What is the Medicare Benefits Schedule (MBS) Fee?

The Medicare Benefits Schedule (MBS) Fee is the amount the Australian Government sets as appropriate to pay a health professional for a particular service. The fee is listed in the Medicare Benefits Schedule (MBS)

The MBS also lists the rates for calculating the benefit payable by the Government:

The Schedule Fee may differ from the health service provider’s actual fee.

Although Medicare is a public scheme, most health professionals providing services where Medicare Benefits are available, run private businesses. Under Australian law, they are entitled to set their own fees at whatever they decide is appropriate.

As a patient, you are responsible for paying any difference between the Medicare Benefit for a service and the fee charged by your health service provider. The difference between these amounts is known as an ‘out-of-pocket’ cost.

You do not have to pay any out-of-pocket costs if your health professional accepts the Medicare benefit as full payment for the service. This is known as bulk billing.