Menopause Health Assessment MBS Items

From 1 July 2025, a new government initiative including two new temporary MBS items (695 and 19000) for health assessments targeting women experiencing menopause or perimenopause, will be introduced. These items will be temporary for an initial two year period, allowing for longer-term arrangements to be considered. Providers are responsible for ensuring Medicare services claimed using their provider number meet all legislative requirements.

These items will be made billable in the July 2025 Data Update. Updates to the Health Assessment workflow will be coming for Bp Premier in a future release and a full description of the changes to the MBS can be found on the MBS website.

When should I bill these items?

Both of these new items apply only to patients who:

1. Are experiencing one or more symptoms for the following, or undergoing treatment for those symptoms:
1. Premature ovarian insufficiency;
2. Early menopause;
3. Perimenopause;
4. Menopause; and
2. Have not received either of these services within the preceding 12 months from the date of receiving either of these services.

What is the health assessment criteria for these items?

IMPORTANT   The health assessment must last at least 20 minutes.

Category 1	Professional attendances
Group A14	Health Assessments

Item	Description	Fee ($)
695	Menopause and Perimenopause Health Assessment Professional attendance on a patient for the assessment and management of menopause or perimenopause by a general practitioner lasting at least 20 minutes and including, but not limited to: collecting relevant information, including taking a patient history to determine pre-, peri-, or post-menopausal status, patient well being and contraindications for management; and undertaking a basic physical examination, including recording blood pressure, and review of height and weight; and initiating investigations and referrals as clinically indicated, with consideration given to the need for cervical screening, mammography and bone densitometry; and discussing management options including non-pharmacologhical and pharmacological strategies including risks and benefits; implementing a management plan which includes patient centred symptoms management; and providing the patient with preventative health care advice and information as clinically indicated, including advice on physical activity, smoking cessation, alcohol consumption, nutritional intake and weight management.	101.9

Category 1	Professional attendances
Group A7	Acupuncture and Non-Specialised Practitioner Items
Subgroup 5	Prescribed medical practitioner health assessments

Item	Description	Fee ($)
19000	Menopause and Perimenopause Health Assessment Professional attendance on a patient for the assessment and management of menopause or perimenopause by a general practitioner lasting at least 20 minutes and including, but not limited to: collecting relevant information, including taking a patient history to determine pre-, peri-, or post-menopausal status, patient well being and contraindications for management; and undertaking a basic physical examination, including recording blood pressure, and review of height and weight; and initiating investigations and referrals as clinically indicated, with consideration given to the need for cervical screening, mammography and bone densitometry; and discussing management options including non-pharmacologhical and pharmacological strategies including risks and benefits; implementing a management plan which includes patient centred symptoms management; and providing the patient with preventative health care advice and information as clinically indicated, including advice on physical activity, smoking cessation, alcohol consumption, nutritional intake and weight management.	81.50

Who can assist?

Practice nurses, Aboriginal health workers and Aboriginal and Torres Strait Islander health practitioners engaged by the practice may assist in accordance with accepted medical practice under the supervision of the medical practitioner.

Assistance provided must be in accordance with accepted medical practice and under the supervision of the GP or PMP.

How do I bill these items?

1. When you have finished consulting with the patient, click Finalise visit from the patient record to display the Finalise Visit screen.



2. The Account type defaults according to the billing configuration:
• If Setup > Configuration > Billing > Billing precedence is set to 'Patient', the type defaults to the Usual account recorded in the patient's demographic
• If Billing precedence is set to 'Doctor', the type defaults to the Default account type recorded in the provider's Edit user details.

Selecting the account type Direct Bill indicates that the account will be billed to either Medicare or DVA.

3. Search for the MBS item you require (695 or 19000) and double-click on the description to populate the Items to bill list.
4. To add additional items, repeat step 3.
5. Enter any Notes to reception if required. Text entered here will appear when reception staff create the patient account, and will be recorded on the account notes. Provider notes do not appear on the invoice.
6. If you are done with the patient clinical record, click Save and Close.

Learn more about finalising a visit in the Preview notes, start and finalise a visit article.

Resources

• Health Insurance (Section 3C General Medical Services - Menopause and Perimenopause and Health Assessment Services) Determination 2025
• July 2025 Amendments to the Medicare Benefits Schedule

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Information correct at time of publishing (23 June 2025).