Menopause & MHT Prescribing — MBS 695 Checklist + Australian Clinical Guidance

📋 Source: MBS item 695 (Menopause & Perimenopause Health Assessment, fee $104.55) — MBS Online (mbsonline.gov.au), verified against MBS Book July 2026. Clinical guidance: Magraith K, Jang C, “Demystifying menopausal hormone therapy prescribing”, Aust J Gen Pract (RACGP) 2026;55(4); A Practitioner’s Toolkit for Managing Menopause (RACGP Accepted Clinical Resource); Australasian Menopause Society (menopause.org.au). Verified August 2026.
Your doctor or healthcare provider knows your history and circumstances — always follow their personalised advice over general information.
HomeCliniciansMenopause & MHT Prescribing — MBS 695 Checklist + Australian Clinical Guidance
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Menopause & MHT Prescribing
Australian clinical reference for GPs. MBS item 695 billing components, MHT prescribing scenarios, AMS-sourced guidance, contraindications, non-hormonal options.
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📋 Item 695 note template — copy & paste into your consult notes

A blank documentation skeleton mirroring the six required components, with placeholders. Edit to fit the consult — informational, not advice.

MBS item 695 (GP) & 19000 (PMP) — Menopause Health Assessment

Introduced via the Health Insurance (Section 3C General Medical Services – Menopause and Perimenopause Health Assessment Services) Determination 2025 (F2025L00583). Schedule fee $104.55 for item 695 (GP) and $83.60 for item 19000 (prescribed medical practitioner). Benefit 100% of schedule fee. EMSN cap $305.70 (item 695) / $244.50 (item 19000).

CriterionRequirement
Minimum time20 minutes face-to-face
Patient eligibilityMedicare-eligible AND experiencing peri/menopause symptoms, premature ovarian insufficiency, or early menopause, OR undergoing treatment for symptoms
FrequencyOnce per 12 months (per patient)
Usual GP rulePatient must access via their usual GP or PMP if reasonably practicable (Clause 2.15.14)
Co-claimingCannot be co-claimed with a separate consultation unless clinically necessary. CAN be co-claimed with a different category of health assessment (e.g. 715 or Type 2 diabetes risk evaluation) — no minimum interval
Practice nurseMay assist (information collection, providing information at GP's direction). On-behalf-of items 10997/10987 NOT claimable alongside

Source: MBS Book July 2026, explanatory note AN.14.3. Practitioners may refer to A Practitioner's Toolkit for Managing Menopause (Monash University), explicitly referenced in the explanatory notes.

Item 695 billing checklist

The Determination requires all six components be included. Tick as you complete them — useful as a mid-consult check or a notes-template prompt.

0 of 7 components ticked

Source: Health Insurance (Section 3C General Medical Services – Menopause and Perimenopause Health Assessment Services) Determination 2025; MBS Book explanatory note AN.14.3.

MHT prescribing scenarios — what AMS guidance says

The Australasian Menopause Society publishes information sheets and a clinician toolkit. This picker summarises what they (and the Monash Practitioner's Toolkit) describe for common scenarios. It's a guidance summary — individual prescribing remains your clinical decision.

A blank documentation skeleton with placeholders — edit to fit the consult. Not a recommendation.

Sources: Australasian Menopause Society Position Statement on MHT and Types of MHT available in Australia patient information sheet; A Practitioner's Toolkit for Managing Menopause (Monash University); RACGP Silver Book — menopause section. Always check current AMS information sheets at menopause.org.au as guidance evolves.

MHT product categories by routetap to expand

What's broadly available in Australia, by route. Specific PBS-listed brands and current restrictions: verify at pbs.gov.au. The Australasian Menopause Society publishes a current Types of MHT available in Australia patient information sheet with branded product detail.

