MBS Item 699: The Most Underused Preventive Tool in General Practice
A practical guide for Australian GPs on using MBS Item 699 Heart Health Checks to detect cardiovascular risk early, activate preventive systems, and integrate lifestyle and chronic disease care.
MBS Item 699: The Most Underused Preventive Tool in General Practice
Heart attacks rarely happen “out of nowhere”.
They build slowly over years.
Elevated blood pressure.
Borderline cholesterol.
Rising HbA1c.
Gradual weight gain.
Smoking relapse.
Sedentary lifestyle.
And then one day — a cardiovascular event.
MBS Item 699, the Heart Health Assessment, exists to interrupt that trajectory.
It is not just a billing item.
It is a structured preventive cardiovascular intervention.
The value of Item 699 is not the rebate. It is the chance to detect cardiovascular risk before it becomes disease.
Official references:
- MBS Online – Item 699
- Services Australia – MBS billing for health assessments
- Heart Foundation – Heart Health Checks for professionals
Table of Contents
- What Is MBS Item 699?
- Why This Item Matters
- Who Is Eligible for a Heart Health Assessment?
- What a Proper Heart Health Check Should Include
- The Power of Absolute Cardiovascular Risk
- What Item 699 Often Uncovers
- The Preventive System It Can Activate
- Example Clinical Scenario
- Why Patients Often Appreciate Heart Health Checks
- Documentation and Compliance
- The Bigger Perspective
- Final Thoughts
- Explore More Preventive Care Tools
What Is MBS Item 699?
MBS Item 699 is the general practitioner item for a Heart Health Assessment.
According to MBS Online, it applies to a professional attendance by a GP on a patient 30 years of age or over, lasting at least 20 minutes, for a heart health assessment. It can generally be claimed once per patient in a 12-month period. It also cannot be claimed if the patient has had another health assessment service in the previous 12 months, except for an Aboriginal and Torres Strait Islander health assessment item. :contentReference[oaicite:0]{index=0}
The purpose of the heart health assessment is to:
- identify cardiovascular risk factors
- calculate and record absolute cardiovascular disease (CVD) risk
- start preventive intervention
- support ongoing risk management
The Heart Foundation describes Item 699 as one of the first MBS items to formally incorporate absolute cardiovascular risk calculation into routine preventive care. :contentReference[oaicite:1]{index=1}
Why This Item Matters
Cardiovascular risk is often silent.
Many patients with rising risk feel completely well.
They may:
- attend only for acute issues
- renew scripts without broader review
- underestimate long-term cardiovascular risk
- delay preventive care
Without structured assessment:
- blood pressure trends are missed
- lipid abnormalities are treated in isolation
- smoking status drifts
- central adiposity increases gradually
- glucose control worsens unnoticed
Cardiovascular disease often develops quietly. Item 699 creates a reason to look before symptoms appear.
The Heart Foundation’s 2026 CVD risk guideline emphasises identifying people for risk assessment, calculating CVD risk with a validated tool, and managing that risk longitudinally. :contentReference[oaicite:2]{index=2}
Who Is Eligible for a Heart Health Assessment?
The current MBS description for Item 699 applies to patients 30 years and over and requires a heart health assessment by a GP lasting at least 20 minutes. :contentReference[oaicite:3]{index=3}
That makes this item broader than many clinicians assume.
Quick summary
| Item | Who provides it | Main purpose |
|---|---|---|
| 699 | GP | Heart health assessment |
| 177 | Prescribed medical practitioner | Heart health assessment |
Both items sit under the Heart health assessment category in the MBS. :contentReference[oaicite:4]{index=4}
What a Proper Heart Health Check Should Include
The Heart Foundation states that a Heart Health Check should include gathering information about a patient’s CVD risk factors, calculating and recording absolute CVD risk using a validated calculator, and managing that risk on an ongoing basis. :contentReference[oaicite:5]{index=5}
In practice, a structured consultation may include:
- blood pressure measurement
- lipid profile review
- HbA1c or fasting glucose
- BMI and waist circumference
- smoking status
- alcohol intake
- physical activity assessment
- family history of cardiovascular disease
- medication review
- absolute CVD risk calculation
Most importantly, the consultation should produce a clear preventive management plan.
