Medicare Items Claimable by Aboriginal Health Workers

Aboriginal Health Workers in Victoria are able to apply for Medicare Registration on successful completion of Certificate 3 Aboriginal & Torres Strait Islander Health.  The Victorian Aboriginal Community Controlled Health Organisation is required to endorse the application prior to submission to Medicare.  This may be subject to change when national registration for Aboriginal Health Workers commences mid-2012.

Aboriginal Health Workers often work as part of the health team (Practice Nurse and General Practitioner) who gather information for an Aboriginal Health Check (Medicare item 715).  There are also a number of individual MBS items that eligible AHWs can claim.

MBS Item: 10986 – 4 year old Child Health Check

Service provided by a practice nurse or registered Aboriginal health worker being the provision of a health assessment for a patient who is receiving or has received their four year old immunisation, if:

• the service is provided on behalf of, and under the supervision of, a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), and
• the person is not an admitted patient of a hospital.

Not being an attendance on a patient in respect of whom a payment has already been made under this item or item 701, 703, 705, 707.  Benefits are payable on one occasion only for each eligible patient.

MBS Item: 10987

Follow-up service provided by a registered Aboriginal Health Worker or Practice Nurse, on behalf of a medical practitioner, for an Aboriginal and/or Torres Strait Islander who has received a health assessment.

Item description:

• Examinations/intervention as indicated by health assessment;
• Education regarding medication compliance and associated monitoring;
• Checks on clinical progress and service access;
• Education, monitoring and counseling activities and lifestyle advice
• Taking a medical history;
• Prevention advice for chronic conditions, and associated follow up

MBS item 81300 -   Allied Health Follow up Service

An Aboriginal & Torres Strait Islander patient may be referred by their GP for allied health services, (including eligible AHWs), when the GP has completed a health assessment and identified a need for follow-up allied health services.

• The services must be at least 20 minutes duration.
• Service is an individual service, not as part of a group, and AHW must personally attend the patient.
• AHW must provide written report to GP
• Person is not an admitted patient of a hospital

MBS item 10950 – Chronic Disease Follow up Service

Aboriginal or Torres Strait Islander health service by an eligible Aboriginal Health Worker for persons with a chronic condition and complex care needs.

This item may only be accessed by a patient with a GP Management Plan and Team Care Arrangements OR resident of an aged care facility whose medical practitioner has contributed to a Multidisciplinary Care Plan (items 721, 723, 729, 731, and 732).

The service must be at least 20 minutes duration.  Medical Practitioner must use referral form to AHW.  This form must have been issued by Department Health & Ageing, or contain all components of the form issued by the department.

MBS item 10997 – Chronic Disease follow up service

This item may only be accessed by a patient with a GP Management Plan, Team Care Arrangements or Multidisciplinary Care Plan (item 721, 723, 729, 731 and 732).

This item will assist patients who require access to ongoing care, routine treatment and ongoing monitoring and support between the more structured reviews of the care plan by the patients usual GP.
This item may be used to provide:

• Checks on clinical progress
• Monitoring medication compliance
• Self-management advice, and
• Collection of information to support GP reviews of care plans.

Further Information

MBS online    http://www.mbsonline.gov.au/

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