RouteActive ingredientsTypical use case
Oral combined
Continuous or sequential
Oestradiol + progestogen (norethisterone, dydrogesterone, drospirenone or medroxyprogesterone, depending on product)Convenient, broadly used. Higher VTE risk than transdermal per AMS guidance.
Oral oestrogen-aloneOestradiol or oestradiol valeratePost-hysterectomy. Add separate progestogen if uterus present.
Transdermal patch
Combined or oestrogen-alone
Oestradiol ± norethisteroneAMS notes lower VTE risk and may be preferred in higher-risk patients (obesity, migraine, smoker, age >60).
Transdermal gel/sprayOestradiolDose flexibility. Combine with separate progestogen if uterus present.
Vaginal — local oestrogenOestriol cream, oestradiol pessary/tablet, oestradiol ringGenitourinary syndrome of menopause (vaginal dryness, dyspareunia, recurrent UTI). Minimal systemic absorption — generally usable when systemic MHT is contraindicated, per AMS.
Separate progestogensMicronised progesterone, medroxyprogesterone acetate, norethisterone, dydrogesteroneEndometrial protection when oestrogen-alone used in women with uterus. AMS notes micronised progesterone has the lowest breast cancer signal per WHI re-analysis and is increasingly preferred.
Tibolone
STEAR — separate category
Tibolone (synthetic steroid with oestrogenic, progestogenic, and androgenic effects)Alternative to combined MHT. Postmenopausal only (per AMS, generally ≥12 months amenorrhoea).

Source: Australasian Menopause Society Types of MHT available in Australia; AMS Position Statement. For PBS listing status and restricted indications of any specific brand, see pbs.gov.au.

💊 MHT shortages & substitution (current) — tap to expand

Oestradiol transdermal patch shortages continue through 2026. A Serious Scarcity Substitution Instrument (SSSI) is in effect to 28 Feb 2027 — pharmacists may dispense a specified alternative brand/strength patch without a new script within its parameters; counsel patients they may receive a different brand. Some products are discontinued (e.g. Climara, all doses); the TGA has approved certain overseas-registered products under s19A as substitutes (supply varies).

For formulation or dose switches, the AMS Guide to MHT Doses (Australia) gives approximate equivalences across products and routes. Practical: direct stable patients to the pharmacist for like-for-like SSSI substitution; reserve appointments for formulation changes, titration or new starts.

Sources: AMS MHT Shortages & Guide to MHT Doses (Australia); TGA Medicine Shortage Reports; DoH Serious Scarcity Substitution Instrument. Verify current status — shortages and instruments change.

Contraindications & cautions (per AMS guidance)tap to expand
CategoryWhat AMS lists
Absolute contraindications
(systemic MHT)
  • Current, suspected, or past oestrogen-dependent breast cancer
  • Active or recent VTE / PE
  • Active or recent arterial thromboembolic disease (e.g. MI, stroke)
  • Active liver disease with abnormal LFTs
  • Undiagnosed abnormal vaginal bleeding
  • Known thrombophilic disorder (relative depending on type and prior events)
  • Pregnancy
Cautions / relative
contraindications
  • Strong family history of breast cancer or VTE
  • Migraine with aura (consider transdermal route)
  • Gallbladder disease (transdermal preferred)
  • Hypertriglyceridaemia (oral oestrogen increases triglycerides; transdermal does not)
  • Uncontrolled hypertension
  • Active smoker, particularly >35 years
  • Endometrial hyperplasia or atypia (manage first)
  • Diabetes with vascular complications
Generally NOT contraindicating local vaginal therapyMost of the above absolute contraindications relate to systemic MHT. AMS notes vaginal oestrogen has minimal systemic absorption and is generally usable in many situations where systemic MHT is contraindicated, including a history of breast cancer (consultation with oncology recommended). Decision is individual.

Source: Australasian Menopause Society Position Statement on MHT (current version at menopause.org.au); A Practitioner's Toolkit for Managing Menopause (Monash). This is a summary — refer to original guidance for full criteria and update history.

Non-hormonal pharmacotherapy (AMS information sheet)tap to expand

Used when MHT is declined, contraindicated, or inadequate. The AMS publishes a Non-hormonal treatment of menopausal symptoms information sheet. Summary of categories described:

CategoryWhat AMS lists
SSRIs / SNRIsSome agents have evidence for vasomotor symptoms (off-label in Australia for most). AMS notes paroxetine, escitalopram, venlafaxine and desvenlafaxine among those with VMS evidence. Avoid paroxetine with tamoxifen (CYP2D6 interaction).
GabapentinEvidence for VMS, particularly night sweats. Sedating — often dosed nocte.
ClonidineModest VMS benefit. Older option, less commonly used now due to side-effect profile.
OxybutyninVMS evidence; anticholinergic burden caveat in older patients.
Neurokinin-3 receptor antagonists
e.g. fezolinetant
Newer class targeting VMS specifically. Check current TGA approval status and Australian availability at tga.gov.au.
Vaginal moisturisers & lubricantsFor GSM when local oestrogen not used/wanted. Non-prescription, ongoing rather than as-needed dosing.
CBTAMS notes evidence for CBT in managing VMS impact and associated sleep/mood. Available via psychologist referral (MHCP if criteria met).

