What the Medical Benefits Schedule changes mean for you

The MBS is a list of all the medical services that the Australian Government pays a Medicare rebate for. The MBS gives Australians financial assistance towards the cost of medical services. Simply, it includes all the medical procedures and services health funds are allowed to cover you for.

You may have heard in the media about changes to the Medicare Benefits Schedule (MBS) items.

The changes follow a five-year clinician-led review called the MBS Review Taskforce to update the MBS. The government says it’s the most rigorous review of Medicare since its foundation in 1984, covering 5,700 items and delivering 1,400 recommendations. The review:

focused on ensuring MBS items meet the goals of affordable and universal access, best practice healthcare, and value for both the individual patient and the health system

What are the changes

The changes from 1 July 2021 mainly affect:

  • general surgery
  • orthopaedic surgery
  • cardiac services

There are also some minor changes. All the changes can be viewed at MBS Online. The original plan from the MBS Review Taskforce has annual changes implemented for the eight years from 2016 to 2023 which the government has the discretion to implement, change or ignore.

Only 900 items have changed this year from the 5,700 items reviewed by the taskforce.

How does this affect you?

The biggest chunk of these changes affects surgeries and that means only people going to hospital for surgery will be affected. If you have an upcoming surgery, your specialist will be able to tell you if the MBS changes affect you.

From there it’s the same process as usual for any planned surgery. Simply get Informed Financial Consent (aka a quote) from your treating specialist before you proceed to learn about your out-of-pocket costs. Our Going to Hospital Guide has all info you need.

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