The Power of Absolute Cardiovascular Risk
A key feature of Item 699 is the use of absolute cardiovascular risk, rather than discussing isolated numbers one by one.
Instead of saying:
“Your cholesterol is slightly elevated.”
the conversation becomes:
“Your five-year cardiovascular risk is elevated, and here is what we can do about it.”
This improves:
- shared decision-making
- patient understanding
- medication uptake
- lifestyle engagement
Use the Australian calculator and guideline here:
The Heart Foundation also provides consultation templates and a Heart Health Check toolkit designed for use during the appointment. :contentReference[oaicite:6]{index=6}
What Item 699 Often Uncovers
A heart health assessment frequently uncovers:
- undiagnosed hypertension
- prediabetes
- metabolic syndrome
- central obesity
- smoking relapse
- sedentary behaviour
- excessive alcohol intake
- poor medication adherence
It may also reveal psychosocial contributors such as:
- financial stress
- social isolation
- poor diet due to cost
- shift-work-related sleep disruption
Cardiovascular risk is rarely purely biological. It is behavioural, social, and metabolic.
Related articles:
- Chronic Disease: Definition, Risk Factors and Long-Term Management
- How AI Is Making GP Health Assessments Actually Doable
The Preventive System It Can Activate
When used properly, Item 699 becomes the start of a preventive care system.
Lifestyle intervention
- exercise goals
- smoking cessation planning
- alcohol reduction strategies
- dietary changes
- weight management
Medication optimisation
- statin initiation or adjustment
- antihypertensive therapy review
- diabetes medication review
Allied health referral
- dietitian
- exercise physiologist
- diabetes educator
Structured follow-up
- repeat pathology
- repeat blood pressure review
- cardiovascular risk reassessment
- monitoring plan
The item is not the endpoint.
It is the ignition.
Related reading:
- GP Chronic Condition Management Plan (GPCCMP): Requirements, Eligibility and MBS Item 965 Explained
- From Standard Consult to Chronic Care Review: Ethically Using Item 965 & 967 to Improve Patient Outcomes
Example Clinical Scenario
A 55-year-old patient attends for script renewal.
You notice they have not had a structured cardiovascular risk review recently.
You say:
“We haven’t done a formal cardiovascular risk assessment for a while. Would you be open to doing a Heart Health Check today?”
During the assessment you find:
- BP 148/92
- LDL elevated
- HbA1c 6.2%
- smoking 10 cigarettes daily
- BMI 31
Now the conversation shifts from reactive prescribing to preventive strategy.
One structured review may reduce the future risk of:
- myocardial infarction
- stroke
- avoidable hospital admission
Why Patients Often Appreciate Heart Health Checks
Patients commonly say things like:
- “No one has explained my overall risk before.”
- “I didn’t realise these things were connected.”
- “This gives me a clearer plan.”
Structure creates clarity.
Clarity improves engagement.
The Heart Foundation’s Heart Age and Heart Health Check tools are built around exactly this principle: helping patients understand and act on risk earlier. :contentReference[oaicite:7]{index=7}
Documentation and Compliance
When billing MBS Item 699, ensure:
- the patient meets eligibility criteria
- the consultation lasts at least 20 minutes
- absolute CVD risk is calculated and recorded
- the documentation supports the service provided
- the item is not duplicated inappropriately with another health assessment in the same 12 months unless permitted under MBS rules
Services Australia and MBS Online both make clear that Item 699 is part of the health assessment framework, and normal item rules still apply. :contentReference[oaicite:8]{index=8}
The goal is not maximising billing. The goal is preventing cardiovascular disease.
The Bigger Perspective
The Heart Health Assessment is more than a cardiovascular item.
It is also:
- a lifestyle checkpoint
- a metabolic review
- a smoking intervention opportunity
- an alcohol review trigger
- a preventive care reset
Integrated into routine practice, it transforms care from:
“We’ll see you when something happens.”
to:
“We are actively reducing your future cardiovascular risk.”
Final Thoughts
The real power of MBS Item 699 is not the rebate.
It is the opportunity:
- to detect cardiovascular risk early
- to intervene before disease develops
- to coordinate lifestyle and medication strategies
- to build a preventive care system
Used well, it is one of the most practical preventive tools in Australian general practice.
Explore More Preventive Care Tools
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