The ‘NEW TEMPLATE-Private Health Insurance classification and definitions of MBS items 1 July 2026’ (the ‘PHI Spreadsheet’) released on 4 June 2026, is derived from the MBS XML Data file ‘MBS-XML-20260701.XML’ released on 28 May 2026, effective 1 July 2026.
The new PHI spreadsheet includes:
- PHI classification
- PHI clinical category definitions
- Deleted MBS items within the past two years
Key MBS item changes of potential interest to stakeholders are summarised below, and outlined in the MBS Online - July News 2026
- 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, except certain attendance items by doctors without vocational training;
- most diagnostic imaging services (excluding: positron emission tomography (PET) items and nuclear medicine modifier items), except positron emission tomography items in Group I4 (Subgroup 2) and nuclear medicine modifier items in Group I4 (Subgroup 3); 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 amendments made to the clinical category definitions to the MBS items and assignment of MBS items by clinical category and procedure type set out in the Private Health Insurance Legislation Amendment Rules for 1 July 2026 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.
Collection information
Private health insurance clinical category and procedure type