Risk factors

Ambulatory BP measurement funded by Medicare from November


Ambulatory blood pressure measurement (ABPM) will be funded by Medicare for the diagnosis of hypertension from 1 November.

A new MBS item will cover continuous ambulatory blood pressure recording for 24 or more hours (not in association with ambulatory ECG monitoring) with interpretation and reporting of recordings by a medical practitioner, together with a treatment plan.

The item is for adults who have recorded a clinic BP measurement  of systolic BP between ≥140 to ≤180 mmHg, and/or diastolic BP between 90 to ≤110 mmHg, using a sphygmomanometer, and who has not yet commenced anti-hypertensive therapy, with a maximum one claim per year.

The Medicare funding of $40.5 million for five years is in response to an application by the High Blood Pressure Research Council of Australia (HBPCA), which welcomed the move as recognition of ABPM as the gold standard for measuring BP and bringing Australia in line with the rest of the world.

“The listing of ABPM on the MBS is an important step forward in the management of this condition that affects approximately one third of adult Australians,” it said.

“The outcome highlights the importance of ‘out of office’ blood pressure measurement and considerable gaps in effectively diagnosing and treating high blood pressure. ”

According to an evaluation by the Medicare Services Advisory Committee (MSAC), an estimated 400,000 services would be reimbursed in the first year, falling to around 32,000 services annually after five years.

MSAC endorsed a proposed fee of $107.60 for ABPM to be conducted in GP or specialist clinics, to cover the cost of equipment but not consumables such as batteries.

However, the committee cautioned about the possibility of  ABPM being used for monitoring rather than diagnosis and recommended that the item usage be reviewed after a year to check on how it is being used.

The application to MSAC for funding was made by a select committee of the HBPRCA which included Professor Geoffrey Head (Chair), Dr Anastasia Mihailidou, Professor Michael Stowasser (President at the time) and Professor Markus Schlaich (Current President).

The application was also endorsed by the Cardiac Society of Australia & New Zealand, Heart Foundation and the RACGP.

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