Menopause health assessment (menopause and perimenopause)
MBS item 695: Menopause/perimenopause health assessment, 20+ min
Checked against the MBS in force from . Fee current from .
Item 695 pays a GP for a menopause or perimenopause health assessment of at least 20 minutes, covering history, examination, a management plan and preventive advice. The schedule fee is $104.55, and the Medicare benefit is 100% of it ($104.55).
Also written as HRT consult, MHT review, menopausal hormone therapy, hot flushes, and menopause check.
- Schedule fee
- $104.55
- Medicare benefit (100%)
- $104.55
- Consult the same day
- Only if distinct
Official MBS wording
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: a) collecting relevant information, including taking a patient history to determine pre-, peri- or post-menopausal status, patient wellbeing and contraindications for management; and b) undertaking a basic physical examination, including recording blood pressure, and review of height and weight; and c) initiating investigations and referrals as clinically indicated, with consideration given to the need for cervical screening, mammography and bone densitometry; and d) discussing management options including non-pharmacological and pharmacological strategies including risks and benefits; e) implementing a management plan which includes patient centred symptoms management; and f) 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.
What to check before you bill item 695
Each line links to the MBS passage it comes from.
- By a GP (a non-VR doctor uses the prescribed medical practitioner version) Item 695
- At least 20 minutes Item 695
- In person: there are no video or phone versions of this assessment AN.14.3
- Has menopause or perimenopause symptoms, premature ovarian insufficiency, or early menopause, or is being treated for them AN.14.3
- A history establishing whether the patient is pre-, peri-, or post-menopausal AN.14.3
- A history of the patient’s wellbeing AN.14.3
- Checked for contraindications to treatment AN.14.3
- A basic physical examination, including recording blood pressure AN.14.3
- Reviewed the patient’s height and weight AN.14.3
- Started investigations and referrals as indicated, considering the need for cervical screening, mammography, and bone densitometry AN.14.3
- Discussed management options, drug and non-drug, with their risks and benefits AN.14.3
- Put a management plan in place, including patient-centred management of symptoms AN.14.3
- Gave preventive advice as indicated: physical activity, smoking, alcohol, nutrition, and weight AN.14.3
- You personally saw the patient (a practice nurse or Aboriginal and Torres Strait Islander health worker or practitioner may help collect information, under your supervision) AN.14.3
- Done by the patient’s usual GP or practice, if reasonably practicable (the one that gave, or will likely give, most of their care over 12 months) AN.14.3
- The assessment’s time can’t also count toward another item at this visit, such as a consultation or another health assessment AN.14.3
How often item 695 can be claimed
- Once in 12 months (either version) AN.14.3
Billing item 695 with other items
With a consultation on the same day: only if it’s distinct. A separate consultation the same day only if clinically necessary AN.14.3
Only in some cases with item 695
- Acupuncture (items 197, 193, 195, and 199)
- A separate consultation the same day only if clinically necessary AN.14.3
- General consultation (all 153 items, including 36, 37, 5040, 5043, 5049, and 90043)
- A separate consultation the same day only if clinically necessary AN.14.3
- Prolonged attendance on a patient in imminent danger of death (all 10 items, including 160, 161, 162, 163, 164, and 214)
- A separate consultation the same day only if clinically necessary AN.14.3
- Patient-end support for a specialist video consultation (all 32 items, including 2484, 2485, 2486, 2487, 2488, and 2489)
- A separate consultation the same day only if clinically necessary AN.14.3
- Urgent after-hours attendance (all 8 items, including 585, 599, 594, 588, 591, and 600)
- A separate consultation the same day only if clinically necessary AN.14.3
- Practice nurse follow-up after a health check (Aboriginal and Torres Strait Islander patient) (items 10987, 93200, and 93202)
- Not for a nurse’s help with a menopause health assessment (it is a complete service) AN.14.3
- Practice nurse service for a patient with a care plan (items 10997, 93201, and 93203)
- Not for a nurse’s help with a menopause health assessment (it is a complete service) AN.14.3
Can be billed with item 695
- Aboriginal and Torres Strait Islander health check (items 715, 228, 92004, and 92011)
- A separate time-tiered or Aboriginal and Torres Strait Islander health assessment too, with no minimum gap between them (the same time can’t count for both) AN.14.3
- Health assessment (75+, aged care, and other target groups) (all 8 items, including 701, 703, 705, 707, 224, and 225)
- A separate time-tiered or Aboriginal and Torres Strait Islander health assessment too, with no minimum gap between them (the same time can’t count for both) AN.14.3
Bulk-billing incentive
An extra payment when a doctor bulk bills an unreferred service. With item 695, one of these:
| Item | What it is | Fee |
|---|---|---|
| 10990 | Bulk billing incentive, other services (MM1 practice) | $8.80 |
| 10991 | Bulk billing incentive, other services (MM2 practice) | $13.35 |
| 75855 | Bulk billing incentive, other services (MM3–4 practice) | $14.10 |
| 75856 | Bulk billing incentive, other services (MM5 practice) | $15.10 |
| 75857 | Bulk billing incentive, other services (MM6 practice) | $15.85 |
| 75858 | Bulk billing incentive, other services (MM7 practice) | $16.95 |
Other versions
Menopause health assessment (menopause and perimenopause) has 2 items. The others:
| Item | What it is | Fee |
|---|---|---|
| 19000 | Menopause health assessment by a PMP | $83.60 |
Common questions
- What is the fee for MBS item 695?
- The schedule fee is $104.55, and the Medicare benefit is 100% of it ($104.55). That’s under the MBS in force from 1 August 2026.
- How many minutes is item 695?
- At least 20 minutes.
- Can item 695 be done by video or phone?
- No. In person: there are no video or phone versions of this assessment.
- Who can bill item 695?
- By a GP (a non-VR doctor uses the prescribed medical practitioner version).
- How often can item 695 be claimed?
- Once in 12 months (either version).
- Can item 695 be claimed on the same day as a consultation?
- Yes, if it’s distinct. A separate consultation the same day only if clinically necessary.
- Can you bill 695 and 715 together?
- Yes. A separate time-tiered or Aboriginal and Torres Strait Islander health assessment too, with no minimum gap between them (the same time can’t count for both). (Source: MBS AN.14.3.)
- Can you bill 695 and 701 together?
- Yes. A separate time-tiered or Aboriginal and Torres Strait Islander health assessment too, with no minimum gap between them (the same time can’t count for both). (Source: MBS AN.14.3.)
- Can you bill 695 and 36 together?
- Only in some cases. A separate consultation the same day only if clinically necessary. (Source: MBS AN.14.3.)
- Can you bill 695 and 10987 together?
- Only in some cases. The practice nurse items can’t be claimed for a nurse’s or health worker’s help with the assessment (it is a complete service). (Source: MBS AN.14.3.)
- Can you bill 695 and 10997 together?
- Only in some cases. The practice nurse items can’t be claimed for a nurse’s or health worker’s help with the assessment (it is a complete service). (Source: MBS AN.14.3.)
- Can item 695 be billed with a bulk-billing incentive?
- Yes. An extra payment when a doctor bulk bills an unreferred service. The items are 10990, 10991, 75855, 75856, 75857, and 75858.
Sources
- Item 695: Group A14 Health Assessments
- Note AN.14.3: Menopause and Perimenopause Health Assessments (MBS items 695 and 19000)
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