How I've Been Billing My Menopausal Patients

Since the introduction of the Menopause and Perimenopause Health Assessment (item 695), one of the most common questions I receive is:

"How are you actually using it in practice?"

The answer is probably less complicated than you think.

Not Every Menopausal Patient Needs a 695

The first mistake many practices make is assuming every menopause consultation should become a health assessment.

That's not the purpose of the item.

Many patients simply require a standard consultation for:

• Symptom review

• Discussion of next treatment options

• Follow-up and monitoring

• 
  

These patients are often appropriately billed using time-based attendance items.

When I Consider a 695

I consider a Menopause Health Assessment when a patient requires a comprehensive assessment that includes:

• Medical history review

• Cardiovascular risk assessment

• Bone health considerations

• Mental health screening

• Lifestyle assessment

• Future health planning

These consultations are significantly more structured than a routine menopause review.

Where I Commonly Co-Bill

One of the biggest opportunities many practices are missing is that menopause rarely exists in isolation.

Many women presenting for menopause care also meet criteria for other MBS services.

Menopause Health Assessment (695) + Heart Health Assessment (699)

This is probably one of my most common combinations.

Many menopausal and perimenopausal women are entering a stage of life where cardiovascular risk becomes increasingly important.

During these consultations I am often assessing:

• Blood pressure

• Lipid profile

• Diabetes risk

• Weight and waist circumference

• Exercise habits

• Smoking status

• Family history

  
  

Where both item requirements are fully met, a Heart Health Assessment may also be appropriate.

Menopause Health Assessment (695) + GP Chronic Condition Management Plan (965)

Another common scenario is the woman who presents for menopause management but is also living with one or more chronic conditions.

Examples include:

• Hypertension

• Type 2 diabetes

• Osteoarthritis

• Obesity

• Anxiety or depression

• Hyperlipidaemia

  
  

The menopause consultation often becomes the catalyst for broader chronic disease management planning.

Where clinically appropriate, I frequently develop a GP Chronic Condition Management Plan to support ongoing care and referrals.

Learn More

Our Menopause Health Assessment Course walks through patient selection, documentation, workflows and compliance considerations so your team can confidently implement item 695 in practice.