Source: Australasian Menopause Society Non-hormonal treatment of menopausal symptoms patient information sheet (menopause.org.au).

Postmenopausal bleeding — always assess
Any bleeding >12 months after last menstrual period requires investigation. AMS and RACGP both list PMB as warranting urgent assessment given the ~10% rate of endometrial cancer in PMB presentations. Initial workup typically: transvaginal ultrasound (endometrial thickness), and gynaecology referral if endometrial thickness ≥4mm or persistent bleeding despite normal initial imaging. Bleeding in a woman on MHT requires the same workup — MHT does not exclude pathology.

Source: AMS Bleeding after menopause information sheet; RACGP Red Book chapter on women's health.

When to refer (per AMS / RACGP / Monash Toolkit)tap to expand
ScenarioTo whom
Postmenopausal bleedingGynaecology (TVUS first; referral if ET ≥4mm or persistent bleeding)
Premature ovarian insufficiency (<40)Endocrinology or specialist menopause clinic — investigations to determine cause, fertility implications, long-term hormone management
Early menopause (<45) with complex managementSpecialist menopause clinic if available; gynaecology or endocrinology otherwise
MHT contraindicated, severe symptoms not controlledSpecialist menopause clinic; consider gynaecology / endocrinology / psychiatry depending on dominant symptom
Personal history of hormone-sensitive cancerDiscuss with treating oncologist before any MHT (including vaginal)
Endometrial thickness, ovarian mass, abnormal screeningGynaecology
Significant osteoporosis / fragility fractureEndocrinology or specialist bone clinic (also consider FRAX-driven Tx)

Specialist menopause clinics exist in most capital cities; the Australasian Menopause Society maintains a Find a Doctor directory at menopause.org.au.

Investigations to considertap to expand

Item 695 explicitly requires consideration of cervical screening, mammography and bone densitometry. Other investigations per clinical context.

  • Routine screening per RACGP Red Book: cervical screening (NCSP — 5-yearly ages 25-74), mammography (BreastScreen 50-74, eligible 40-49 and 75+), lipids, BP, diabetes risk (AUSDRISK)
  • Bone density (DXA): Medicare-funded under specific criteria — early menopause <45, prolonged secondary amenorrhoea, fragility fracture, glucocorticoids ≥3 months, conditions associated with osteoporosis
  • FSH/LH/oestradiol: AMS notes hormone levels are NOT required to diagnose menopause in women >45 with typical symptoms and irregular/absent periods — diagnosis is clinical. Consider in atypical presentations, women <45, or when stage uncertain
  • TSH: often considered to exclude thyroid disease as alternative explanation for symptoms
  • Vitamin D, FBC, UEC, LFT, lipids, HbA1c: baseline for cardiovascular and bone health discussions, particularly if considering MHT

Source: AMS information sheets; RACGP Red Book 10th edition (preventive activities); MBS Book item 695 component (c).

Sources cited on this pagetap to expand
  • Australasian Menopause Society (AMS) — Position Statement on MHT; Types of MHT available in Australia; Non-hormonal treatment of menopausal symptoms; Bleeding after menopause; Menopause and bone health; Menopause and cardiovascular disease. menopause.org.au
  • A Practitioner's Toolkit for Managing Menopause — Monash University, referenced in MBS explanatory notes: monash.edu/medicine/sphpm/units/womenshealth/practitioner-toolkit
  • RACGP Red Book — Guidelines for preventive activities in general practice, 10th edition (women's health, cardiovascular, bone)
  • RACGP Silver Book — Aged Care Clinical Guide, menopause section
  • MBS Book July 2026 — items 695 ($104.55) and 19000 ($83.60); explanatory note AN.14.3
  • Health Insurance Determination 2025 — F2025L00583: legislation.gov.au
  • PBS Schedule March 2026 — current MHT listings and patient copayments: pbs.gov.au
  • Therapeutic Goods Administration (TGA) — for current product approvals (particularly newer non-hormonal agents): tga.gov.au
  • Jean Hailes for Women's Health — patient resources: jeanhailes.org.au

About this reference: Last reviewed May 2026. AskMyGP summarises Australian guidance — it is not a substitute for the original source documents, which should be consulted directly for full criteria and updates. Clinical decisions remain the prescriber's responsibility.

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