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Detail of new women’s health MBS items explained


Karen Burge


25/06/2025 4:42:30 PM

With the items’ launch just days away, details of the menopause assessments have been released, including its rebates and mandatory clinical activities.

Middle-aged GP
‘The introduction of these items is a positive step towards reducing some of the gender bias within our health system.’

The Federal Government has explained exactly how new women’s health items, coming into effect from July, will be used in general practice.
 
The Medicare Benefits Schedule (MBS) changes come as part of a $793 women’s health package revealed in the lead-up to this year’s Federal Election.
 
Commencing 1 July, GPs will have access to item 695 for menopause and perimenopause health assessment services for patients experiencing premature ovarian insufficiency, early menopause, perimenopause and menopause.
 
Item 19000 will apply to prescribing medical practitioners, described as being those practising in general practice but not vocationally registered with either of the colleges.
 
The MBS item fee is $101.90 for GPs and $81.50 for prescribing medical practitioners, and involves a minimum service duration of 20 minutes.
 
It will attract a single bulk-billing incentive and be an eligible service under the Bulk Billing Practice Incentive Program from 1 November.
 
At an RACGP webinar hosted by college President Dr Michael Wright on Tuesday, speakers from the Department of Health, Disability and Aged Care (DoHDA) outlined how the new MBS items will support ‘appropriate care and symptom management’ to women experiencing menopause or perimenopause.
 
Dr Wright said the new items will support greater access and improved health outcomes.
 
‘We know that currently women are disproportionately avoiding healthcare and particularly care for women’s health due to the cost,’ he told webinar participants.
 
‘The introduction of these items is a positive step towards reducing some of the gender bias within our health system.’
 
Health assessments will be available annually and must include (but are not limited to) the following clinical activities:
 

  • Collection of relevant information, including taking a patient history to determine pre, peri or post-menopausal status, patient wellbeing and contraindications for management
  • A basic physical examination, including recording blood pressure, and review of height and weight  
  • Initiating investigations and referrals as clinically indicated, with consideration given to the need for cervical screening, mammography and bone densitometry
  • Discussion of management options, including non-pharmacological and pharmacological strategies including risks and benefits
  • Implementing a management plan which includes patient-centred symptoms management
  • Providing the patient with preventive healthcare advice and information as clinically indicated, including physical activity, smoking cessation, alcohol consumption, nutritional intake and weight management
 
Practice nurses, Aboriginal health workers and Aboriginal and Torres Strait Islander health practitioners engaged by a practice may assist ‘in accordance with accepted medical practice under the supervision of the medical practitioner’.
 
Speaking at the webinar, Louise Riley, Assistant Secretary of the MBS Policy And Reviews Branch at DoHDA, said these new items will be available annually and there will be no age limit on when they can be applied.
 
The item is also being applied ‘temporarily’ while further MBS changes are being considered.
 
‘It has been announced as a temporary item for two years, and that’s because … we’ve been doing work on a review of all of the health assessment items because one of the findings from the MBS Review Taskforce a few years ago was that those items are quite poorly structured,’ she told webinar attendees.
 
‘They probably don’t target the right stages in life or the right population groups based on more contemporary clinical evidence.
 
‘So the menopause and perimenopause health assessment items were announced as temporary [for] two years, recognising that the focus on this stage of life for women will become part of a permanent feature of the reformed health assessment items.’
 
DoHDA information suggests providers will need to familiarise themselves with the requirements of the new items.
 
‘Providers have a responsibility to ensure that any services they bill to Medicare fully meet the eligibility requirements outlined in legislation,’ a factsheet on the changes explains.
 
The exact item descriptors will be made available on 1 July when the new items go live.
 
The webinar is now available to watch back on the RACGP website.
 
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MBS items Medicare Medicare Benefits Schedule menopause perimenopause women's health


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Dr Aun Teeng Ritchie   26/06/2025 8:33:12 AM

This is really poor form for the government to never give enough details for any item numbers until five minutes before the deadline.


Dr Peter James Strickland   26/06/2025 2:01:16 PM

There is no so-called bias in the Health system against women, but rather the opposite in my experience over 50 odd years. The bias, if anything, is often against men, and esp. for testosterone deficiency, and which requires an expensive and delayed referral to an endocrinologist when the physical symptoms and investigations are obvious, and now the urologists have suggested that PSA testing should not be done at routine medicals for guys (allowing more possibility of dying from aggressive prostate cancer). Women are provided with very adequate HRT, have access to their own hospital for gynaecology, have safe contraception readily available, and are more likely to use the Medicare system etc in most aspects of that system for all their health needs that I have seen over many years, apart from worker's compensation and sports and other injuries, and simply because they live longer by an average of about 3 years.


Dr Suzette Julie Finch   26/06/2025 2:07:12 PM

The bulk bill incentives are less helpful in our general practice as in the CBD & people flip in & out to their local GP depending on work & gp availability etc. Not ideal but I have cc their ‘other’ suburban gp most of the time to maintain continuity. If they have been seen by myself or CBD colleagues within the last 12 months can we apply the bb incentive if we aren’t their Mymedicare home practice? This would still be less than our typical billing for equivalent 36 but if its results prior to a finalised plan with the potential to do all the Ix, Hx, Informed Mx, Preventative health & psychology care involved with menopause that we usually (and under pressure to get done in minimal appointment for our demographic, then I would consider BBing that consult as often do if it’s straight forward recent results, simple plan etc, this simple plan still takes time for all of the above but it’s a check list that we do anyway.


Dr Shelagh Mary McCormick   27/06/2025 5:24:42 PM

Were any GPs who do menopause consultations involved in developing this item number? I do these frequently as a special interest and usually take 2x30 mins to get to the point of the management plan. In order to go through risks/benefits/options individualised for the woman in front of me takes time to do well.