Better health and ageing for all Australians

Medicare Benefits

The Australian Government pays Medicare Benefits to assist consumers with the costs of medical, optometrical and, in some cases, dental surgical services, provided on a private basis.

Where Medicare benefits fit | MBS Online | Medicare Offices | Statistics | Changing MBS items | Legislation


Where do Medicare benefits fit?

For a description of how Medicare benefits fit into Medicare and the Australian Health Care System, see "Overview of the Australian healthcare system"

Medicare Offices - Administration of Medicare benefits by the Medicare Australia

Medicare benefits claims and payments are processed by Medicare Australia, now part of the portfolio of the Minister for Human Services .

MBS Online

MBS Online contains the Medicare Benefits Schedule (MBS), A listing of the Medicare services subsidised by the Australian government. The Schedule is part of the wider Medicare Benefits Scheme managed by the Department of Health and Ageing and administered by Medicare Australia. MBS Online contains the latest MBS information and is updated as changes to the MBS occur. This site provides:
  • search the MBS functionality to allow both items and explanatiory notes to be easily accessed;
  • downloadable PDF versions of the MBS;
  • an email subscription to allow users to be notified of changes to the MBS; and
  • a create publication functionality whereby a dynamic PDF can be created based on preferred items.

Medicare Benefits Statistics

Statistics on the numbers and value of Medicare benefits paid are at Medicare Benefits Statistics

    How changes to the Medicare Benefits Schedule are decided

    The need for changes to the way services currently included the Schedule are subsidised are considered by the Medicare Benefits Consultative Committee. Proposals for new treatments to be included in the Schedule are considered by the Medical Services Advisory Committee.

    Medicare Benefits Consultative Committee

    The Medicare Benefits Consultative Committee provides a forum for discussion between the Department and the medical profession on existing items in the Medicare Benefits Schedule (other than items covering diagnostic imaging and pathology items)

    It provides for the review of an item or group of items in terms of adequacy of descriptions of items and fees for items and the existing structure of the Schedule but not so as to involve a general review of the overall fees throughout the Schedule, having regard to appropriate medical practice. The considerations of the Committee lead to amendments to the Medicare Benefits Schedule.
    Membership of the Committee comprises representatives of the Department of Health and Aged Care, the Health Insurance Commission, the Australian Medical Association and the relevant craft or craft groups whose members have an interest in the items which are under review.

    A similar committee operates when items concerning optometrical or certain dental services (such as those relating to cleft lip and palate conditions) are being reviewed, except memebership includes respectively the Optometrists Association Australia or the Australian Dental Association and the relevant dental craft group(s).

    There are separate consultative arrangements for the Diagnostic Imaging and Pathology Services tables.

    Medical Services Advisory Committee

    The Medical Services Advisory Committee advises the Minister for Health and Ageing on the strength of evidence on new medical technologies and procedures in terms of their safety, effectiveness and cost effectiveness, and under what circumstances funding by the Medicare benefits should be supported.Top of page

    Legislation covering Medicare benefits

    Medicare benefits are provided for by the Health Insurance Act 1973 which should be read in conjunction with the National Health Act 1953. These Acts and the Regulations made under them are available at the ComLaw web site