The Australian Federal Government has announced a new Medicare rebate for menopause health assessments, effective as of July 1, 2025, as part of a $64.5 million package to improve healthcare for women experiencing perimenopause and menopause. The initiative follows a Senate inquiry into menopause, which highlighted the inadequacy of current healthcare for women during this stage of their lives.
While Australian women experience menopause at 51 on average, significant health risks such as a higher risk of heart disease or diabetes can develop earlier for women who go through menopause between the ages of 40-50. $26 million has been allocated for the new perimenopause and menopause assessments and $12.8 million for a community awareness campaign.
The government will continue to support women experiencing perimenopause and menopause through a number of national policies and funding for public hospitals through the National Health Reform Agreement MBS rebates for relevant health services.
How are these items billed?
The following information has been sourced from the Health Insurance Determination 2025 from Louise Riley, delegate of the Minster for Health, Disability and Ageing.
Two new MBS items (695 and 19000) for health assessments targeting women experiencing menopause or perimenopause will be made available on July 1, 2025. These health assessment services include but are not limited to the following:
- collecting relevant information, including take a patient history to determine pre-, peri- or post-menopausal status, patient wellbeing and contradictions for management; and
- undertaking a basic physical examination, including recording blood pressure, and review of height and weight; and
- discussing management options including non-pharmacological and pharmacological strategies including risks and benefits.
Each of the services listed (695 and 19000) apply only to a patient who:
A. is experiencing one or more symptoms for the following, or undergoing treatment for those symptoms:
-
- premature ovarian insufficiency;
- early menopause;
- perimenopause;
- menopause; and
B. has not received either of these services within the preceding 12 months from the date of receiving either of these services.
Is this enough to support women?
With menopause affecting over half of the Australian population at some point in their lives, this initiative is a welcome change. Health Minister Mark Butler emphasized the importance of this reform, stating “With no new contraceptive pill or menopausal hormone therapy added to the PBS in decades, it was clear the PBS wasn’t working for women.”
By providing dedicated funding for assessments and raising awareness, here’s hoping that this initiative will give providers the confidence and support to care for more Australians as they navigate this pivotal stage of their lives.
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