The 45–49 Health Assessment: A Practical Course for General Practice Nurses
Run a useful, well-organised 45–49 health assessment, from the eligibility check to follow-up that actually happens.
For registered and enrolled nurses in Australian general practice who prepare patients for, and assist GPs with, the once-only MBS health assessment for people aged 45–49 at risk of chronic disease. An optional companion on the separate 40–49 type 2 diabetes risk evaluation is on the Materials tab. Billing detail is kept brief; the nurse’s part of the appointment is the focus.
Already completed this training? Quick refresher
A quick reminder for experienced staff. Revisit only what you need.
- Check assessment eligibility and history before promising a Medicare-funded service.
- Collect the information that changes the GP’s prevention plan; avoid duplicating what is already reliable.
- The GP makes clinical decisions and completes the eligible service; preparation is recorded separately.
Open the lessons and tools. Use current local procedures and sources.
This optional refresher does not record a new completion. Certificates require the full course and its assessments.
By the end of this course you can
- Prepare: check eligibility, find out whether the assessment has already been claimed (including at another practice), know when a 715 is the better service for an Aboriginal or Torres Strait Islander patient, and explain the appointment in plain words.
- Assess: gather the history that changes care, use AUSDRISK and the CVD risk calculator properly, check screening and immunisation status in the right registers, and know what to cover when time is short.
- Act: hand over with ISBAR, agree one realistic step with the patient, document, and set follow-up for the needs found rather than a repeat assessment.
Course at a glance
- 12 lessons, plus an optional companion on the 40–49 diabetes risk evaluation and a set of practical resources with a desk checklist, both on the Materials tab.
- Time: about 60 minutes, including reading, activities and the final assessment. Each lesson stands alone, so you can read on a phone between patients.
- Final assessment: 16 scenario questions, one best answer each. Pass mark 80% (13 correct), no time limit, unlimited attempts. Each answer explains the rule and names the lesson to revisit.
- Certificate of completion when you have completed every lesson and passed the assessment.
You should already be able to take a history and measure blood pressure, height, weight and waist. No billing experience is needed. The people and practice in this course (Rivergum General Practice) are made up.
Professional development and standards
This course is professional development, not accredited CPD. Nurses may record their actual learning time as self-directed CPD under the NMBA Registration standard: Continuing professional development, where the learning is relevant to their practice. It was written with reference to the MBS explanatory notes, the RACGP Red Book (10th edition), the 2023 Australian CVD risk guideline, the national cancer screening programs and the Australian Immunisation Handbook, as at September 2026. It supports, and does not replace, current official guidance, your professional standards and your practice’s clinical governance, and it does not confer a qualification, expand your scope of practice or create any billing entitlement.
Optional companion: the 40–49 type 2 diabetes risk evaluation
Companion module · About 4 minutes · For nurses
Check 1 — A 42-year-old with a score of 14
Riley is 42 and scored 14 on AUSDRISK six weeks ago. Reception says Riley must wait until 45. Is that right?
Compare your decision
No. The 40–49 risk evaluation starts at 40, and the score and its date fit. The person who checks claims looks for previous evaluations, and the GP confirms clinical need.
If the questionnaire were more than 3 months old, it would need repeating. A score of 11 wouldn't meet the MBS threshold, but it wouldn't decide whether Riley needs a blood test either. Reception books the patient and passes eligibility questions to the nurse; reception doesn't decide eligibility.
A patient asks, "My diabetes risk score is high. Does that mean I have diabetes?" The 40–49 type 2 diabetes risk evaluation is a separate MBS target group from the 45–49 assessment, although both use items 701–707. This course calls it the "risk evaluation" throughout, the MBS term.
Keep the two pathways distinct
| Feature | 40–49 diabetes risk evaluation | 45–49 health assessment |
|---|---|---|
| Focus | Risk of developing type 2 diabetes | Risk of developing chronic disease |
| Age | 40–49 inclusive | 45–49 inclusive |
| Risk requirement | A high AUSDRISK result (12 or more), completed no more than 3 months before | A specific risk factor identified in the GP's clinical judgement |
| Frequency | Once every 3 years while age-eligible | Once only |
A patient eligible for both can have both (no minimum interval), but the claim must identify the target group and the work must not be duplicated. The GP personally attends and carries out the full evaluation; the questionnaire is one input, not the service.
The score doesn't decide testing
MBS eligibility and clinical testing are separate questions. Aboriginal and Torres Strait Islander adults have blood testing from 18, opportunistically and/or annually under the current guidance, whatever their score. Previous gestational diabetes, impaired glucose or symptoms may also warrant testing regardless of the score. AUSDRISK isn't used for people who already have diabetes.
Prepare and explain
Confirm the questionnaire answers, medicines, previous glucose results (including in pregnancy), family history and waist. Use the official scoring; don't estimate a missing answer.
"This score means we should look more closely at your diabetes risk. It doesn't mean you have diabetes. The doctor will decide whether you need a blood test. What worries you most about the result?"
