This health check is for a patient who, in the clinical judgement of the medical practitioner and based on the identification of a specific risk factor, is at risk of developing a chronic disease.

A health assessment at this stage of life can assist patients to make the necessary lifestyle changes to prevent or delay the onset of chronic disease.

To undertake an assessment of a person aged 45 to 49 years (inclusive) with a chronic disease risk factor, depending on the length of the consultation which will be determined by the complexity of the patient’s presentation.

Chronic disease risk factors

A chronic disease or condition is one that has been, or is likely to be present for at least six months, including (but not limited to) asthma, cancer, cardiovascular illness, diabetes mellitus, a mental health condition, arthritis or a musculoskeletal condition.

The decision that a patient is at risk of developing a chronic disease is a clinical judgement made by the GP. However, at least one risk factor must be identified. Risk factors that the GP may consider include, but are not limited to:

•lifestyle risk factors, such as smoking, physical inactivity, poor nutrition or alcohol use;

•biomedical risk factors, such as high cholesterol, high blood pressure, impaired glucose metabolism or excess weight; and

•a family history of a chronic disease

Components of the health assessment for people aged 45 to 49 years old who are at risk of developing chronic disease

The health assessment must include:

information collection, including taking a patient history and undertaking examinations and investigations as clinically required; making an overall assessment of the patient’s health, including the patient’s readiness to make lifestyle changes;

initiating interventions and referrals as clinically indicated;

providing advice and information about lifestyle modification programs to the patient including strategies to achieve lifestyle and behaviour changes;

keeping a record of the health assessment, and offering the patient a written report about the health assessment, with recommendations about matters covered by the health assessment; and

Subsidised Lifestyle Modification Programs

offering the patient’s carer (if any, and if the medical practitioner considers it appropriate and the patient agrees) a copy of the report or extracts of the report relevant to the carer.


The intention of a lifestyle modification program is to help people modify their risk factors to delay or prevent the onset of a chronic disease. A typical program will be a series of group motivational and educational sessions supporting lifestyle changes and adoption of healthy lifestyle choices.

Medical practitioners should contact their local Division of General Practice to identify what subsidised lifestyle modification programs are available locally.

The patient’s medical practitioner will complete a lifestyle modification program GP Referral Form for the patient to present to the provider of the program for registration. The GP Referral Form can be obtained from

Relevant resources on lifestyle modification, including information for patients who may not wish to attend or are unable to participate in a formal subsidised lifestyle modification program, are available at

Restrictions on providing a health assessment for people aged 45 to 49 years old who are at risk of developing chronic disease

A Medicare rebate is payable once only for each eligible patient.

The Medicare rebate is not payable in conjunction with another consultation on the same day, except where it is clinically required (ie. the patient has an acute problem that needs to be managed separately from the assessment), and is not available to admitted patients of a hospital or day-hospital facility.

Other Requirements

In circumstances where the medical practitioner is unsure whether the patient is at risk of developing a chronic disease, the medical practitioner may choose to determine first whether a patient has a risk factor (billed under an appropriate general attendance item), and if so, undertake a health assessment during a subsequent visit.

For patients found to have an existing chronic condition, the medical practitioner should use his/her clinical judgement to determine whether the patient should receive a health assessment or be managed through other services such as the MBS Chronic Disease Management items.

People aged 45 to 49 years (inclusive) who have had a health assessment may also receive a type 2 diabetes risk evaluation if they are at high risk of developing type 2 diabetes and meet the relevant eligibility criteria.

Guidelines and Resources

For more information about MBS health assessments including a sample proforma for this health assessment, visit the Department of Health and Ageing website at Medicare Australia provider enquiry line on 132 150.

For detailed information about item descriptors and explanatory notes visit the Department of Health and Ageing website at

Medical practitioners are encouraged to utilise relevant guidelines and resources, such as:

The Department of Health and Ageing’s Lifescripts guidelines and evidence cards, assessment tools and prescription pads available ‘SNAP’ (Smoking, Nutrition, Alcohol and Physical activity) – A population health guide to behavioural risk factors in general practice available at

RACGP guidelines for preventive activity in general practice at red book and/or green book.

‘Overweight and Obesity in Adults: A Guide for General Practitioners’, a National Health and Medical Research Council publication at


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