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The ‘Private Health Insurance classification of MBS items 1 July 2025’ (the ‘PHI Spreadsheet’) released on 12 June 2025, is derived from the MBS XML Data file ‘MBS-XML-20250701 Version 2.XML’ released on 10 June 2025, effective 1 July 2025.
Reflected in the ‘PHI Spreadsheet’ are MBS 1 July 2025 changes to the General Medical Services Table (GMST), Pathology Services Table (PST) and the Diagnostic Imaging Services Table (DIST).
Key MBS item changes of potential interest to stakeholders are summarised below, and outlined in the MBS Online - July 2025 News:
- amendments to General medical services
- amendments to Pathology services
- amendments to Annual fee indexation will be applied to:
- most of the general medical services items
- most diagnostic imaging services (excluding: positron emission tomography (PET) items and nuclear medicine modifier items), and
- pathology items in Group P1, Group P4, Group P5, Group P6, Group P8 and Group P12.
- Other administrative and machinery changes.
Further information including fact sheets and quick reference guides is at MBS Online.
PHI Spreadsheets reflect the assignment of MBS items by clinical category and procedure type set out in the Private Health Insurance Legislation Amendment Rules for 1 July 2025 which will be published on the Federal Register of Legislation following the finalisation of regulatory approval processes. Details of the changes will be available in the Explanatory Statement that will accompany the Amendment Rules.
Formal notification of the Amendment Rules registration from the Department of Health and Aged Care will be via Private Health Insurance Circular.
Receive notification of updates to PHI Spreadsheets, and other PHI information, by emailing PHI@health.gov.au and requesting subscription to the email newsletter.
For previous versions of PHI Spreadsheet publications, review the Private health insurance clinical category and procedure type collection, or visit the National Library's web archive.