Private health insurance resources
Private Health Insurance classification of MBS items 1 July 2024
This spreadsheet classifies MBS items by private health insurance clinical category or procedure type and includes MBS items effective 1 July 2024.
Private Health Insurance clinical category definitions 1 July 2024
Standard clinical category definitions for private health insurance hospital policies, released on 31 May 2024 and effective 1 July 2024.
NTREAP meeting outcomes – 7 June 2024
Natural Therapies Review Expert Advisory Panel (NTREAP) meeting outcomes for 7 June 2024 meeting.
PHDB data specification – Hospital to department – 2024–25
The Private Health Data Bureau (PHDB) data specifications for 2023–24 details the financial, clinical and demographic data that hospitals must provide to us. Effective from 1 July 2024.
Changes in HCP and PHDB data specifications – 2024–25
This fact sheet outlines changes in the data specifications for Hospital Casemix Protocol (HCP) and Private Hospital Data Bureau (PHDB) data for the 2024–25 financial year. They take effect on 1 July 2024.
GT-Dental data specification – Insurer to department – 2024–25
The Hospital Casemix Protocol (HCP) data specification for General Treatment-Dental files for 2024–25 details the financial, clinical and demographic data that hospitals must provide private health insurers. Private health insurers must then provide this data to us. Effective from 1 July 2024.
HCP data specifications – HCP2 – Insurer to department – 2024–25
The Hospital Casemix Protocol (HCP) data specification for HCP2 files for 2024–25 details the financial, clinical and demographic data that hospitals must provide private health insurers. Private health insurers must then provide this data to us. Effective from 1 July 2024.
HCP data specifications – Hospital to insurer – 2024–25
The Hospital Casemix Protocol (HCP) data specifications for HCP files details the financial, clinical and demographic data that hospitals must provide to private health insurers. Private health insurers must then provide this data to us. Effective from 1 July 2024.
HCP data specifications – HCP1 – Insurer to department – 2024–25
The Hospital Casemix Protocol (HCP) data specification for HCP1 files for 2024–25 details the financial, clinical and demographic data that hospitals must provide private health insurers. Private health insurers must then provide this data to us. Effective from 1 July 2024.
Health Insurance Legislation Amendment (Assignment of Medicare Benefits) Bill 2024 – Simplified billing overview
This document includes an overview of the key elements of the Health Insurance Legislation Amendment (Assignment of Medicare Benefits) Bill 2024 as introduced to Parliament on 29 May 2024. It focuses on simplified billing assignment.
Advice on the Prescribed List adjusted benefit amounts
These documents contain advice on the Prescribed List (PL) adjusted benefits, resulting from the public benchmarking undertaken by the Independent Health and Aged Care Pricing Authority (IHACPA). The documents outline the November 2023 PL benefits, and the adjusted benefits effective 1 July 2024.
Overseas Student Health Cover (OSHC) Review 8 June 2022
This report summarised stakeholders views to assist with improvements to the 2022 OSHC Deed.
NTREAP meeting outcomes – 11 April 2024
Natural Therapies Review Expert Advisory Panel (NTREAP) meeting outcomes for 2 April meeting.
NTREAP meeting outcomes – 29 April 2024
Natural Therapies Review Expert Advisory Panel (NTREAP) meeting outcomes for 29 April 2024 meeting.
Private health insurance reform data quarterly trends report
This report provides statistic and data trends on private health insurance reforms by quarter.
Medical Costs Finder – Digital sessions privacy notice
This privacy notice is for anyone accessing digital information sessions for about the Medical Costs Finder. This document outlines the privacy notice related to these online events as we are collecting registrations for the webinars.
Natural Therapies Review 2024 – Aromatherapy evidence evaluation
This report outlines the evaluation of evidence on the clinical effectiveness of aromatherapy as part of the Natural Therapies Review 2024.
Private Health Insurance classification of MBS items – 1 March 2024
This spreadsheet classifies MBS items by private health insurance clinical category or procedure type and includes MBS items effective 1 March 2024.
Private Health Insurance clinical category definitions – 1 March 2024
Standard clinical category definitions for private health insurance hospital policies, released on 9 February 2024 and effective at 1 March 2024.
Medical Costs Finder – Stakeholder kit
This stakeholder kit is designed to promote the Medical Costs Finder website.
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Medical Costs Finder – 30 second video
The Medical Costs Finder shows the typical costs of common services across Australia to take the surprise out of private medical costs.
Surgical guides and biomodels – Condition for Prescribed List reimbursement – Frequently asked questions
This document from contains answers to Frequently Asked Questions on the intent and operation of the condition for Prescribed List reimbursement for surgical guides and biomodels.
Prescribed List of Medical Devices and Human Tissue Products Guide – Draft
The draft of the Prescribed List Guide will provide sponsors with assistance in preparing their applications for the July 2024 Prescribed List. Stakeholders should keep in mind that this is a draft only that will be further amended and edited.
Private Health Insurance classification of MBS items – 1 January 2024
This spreadsheet classifies MBS items by private health insurance clinical category or procedure type and includes MBS items effective 1 January 2024.
Private Health Insurance clinical category definitions – 1 January 2024
Standard clinical category definitions for private health insurance hospital policies, released on 20 December 2023 and effective at 1 January 2024.
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