Private health insurance resources
GT-Dental data specification – Insurer to department – 2025–26
The Hospital Casemix Protocol (HCP) data specification for General Treatment-Dental files for 2025–26 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 2025.
Natural Therapies Review 2024 – Report and recommendations
Read the final report from the Chair of the Natural Therapies Review Expert Advisory Panel. The review considered a range of natural therapies and recommends which ones should be eligible for subsidy through private health insurance rebates.
NTREAP meeting outcomes – 10 December 2024
Natural Therapies Review Expert Advisory Panel (NTREAP) meeting outcomes for 10 December 2024 meeting.
Private Health Insurance clinical category definitions 1 March 2025
Standard clinical category definitions for private health insurance hospital policies, released on 19 February 2025 and effective 1 March 2025.
Prescribed List of Medical Devices and Human Tissue Products
This page lists the medical devices and human tissue products private health insurers must pay benefits for to the patients who have appropriate insurance policies. The latest version of the Prescribed List is effective from 1 July 2025.
Stakeholder feedback summary – Consultation Paper 9 – CIED and the cost of technical support services
This document provides a high-level summary of stakeholder feedback received in response to Consultation Paper 9 – CIED and the cost of technical support services.
Natural Therapies Review 2024 – NHMRC process report
This report from the National Health and Medical Research Council (NHMRC) details the methods used to assess, for a range of therapies, whether they are suitable to be covered by private health insurance.
Prescribed List post-listing review framework
We have developed a Prescribed List Post-listing Review Framework that is used to guide the post-listing review process as part of the Prescribed List Reforms.
Private Health Insurance classification of MBS items 1 January 2025
This spreadsheet classifies MBS items by private health insurance clinical category or procedure type and includes MBS items effective 1 January 2025.
Private Health Insurance clinical category definitions 1 January 2025
Standard clinical category definitions for private health insurance hospital policies, released on 12 December 2024 and effective 1 January 2025.
Interim Evaluation #1 of the Prescribed List Reforms
The interim evaluation report covers the period from May 2021 to June 2024 and reports on whether the reforms being implemented and achieving the expected outcomes.
Reforms to the Prescribed List Part B – Analysis of stakeholder feedback
This report is to provide an analysis of stakeholder feedback received.
Private Health Insurer pandemic commitment monitoring – 2023
A summary of 2023 funds returned from private health insurers to policyholders in response to the COVID-19 pandemic.
Private Health Insurer pandemic commitment monitoring – 2024
A summary of 2024 funds returned from private health insurers to policyholders in response to the COVID-19 pandemic.
Private Health Insurer pandemic commitment monitoring – 2022
A summary of 2022 funds returned from private health insurers to policyholders in response to the COVID-19 pandemic.
Natural Therapies Review 2024 – Buteyko evidence evaluation
This report outlines the evaluation of evidence on the clinical effectiveness of Buteyko as part of the Natural Therapies Review 2024.
Private Health Insurance Clinical Categories Review Advisory Committee Report
This report sets out 24 recommendations for the department to better clarify the coverage requirements of the categories and the regulations in the Private Health Insurance.
Natural Therapies Review 2024 – Reflexology evidence evaluation
This report outlines the evaluation of evidence on the clinical effectiveness of reflexology as part of the Natural Therapies Review 2024.
Natural Therapies Review 2024 – Feldenkrais evidence evaluation
This report outlines the evaluation of evidence on the clinical effectiveness of Feldenkrais as part of the Natural Therapies Review 2024.
Natural Therapies Review 2024 – Alexander Technique evidence evaluation
This report outlines the evaluation of evidence on the clinical effectiveness of the Alexander Technique as part of the Natural Therapies Review 2024.
Natural Therapies Review 2024 – Kinesiology evidence evaluation
This report outlines the evaluation of evidence on the clinical effectiveness of kinesiology as part of the Natural Therapies Review 2024.
Natural Therapies Review 2024 – Bowen Therapy evidence evaluation
This report outlines the evaluation of evidence on the clinical effectiveness of Bowen Therapy as part of the Natural Therapies Review 2024.
Baseline evaluation of the Prostheses List reforms – Final report
This evaluation focuses on the Prostheses List reforms, which are running from 1 July 2021 to 30 June 2025. Evaluation of these reforms will determine whether the reform program is being implemented as intended.
Prescribed List billing codes – Removal of medicine and medicine accessories – 1 November 2024
This list includes details of the 26 billing codes for medicines and related accessories scheduled to be removed from Part D of the Prescribed List effective 1 November 2024.
Private Health Insurance classification of MBS items 1 November 2024
This spreadsheet classifies MBS items by private health insurance clinical category or procedure type and includes MBS items effective 1 November 2024.
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