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MBS item scrutiny profile

MBS Item 715 — PSR scrutiny profile

Subheading 2 - Aboriginal And Torres Strait Islander Peoples Health Assessment Professional attendance by a general practitioner, at consulting rooms or in a place other than a hospital or a residential aged care facility: (a) for a health assessment of a patient who is of Aboriginal or Torres Strait Islander descent; and (b) that includes the following: (i) recognising the patient’s health priorities; (ii) taking the patient’s medical history; (iii) undertaking any relevant physical examinations; (iv) undertaking or arranging any required investigations; (v) assessing the patient using the information gained in the health assessment; (vi) initiating any necessary interventions and referrals; (vii) developing and documenting a plan to manage the patient’s health, including for follow‑up, based on the health assessment and the patient’s priorities; (viii) offering the patient (or the patient’s carer (if any) if the practitioner considers it appropriate and the patient agrees) a written report of the health assessment, with recommendations on matters covered by the health assessment and a strategy for the patient’s good health; (ix) if the offer referred to in subparagraph (viii) is accepted—giving the report to the patient or the patient’s carer (as applicable); (x) adding a record of the health assessment to the patient’s medical records Applicable only if a service to which this item or item 228, 92004 or 92011 applies has not been provided to the patient in the preceding 9 months Note: For items 92004 and 92011, see the Telehealth Attendance Determination.

Appears in 3 published determinations since 2022, with related issues and repayments shown only where recorded.

Scrutiny profile

Determinations
3
Date range
29 Sept 2022 - 1 Mar 2026
Recorded repayment median
$240,000
Specialties involved
2

Co-occurring issue categories

  1. Inadequate documentation3
  2. Chronic disease management1
  3. Clinical appropriateness1
  4. Excessive servicing1
  5. MBS requirement breach1
  6. Mental health treatment plan1
  7. PBS prescribing1

Specialties involved

  1. Unknown2
  2. General Practice1

Repayment range

Calculated only across the 3 published cases where a repayment amount is recorded.

Low
$200,000
Median
$240,000
High
$700,000

Published cases mentioning item 715

What survives review

Documentation has to stand alone

The note should show the presenting problem, assessment, clinical reasoning, time or complexity when relevant, and the plan without relying on memory.

Chronic disease management

Keep the source record clear enough for an external peer to connect the patient need, the service provided, and the item claimed.

Show the clinical input

For higher-value or repeated services, the record should make the practitioner contribution visible rather than just recording an administrative event.

Excessive servicing

Keep the source record clear enough for an external peer to connect the patient need, the service provided, and the item claimed.

Educational disclaimer

This educational module is based on publicly available PSR case-outcome material. It is general educational information only and does not constitute legal advice, billing advice, or a substitute for reviewing the MBS, PSR material, or obtaining professional advice.

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