What services are included on the Medicare Benefits Schedule (MBS)?

Services from doctors included on the MBS

MBS Benefits are payable for these types of services from doctors:

• consultations with general practitioners (GPs) and specialists
• tests and examinations needed by doctors to diagnose and treat illnesses, including some imaging services and pathology services from medical specialists
• most surgical and other therapeutic procedures performed by doctors
• specified dental items under the Cleft Lip and Palate Scheme.

Services from allied health professionals included on the MBS

MBS Benefits are payable for some services from allied health workers, including:

• eye tests conducted by optometrists
• specified dental items under the Cleft Lip and Palate Scheme
• up to 10 consultations with psychologists (with a referral)
• allied health services for patients with chronic diseases.

How services from allied health services for patients with a chronic disease are funded under the MBS

You can claim Medicare Benefits for some allied health services if you are an eligible patient with a chronic disease and a doctor refers you to these allied health practitioners:

• Aboriginal Health Workers or Aboriginal and Torres Strait Islander Health Practitioners
• audiologists
• chiropractors
• diabetes educators
• dieticians
• exercise physiologists
• mental health workers
• occupational therapists
• osteopaths
• physiotherapists
• podiatrists
• psychologists
• speech pathologists.

To claim a Medicare Benefit for these services, you need to satisfy these criteria:

• you must be eligible
• your doctor must refer you to the allied health professional
• an eligible allied health professional must deliver the service to you
• the allied health professional must bill using the correct MBS item number
• the allied health practitioner must give reports to your referring doctor.

If you are an eligible patient, you can use 5 services each year:

• one type of service (for example, 5 podiatry services) or
• a combination of different types of services (for example, one podiatry, 2 physiotherapy and 2 occupational therapy services).

How the decision is made whether or not to include a particular service on the MBS

The decision about which services to include on the MBS is evidence-based. 

The Medical Services Advisory Committee (MSAC), an independent body, determines which medical services the Australian government subsidises. It aims to, for example:

1. Deliver optimum value for money in government subsidisation of medical services.
2. Prioritise uptake of effective new technologies and procedures.