of Australia’s total disease burden. This item supports the prevention and treatment of heart disease which remains a major focus of the Government, and complements significant funding through the MBS and the Pharmaceutical Benefits Scheme (PBS). The heart health check complements the range of MBS items that support rebates for people to discuss their risk of heart disease with their GP, including time-based consultations for preventive health, health assessments, and Chronic Disease Management items.
What does this mean for providers?
GPs will benefit from having access to an MBS item that is specifically for assessing the cardiovascular risk of patients.
GPs will still be able to undertake broader, more complex health assessments where this would be more appropriate.
What does this mean for patients?
As of 1 April, patients will benefit from the introduction of this item through potentially earlier identification of cardiovascular disease and more timely and appropriate medical intervention to support improved outcomes.
When will this change be reviewed?
These new items will be reviewed and evaluated over the next two years, in consultation with the profession, to help inform their effectiveness and any future improvements. In addition to the evaluation of the new items, the Department of Health regularly reviews the usage of new and amended MBS items in consultation with the profession. All MBS items may be subject to compliance processes and activities, including random and targeted audits which may require a provider to submit information about the services claimed. Significant variation from forecasted expenditure may warrant review and amendment of fees, and incorrect use of MBS items can result in penalties including the health professional being asked to repay monies that have been incorrectly received.
Where can I find more information?
The full item descriptor and information on other changes to the MBS can be found at the MBS Online website or by calling the Department of Human Services on 132 150.
New items
(Draft wording of items to be finalised through regulatory amendments)
MBS item 699
Professional attendance for a heart health assessment by a general practitioner at consulting rooms lasting at least 20 minutes and must include:
(a) collection of relevant information, including taking a patient history that is aimed at identifying cardiovascular disease risk factors, including diabetes status, alcohol intake, smoking status, cholesterol status (if not performed within the last
12 months) and blood glucose;
(b) a physical examination, which must include recording of blood pressure;
(c) initiating interventions and referrals to address the identified risk factors; (d) implementing a management plan for appropriate treatment of identified risk factors; (e) providing the patient with preventative health care advice and information, including modifiable lifestyle factors; with appropriate documentation.
MBS item 177
Professional attendance for a heart health assessment by a medical practitioner (other than a specialist or consultant
physician) at consulting rooms lasting at least 20 minutes and must include:
(a) collection of relevant information, including taking a patient history that is aimed at identifying cardiovascular disease
risk factors, including diabetes status, alcohol intake, smoking status, cholesterol status (if not performed within the last 12 months) and blood glucose;
(b) a physical examination, which must include recording of blood pressure;
(c) initiating interventions and referrals to address the identified risk factors; (d) implementing a management plan for appropriate treatment of identified risk factors; (e) providing the patient with preventative health care advice and information, including modifiable lifestyle factors; with appropriate documentation.
Criteria for eligibility for heart health assessment
The category of people eligible for health assessments are :
- People aged 40 to 49 years (inclusive) with a high risk of developing type 2 diabetes as determined by the Australian Type 2 Diabetes Risk Assessment Tool
- People between the age of 45 and 49 (inclusive) who are at risk of developing a chronic disease
- People aged 75 years and older
- Permanent residents of a Residential Aged Care Facility
- People who have an intellectual disability
- Humanitarian entrants who are resident in Australia with access to Medicare services, including Refugees and Special Humanitarian Program and Protection Program entrants
- Former serving members of the Australian Defence Force including former members of permanent and reserve forces