Follow-up services overview
Background
Follow-up items for First Nations people were added to the MBS in November 2008 to support the health check, as checks alone have limited capacity to improve health outcomes.
Based on health needs identified during a health check, people can access a number of free Medicare services from:
- an Aboriginal and Torres Strait Islander Health Practitioner or Practice Nurse on behalf of and under the supervision of a GP (up to 10 per calendar year)
- various allied health professionals (via referral from a GP), for example, physiotherapists, podiatrists or dietitians (up to 5 per calendar year).
Allied health professionals are required to report back to GPs: any investigations, tests, and/or assessments carried out on the patient; any treatment provided; and future management of the patient's condition or problem.
As part of the Australian Government’s COVID‑19 response, telehealth items were introduced in March 2020 to help reduce the risk of community transmission of COVID‑19 and provide protection for patients and health care providers (Department of Health and Aged Care 2022b). Telehealth consultations may be used for gathering information, but physical examination components are required to be delivered face-to-face.
This chapter presents information on the use of the following MBS items:
MBS item no. | Description | Mode of delivery |
|---|---|---|
10987 | Follow-up provided by an Aboriginal and Torres Strait Islander Health Practitioner or Practice Nurse on behalf of a GP | Face-to-face |
93200 | Follow-up provided by an Aboriginal and Torres Strait Islander Health Practitioner or Practice Nurse on behalf of a GP (available from 20 April 2020) | Videoconference |
93202 | Follow-up provided by an Aboriginal and Torres Strait Islander Health Practitioner or Practice Nurse on behalf of a GP (available from 20 April 2020) | Telephone |
81300 | Follow-up provided by an Aboriginal and Torres Strait Islander Health Practitioner or Aboriginal and Torres Strait Islander Health Worker (with referral from a GP) | Face-to-face |
81305 | Follow-up provided by a Diabetes Educator | Face-to-face |
81310 | Follow-up provided by an Audiologist | Face-to-face |
81315 | Follow-up provided by an Exercise physiologist | Face-to-face |
81320 | Follow-up provided by a Dietitian | Face-to-face |
81325 | Follow-up provided by a Mental health worker | Face-to-face |
81330 | Follow-up provided by an Occupational therapist | Face-to-face |
81335 | Follow-up provided by a Physiotherapist | Face-to-face |
81340 | Follow-up provided by a Podiatrist | Face-to-face |
81345 | Follow-up provided by a Chiropractor | Face-to-face |
81350 | Follow-up provided by an Osteopath | Face-to-face |
81355 | Follow-up provided by a Psychologist | Face-to-face |
81360 | Follow-up provided by a Speech pathologist | Face-to-face |
93048 | Follow-up provided by any eligible allied health professional (with referral from a GP) (available from 30 March 2020) | Videoconference |
93061 | Follow-up provided by any eligible allied health professional (with referral from a GP) (available from 30 March 2020) | Telephone |
The data include follow-up services billed to Medicare by Aboriginal Community Controlled Health Services (ACCHSs) or other health services aimed at First Nations people, as well as by mainstream health professionals.
Note that the data are limited to MBS items billed to Medicare, and do not provide a complete picture of follow-up services provided to First Nations people. For example, First Nations people may receive similar care through mainstream MBS items (that is, items that are not specific to First Nations people); through MBS items delivered in residential aged care; through a health care provider who is not eligible to bill Medicare; through follow-up items for patients with Team Care Arrangements, a shared care plan, or a multidisciplinary care plan; or may have chosen to use private health insurance cover instead of Medicare. Those have not been included in this analysis.
For items relating to follow-up services from Aboriginal and Torres Strait Islander Health Practitioner or Practice Nurse on behalf of a GP (10987, 92300, 93202), patients can receive up to 10 follow-up services in a calendar year.
For allied health items (81300–81360, 93048, 93061), patients need a referral from their GP, following a health check (MBS item 715, etc.) or mainstream health check (MBS items 701, 703, 705 or 707). Patients can receive up to 5 allied health services in a calendar year.
- For analysis on the proportion of health check patients who received a follow-up within 12 months of their health check, see the chapter, Health checks resulting in a follow-up.
- In this report, ‘follow-up service’ is used interchangeably with ‘follow-up’ to assist readability.
- People who received a MBS service are referred to as ‘patients’.
- All people who received a follow-up are assumed to be First Nations people.
- To show the proportions of First Nations people who received a follow-up within a 12-month period, the number of patients was divided by population data based on the Australian Bureau of Statistics’ (ABS) Estimates and Projections, Aboriginal and Torres Strait Islander Australians (Reference period 2006 – 2031) (ABS 2019).
- In this report, the proportion was calculated by counting those patients who had a follow-up in the year ending on either 30 June or 31 December, then dividing that number by the estimated population on the respective date.
- Proportions are presented by reference month – that is, the month at the end of the 12-month period. Data for June corresponds to activity over the financial year, while data for December correspond to activity over the calendar year.
- Population estimates for 31 December were approximated by averaging 30 June estimates from consecutive years.
- Series B projections, based on the 2016 Census of Population and Housing and 2016 Post Enumeration Survey, were used for years following the 2016 Census. Backcast population data were used for years before the 2016 Census.
- The ABS does not produce estimates of non-demographic changes over time, such as changes in whether a person identifies as Aboriginal and/or Torres Strait Islander between Censuses. However, due to non-demographic changes, population estimates based on the 2016 Census may be considerably lower than those based on the 2021 Census, meaning many of the proportions presented in this report may be overestimated. For example, the ABS estimates that there were 984,000 Aboriginal and/or Torres Strait Islander people on 30 June 2021 based on the 2021 Census (ABS 2023), compared with a projected 879,000 people on 30 June 2021, based on the 2016 Census (ABS 2019).
- Population estimates from the ABS represent the population at a point in time (a stock measure), while patients in the MBS data are counted over a period of time (a flow measure). This mismatch can lead to bias since the population estimate may not accurately reflect the population able to receive a Medicare service throughout the entire period. For example, people may receive a Medicare service then die or move away from the geographic region before the end of the period.
- MBS follow-ups in this chapter are reported by date of service, which was not necessarily the date that the service was processed by Services Australia. MBS services in this report were processed on or before 31 March 2024.
- The term 'GP' is used as a generic reference to all medical practitioners providing primary health care services.
- Some records from a small number of service providers have been excluded due to data quality concerns.
ABS (Australian Bureau of Statistics) (2019) Estimates and projections, Aboriginal and Torres Strait Islander Australians, 2006 – 2031, ABS website, Australian Government, accessed 10 August 2023.
ABS (2023) Estimates of Aboriginal and Torres Strait Islander Australians, 30 June 2021, ABS website, Australian Government, accessed 31 August 2023.
Department of Health and Aged Care (2022b) COVID-19 temporary MBS telehealth services, Department of Health and Aged Care website, Australian Government, accessed 10 August 2023.