Simplified billing services
For patients covered by a private health insurance policy who are receiving hospital (in-patient) or hospital-substitute treatment, there are 2 pathways for a simplified billing assignment to occur:
- Implied assignment: If a healthcare provider has an arrangement with a private health insurer (such as a medical gap cover agreement) and that arrangement applies to the service, then the assignment is automatic. This means no patient signature is required.
- Requested assignment: If the healthcare provider does not have an arrangement with the private health insurer or the arrangement does not apply to the service, the healthcare provider will need to facilitate an assignment request for the patient to assign their benefit.
Update to Assignment of Medicare Benefit requirements – Simplified billing
From 1 July 2026, simplified billing assignment of Medicare benefits will be updated for medical practitioners, hospitals, private health insurers, and approved billing agents.
Health provider compliance
We will continue to work with stakeholders about these changes.
Once regulatory changes are finalised, our compliance activities will be consistent with the department’s health provider compliance strategy.
The department will prioritise prevention and education as practitioners work towards adopting new assignment of benefit requirements – within a risk-based approach to its ongoing compliance efforts.
We appreciate your ongoing commitment and welcome any questions or feedback.
AskMBS email advice service
AskMBS helps health professionals, practice managers and others to understand their Medicare Benefits Schedule (MBS) billing requirements. It answers queries on the interpretation of MBS items, explanatory notes and related legislation.
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