Australian Diabetes Risk Assessment. Medicare items 701 703 705 707.

Summary: Type 2 Diabetes Risk Evaluation Factsheet

Purpose

The Type 2 Diabetes Risk Evaluation is a Medicare-supported health assessment for eligible patients aged 40-49 at high risk of developing type 2 diabetes. It involves evaluating risk factors and initiating interventions if necessary.

Depending on the time spent, this service is billed via items 701 to 707.

Health Assessment service	GP	PMP
Brief health assessment lasting no more than 30 minutes	701	224
Standard health assessment lasting at least 30 minutes and less than 45 minutes	703	225
Long health assessment lasting at least 45 minutes and less than 60 minutes	705	226
Prolonged health assessment lasting more than 60 minutes	707	227

Eligibility

• Age: 40-49 years (inclusive).
• Risk: High risk of type 2 diabetes as determined by the Australian Type 2 Diabetes Risk Assessment Tool, completed within the last three months. In other words, you can bill 701-707 only if the result of the Assessment is 12 and above. If the result is lower – bill appropriate consultation item – 23 or 36.
• Frequency: Can be claimed once every three years.

Key Components

1. Review Risk Factors:
   • Assess lifestyle factors (e.g., smoking, inactivity).
   • Evaluate biomedical factors (e.g., high blood pressure, excess weight).
   • Consider a family history of chronic disease.
2. Physical Examination & History Update:
   • Conduct physical exams and clinical investigations.
   • Update patient history.
3. Overall Assessment:
   • Make an overall assessment of the patient’s risk factors.
   • Review examination and investigation results.
4. Interventions & Referrals:
   • If appropriate, initiate interventions or make referrals.
   • Provide follow-up services as needed.
5. Advice & Information:
   • Offer strategies for lifestyle and behaviour changes.

Eligible Practitioners

• General practitioners or prescribed medical practitioners are authorized to conduct these evaluations.

Co-Claiming Restrictions

• A separate consultation cannot be claimed with a Type 2 Diabetes Risk Evaluation unless clinically necessary. Please refer to the co-climing rules here.
• Both services must be distinct and necessary if co-claimed.

Record Keeping

• Practitioners must keep detailed records.
• Any documents created during the evaluation must be retained for at least 2 years.

Regular audits are conducted to ensure compliance with Medicare billing rules.