✅ Verified against MBS Book July 2026. Items 715, 228, 92004, 92011, 10987 and 81300 — fees and rules confirmed line-by-line against the current MBS. Reference only — always confirm at mbsonline.gov.au or call AskMBS on 13 21 50 before billing.
715 — ATSI Health Check
Billing rules, documentation requirements, co-claiming, and follow-up items. Verified against MBS Book July 2026.
📋 Sources: MBS Book July 2026 — Explanatory Note AN.0.43 (item 715), items 715 ($254.10), 92004 ($254.10), 92011 ($203.25 — PMP/non-VR, same as 228), 228 ($203.25 — prescribed medical practitioner/non-VR), 10987 ($28.70, 100%), 81300 ($72.65). Item 228, 92011 and 10987 fees additionally verified via live MBS Online (mbsonline.gov.au) August 2026. Health Insurance (General Medical Services Table) Regulations 2021. NACCHO & RACGP National Guide to a Preventive Health Assessment for Aboriginal and Torres Strait Islander People — racgp.org.au. Verify fees at mbsonline.gov.au. This page is a clinical reference aid — not billing advice.
ATSI health assessment via video — prescribed medical practitioner (non-VR GP)
$203.25
100%
Once per 9 months (shared with 715/228/92004)
228
ATSI health assessment by prescribed medical practitioner (non-VR GP) — same scope as 715 but different eligible provider
$203.25
100%
Once per 9 months (shared with 715/92004/92011)
10987
Practice nurse/AHP follow-up for Indigenous patient after health assessment (on behalf of GP)
$28.70
100%
Up to 10/year
81300
AHW/AHPr health & wellbeing service ≥20 min
$72.65
85%
Up to 10/year (combined M11 group)
Fees current July 2026. Verify at mbsonline.gov.au before billing. All items 100% benefit — no gap for patient when bulk billed.
Eligibility
✅ Patient: Identifies as Aboriginal and/or Torres Strait Islander descent — any age (no minimum or maximum)
✅ Practitioner: GP (vocationally registered) or prescribed medical practitioner. AHWs and practice nurses can assist but cannot claim independently
✅ Setting: Any community setting. Cannot be claimed for admitted hospital inpatients or residential aged care residents (face-to-face 715). Telehealth items 92004/92011 can be used in residential aged care
✅ Frequency: Not more than once every 9 months per patient (counting 715, 228, 92004, or 92011 — all count toward the 9-month interval)
⚠️ Usual GP preference: Where reasonably practicable, the patient’s usual GP or practice should provide the assessment
What must be included — MBS requirements
All of the following are required under the Health Insurance (General Medical Services Table) Regulations 2021:
☐ Recognise the patient’s health priorities
☐ Take a medical history
☐ Undertake relevant physical examinations
☐ Undertake or arrange required investigations
☐ Assess the patient using information gained
☐ Initiate necessary interventions and referrals
☐ Develop and document a plan to manage the patient’s health including follow-up, based on the assessment and the patient’s priorities
☐ Offer the patient (or carer if appropriate) a written report with recommendations and a strategy for good health
☐ If offer accepted — give the report to the patient or carer
☐ Add a record of the health assessment to the patient’s medical records
⚠️ The GP must see the patient as part of the service. Nurses and AHWs may assist but the GP is responsible for the assessment.
Documentation — audit proof
✅ Must be documented
• Date of assessment
• Patient identifies as ATSI (self-identification — not verified by document)
• Health priorities as identified by patient
• All systems reviewed (do not leave blank — document not applicable if not done)
• Investigations ordered or not required (with reasons)
• Referrals made or considered
• Written report offered — and whether accepted or declined
• Follow-up plan and recall set
❌ Common audit failures
• Blank sections — looks like they were not assessed
• No written report offered or documented
• No health plan or follow-up documented
• Claiming more frequently than every 9 months
• GP did not see the patient (nurse-only assessment)
• Claimed for inpatient or RACF resident (face-to-face 715)
• No record of patient identifying as ATSI
Records must be retained for at least 2 years (Health Insurance Act 1973, Clause 4.3). Services Australia conducts post-payment auditing of 715 claims.
Co-claiming and follow-up
📋 Item 228 — Full ATSI health assessment (same scope as 715) for prescribed medical practitioners (non-VR GPs). Not a brief follow-up. Fee $203.25 (100% benefit). Available once every 9 months — this interval is shared with 715, 92004, and 92011. Source: MBS Online (mbsonline.gov.au, confirmed August 2026).
👩⚕️ Item 10987 — Follow-up service by a practice nurse or Aboriginal and Torres Strait Islander health practitioner, on behalf of the GP, for an Indigenous patient who has received a health assessment (715). Fee $28.70 (100% benefit). Up to 10 per calendar year. Covers: examinations, medication monitoring, lifestyle advice, progress checks, prevention advice. GP does not need to be physically present. Source: MBS Online item 10987 (confirmed August 2026).
🤝 Item 81300 series — AHW/AHPr health and wellbeing services (≥20 min). Up to 10 combined services per calendar year across Group M11 items. Requires either a completed 715 identifying follow-up need, or a current GPCCMP.
🩺 GPCCMP (item 965) — If the 715 identifies chronic conditions, a GPCCMP (item 965) can be initiated — unlocking 5 allied health visits. Co-claiming 715 and 965 on the same day requires both services to be clinically necessary and distinct. In practice this is uncommon — the GPCCMP typically follows the 715 once findings are documented. Verify with AskMBS (13 21 50).
Telehealth (92004 / 92011)
• Item 92004 (GP) allows the 715 to be conducted via video — fee $254.10. Item 92011 (prescribed medical practitioner/non-VR GP) allows the same via video — fee $203.25 (mirrors face-to-face equivalent item 228)
• Subject to the established clinical relationship rule (AN.1.1) — patient must have seen the GP or practice at least once in the past 12 months
• Same clinical requirements apply as face-to-face — full assessment must still be conducted
• Can be claimed for patients in residential aged care (unlike face-to-face 715)
• Phone-only attendance is not sufficient — video is required for 92004/92011
🏠 Cultural safety guidance
The MBS guidelines specifically reference the National Guide to a Preventive Health Assessment for Aboriginal and Torres Strait Islander People (NACCHO/RACGP) as the key clinical resource. Where appropriate, approaches should be tailored to community priorities and local epidemiology — e.g. rheumatic heart disease in high-prevalence communities. Consider involving an Aboriginal health worker or interpreter where available.