Medicare Benefits Schedule

As a health practitioner, it is your responsibility to comply with Medicare obligations. It’s important to do the relevant training and understand the requirements and laws that apply. We provide lots of education and support to help you meet your obligations. Compliance and eligibility requirements apply to health practitioners who bill, claim, dispense and prescribe under the Medicare benefits schedule (MBS). There are 10 strategies you should adopt in your practice to identify, manage and prevent the risk of incorrect billing under Medicare.

MBS Online 

MBS Online contains the Medicare Benefits Schedule (MBS), a listing of the Medicare services subsidised by the Australian Government. Search MBS can be used to search details of specific item numbers. Providers with queries relating exclusively to interpretation of the MBS schedule, can email askMBS@health.gov.au.

Assignment of benefit for bulk billing services

Health professionals MUST obtain an ‘assignment of benefit’ from a patient for all bulk billed services. An assignment of benefit is a signature requirement when a patient assigns their Medicare benefit to the servicing provider as full payment of the service (bulk billing). 

In January 2023, the Australian National Audit Office released a report titled Expansion of Medicare Telehealth Services. The report found that there could be legal risks with assigning benefits verbally. The Minister for Health, Disability and Ageing responded by asking the department to modernise the process of assigning benefits for all bulk billed Medicare services. The Department of Health, Disability and Ageing has been working to create digital solutions to improve the Medicare payment processes. This will increase transparency for patients and better ensure the integrity of Medicare. The commencement of new assignment of benefit processes for all Medicare bulk-billed services is 1 July 2026.

Key changes as of July 1st 2026:

• Following a transition period, verbal consent (AoB) will no longer be permitted (including for telehealth).
• An electronic or physical signature will be required from the patient or a responsible person on the AoB agreement. The signature must be identifiable, auditable and compliant with the Electronic Transactions Act 1999 - Federal Register of Legislation.
• Patients will be able to assign a benefit before or after a service is received, so long as the patient agreement is made prior to an MBS claim being lodged.
• Practitioners no longer need to sign the agreement.
• Practitioners will no longer need to use an ‘approved form’, so long as the agreement includes the information required as set out in subsection 65C(4) of the Health Insurance Amendment (Assignment of Medicare Benefits and Other Measures) Regulations 2025 - Federal Register of Legislation.
• Practitioners will be required to keep a copy of the completed AoB agreements for two years and must provide a copy to the patient upon request.

Enduring assignment of benefit

From 1 July 2026, patients registered with MyMedicare, residents of aged care homes, and patients of ACCHOs and AMSs will be able to make an enduring assignment of benefit for ongoing GP bulk billed services, either directly or through a person acting on their behalf.  Specifically; 

• A patient registered with MyMedicare will be able to make one enduring agreement to receive services from all general practitioners at their MyMedicare practice, if offered.
• A patient of an ACCHO or AMS will be able to make an enduring agreement with the ACCHO or AMS, and they will be able to have multiple agreements with multiple ACCHS or AMS.
• A patient living in a residential aged care home will be able to make multiple enduring agreements with different practitioners.

Transition arrangements

The Department will use the 12-month transition period to explore other regulatory and legislative options to further reduce the administrative burden on both GP practices and patients while ensuring the integrity of Medicare is maintained.

Verbal consent will be accepted in all settings for 12 months from the 1st July 2026.

The FAQ for assignment of Medicare benefits document outlines how the assignment of benefit applies to bulk-billed services provided in primary care and hospital settings for private patients and clarifies the legislative requirements commencing on 1 July 2026. Practices can reach out to: AssignmentofBenefit@health.gov.au if you have questions or feedback about the changes.

Begin planning your processes for obtaining pre and post AoB

• Attend webinars and read the FAQs to keep updated about the changes.
• Contact your administration software providers to discuss the options for obtaining digital AoB and if they have created patient resources (i.e Best Practice, Medical Director, Tyro, HotDoc, AutoMed etc).
• Conduct staff meetings and training sessions to ensure that all staff are aware of the changes to process.
• Initiate conversations with partnering RACHs and patients' families to ensure they are prepared for the changes to AoB procedures.
• Consider how will you communicate the changes to patients (i.e posters, emails, social media posts etc).  

Mixed billing for a single service

Under the Health Insurance Act 1973, a bulk billing facility for professional services is available to all persons in Australia who are eligible for a benefit under the Medicare program.  If a practitioner bulk bills for a service the practitioner undertakes to accept the relevant Medicare benefit as full payment for the service.  Additional charges for that service cannot be raised.  This includes but is not limited to: 

• any consumables that would be reasonably necessary to perform the service, including bandages and/or dressings;
• record keeping fees;
• a booking fee to be paid before each service, or;
• an annual administration or registration fee. 

To read the full explanatory notes, please visit the MBS Online website.

Factsheets and news

To view fact sheets that provide guidance and assist in the interpretation of areas of the MBS and to subscribe to MBS news updates, please visit MBS Online.  

Please visit our 'Training and Education’ page for further information and resources.