Then agree one manageable step and make both parts of the plan visible: the clinical follow-up (tests, who reviews results and when) and the patient's own action. Recall for the patient's actual needs at the interval the GP sets; a three-year claiming limit is never a clinical follow-up interval.
Check 2 — A previous 45–49 assessment
Lachlan is 47, had the 45–49 assessment last year and now has a high AUSDRISK score. Does the earlier assessment rule out the diabetes risk evaluation?
Compare your decision
No. It is a different target group with its own requirements. Check its prior-claim history, review what the earlier assessment covered to avoid repeating work, and make sure the claim identifies the diabetes target group.
Apply it in your practice
Check that your record captures: tool and date, score, previous evaluation date, GP decisions, action owner and due date.
Practical resources and official sources
About 4 minutes · For nurses
Optional references: the printable desk checklist, the patient action plan, a records audit for practice managers and the official sources. You do not need to complete every template to finish the course.
1. One-page desk checklist
Print this checklist and keep it at your desk. Detail: the lesson 5 checklist, the item map in lesson 3 and the ISBAR script in lesson 9.
45–49 health assessment: desk checklist
Patient ____________________ Date ___________ Nurse ______________ GP ______________
Before
- ☐ Age 45–49 on the service date
- ☐ Prior 701–707 claims checked, here and elsewhere (target group)
- ☐ Aboriginal or Torres Strait Islander: 715 raised with GP first
- ☐ Risk factor(s) noted for the GP
- ☐ Medicines, results, specialist plans reviewed
- ☐ NCSR and AIR checked (own login)
- ☐ Lipids requested by GP before visit, if agreed
- ☐ Interpreter (TIS, free) or access needs arranged
- ☐ GP 15-minute appointment booked straight after
Cover (* every time; the rest if relevant or at another visit)
- ☐ * Patient priorities and consent
- ☐ * History, medicines, family history (with ages)
- ☐ * Smoking and vaping
- ☐ * Alcohol: AUDIT-C
- ☐ * Physical activity; nutrition in one question
- ☐ * Height, weight, BMI, waist
- ☐ * BP (repeat if raised), pulse
- ☐ * CVD risk calculator (needs lipids)
- ☐ * AUSDRISK (First Nations: blood test)
- ☐ * Mood, sleep, sleepiness when driving
- ☐ Kidney check if risk factors: BP, eGFR, uACR
- ☐ Bowel: help request first kit
- ☐ Cervical: HPV 5-yearly; routine screening: self- or clinician-collected; co-test or symptoms: GP decides
- ☐ Breast: 40–49 by choice; invited from 50
- ☐ Skin: by risk; sun protection
- ☐ Prostate: PSA offered 50–69; from 45 only with family history
- ☐ Lung: not until 50; record pack-years
- ☐ Flu; COVID-19 (from 1 October 2026: NIP at 45–49 only if severely immunocompromised); check state programs
- ☐ Pneumococcal: First Nations from 25. Zoster: First Nations from 50
- ☐ Oral health
- ☐ Menopause or perimenopause
- ☐ Bone health if risk factors
- ☐ Sexual health as relevant
Close
- ☐ Urgent concerns told to the GP in person
- ☐ ISBAR handover given, including what wasn't covered
- ☐ Times and nursing component recorded
- ☐ Patient chose one action (teach-back)
- ☐ Each test or referral has an owner and due date
- ☐ Written plan offered
- ☐ Shared health summary uploaded with consent
- ☐ No recall for a repeat 45–49 assessment
GP Staff Academy. Check current MBS, screening and immunisation guidance before use.
2. Patient action plan and follow-up record
Ask the patient, record the answers and offer a copy:
- What matters most to me?
- What have we agreed, and what results are we waiting for?
- What first step will I try, when, and with what support?
- Who is arranging each test, referral or appointment?
- When and how will I hear about results, and who do I contact if I haven't?
- What should make me seek help sooner?
Not "lifestyle advice given; follow-up as needed" but: "Nadia chose a 15-minute walk after lunch on two workdays a week. The nurse will phone Nadia on 16 October to see how it went. Task assigned in the practice system; Nadia knows who to call to change the time."
3. Optional: a records audit (a practice manager task)
Pick one visible gap ("follow-up actions with no named owner", "45–49s not helped to request a bowel kit"), agree one change, review a small sample of records before and after, discuss the result with the team and decide who keeps it going. The aim is better follow-through, not more claims.
Official sources
Each lesson lists its own sources. The ones to bookmark: MBS AN.0.38 (45–49), AN.0.37 (diabetes risk evaluation), AN.0.36 and item 699; the RACGP Red Book and lifecycle chart; the CVD risk calculator and AUSDRISK; the National Cancer Screening Register; the Immunisation Handbook and NIP schedule; TIS National; AskMBS Advisory. Check the live source before a clinical or claiming decision.