The ‘Private Health Insurance classification of MBS items 1 November 2025’ (the ‘PHI Spreadsheet’) released on 16 October 2025, is derived from the MBS XML Data file ‘MBS-XML-20251101.XML’ released on 3 October 2025, effective 1 November 2025.
Reflected in the ‘PHI Spreadsheet’ are MBS 1 November 2025 changes to the General Medical Services Table (GMST), the Diagnostic Imaging Services Table (DIST), the Pathology Services Table (PST) and the Health Insurance Regulations 2018. This file also includes changes to various instruments made under subsection 3C(1) of the Health Insurance Act 1973.
Key MBS item changes of potential interest to stakeholders are summarised below, and outlined in the MBS Online - November 2025 News:
- amendments to General medical services
- amendments to Pathology services
- amendments to Diagnostic Imaging services
- 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 November 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.
Key changes in the PHI spreadsheet:
- 25 MBS items have been removed from the Type C list. These changes arise from the work of the Private Health CEO Forum to identify and develop short and medium-term options to support the sustainability of the private health sector. These items include dual listed and other items that normally require hospital treatment and were identified on the basis that such changes would assist in reducing administrative burden.
- PHI classification changes to item 16050 and 16055 which were incorrectly classified in the 1 July 2025 spreadsheet.
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 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.