Medicare

About Medicare

What Medicare is, how it works, who’s eligible and who manages it.

What's covered

What Medicare does and doesn’t cover, and other support programs.

Safety nets

Safety nets provide extra support to people with high medical costs.

Compliance

How we protect our health payment system from incorrect billing.

As a health practitioner you must meet certain requirements to bill for Medicare Benefits Schedule (MBS) items under Medicare or prescribe subsidised medicines. Pathology and diagnostic imaging services must also meet accreditation standards to access Medicare.

Information for health practitioners

Health Products Portal

The Health Products Portal helps us work with the medicines and technology sector more efficiently. Industry can make, track, pay for, and manage submissions to list products and services on the Medicare Benefits Schedule (MBS) or Pharmaceutical Benefits Scheme (PBS) Schedule.

Learn more about the portal

Latest news

Victorian woman found guilty of defrauding Medicare

A Victorian medical receptionist has been sentenced today to 2 years imprisonment, with a minimum term of 12 months by the Melbourne County Court after pleading guilty to charging more than $181,000 in fraudulent Medicare payments.

17 March 2023

Ashgrove pharmacist found guilty for more than $1.9m in Medicare fraud

A pharmacist has been convicted and sentenced to five years imprisonment today, after pleading guilty to fraudulently claiming more than $1.9 million in payments under the Pharmaceutical Benefits Scheme (PBS).

14 March 2023

Jail time for Pharmacist and Practice Manager

A Pharmacist and Practice Manager from across Australia were sentenced last week after fraudulently claiming more than $470,000 in payments under the Medicare Benefits Scheme (MBS) and the Pharmaceutical Benefits Scheme (PBS).

7 February 2023

View more news

Latest resources

Medicare billing in public hospitals – overview

20 March 2023

Fact sheet

Public patients in a public hospital receive services free of charge. However, patients may elect to be a private patient and claim Medicare benefits instead. To ensure appropriate billing, you need to know when patients can claim Medicare benefits when they attend a public hospital.