November 2025 News

Files for November 2025 amendments to the Medicare Benefits Schedule

Page last updated: 03 October 2025

The 1 November 2025 MBS files are available on the November 2025 Downloads Page.

Summary of MBS Changes for 1 November 2025

From 1 November 2025, there will be changes to the MBS. These changes include a range of administrative and policy changes, including to implement the Government’s responses to recommendations from the MBS Review Taskforce (the Taskforce) and the Medical Services Advisory Committee (MSAC). The changes will affect the:

Greatest Permissible Gap

On 1 November 2025, the Greatest Permissible Gap (GPG) amount will be indexed in line with the consumer price index (September quarter).

Further information on the GPG is available on the Department’s website.

Bulk Billing Changes

From 1 November 2025, MBS bulk billing incentive items will be amended to remove the requirement that the patient is under 16 years of age or a Commonwealth concession card holder. MBS bulk billing incentives will be able to be claimed when any Medicare-eligible patient is bulk billed. Further information can be found at Bulk Billing Incentives – Changes to Eligibility.

Update the terminology for Aboriginal and Torres Strait Islander Health Workers and Practitioners

From 1 November 2025, legislation has been updated to adopt the terminology used by the Aboriginal and Torres Strait Islander health professions. This will help to promote and distinguish these professions so they are appropriately recognised for providing holistic primary health care services to Aboriginal and Torres Strait Islander people.

Other changes to general medical services

From 1 November 2025, changes will be made relating to general medical services. These include:
  • Amending four MBS items for complex Long Acting Reversible Contraceptive (LARC) services and increasing fees. Adding one new MBS item (item 82204) to provide a loading fee of 40% of the fee for each relevant LARC procedural item (82201, 82202 or 82203) where all items associated with a patient’s LARC care are bulk billed by an eligible nurse practitioner;
  • Adding new surgical assistance MBS items for Nurse Practitioners;
  • Amending skin excision MBS items to allow for healing by secondary intention;
  • Amending myringoplasty and tympanomastoid MBS items to clarify co-claiming restrictions;
  • Better Access Redesign changes – linking the preparation of a Mental Health Treatment Plan (MHTP), referrals for treatment, and reviews of a MHTP to either a patient’s General Practitioner (GP) or Prescribed Medical Practitioner (PMP) at a patient’s MyMedicare practice or their usual medical practitioner. MHTP review and mental health consultation items will be removed from the MBS, with GPs and PMPs able to use general attendance items to review, refer and/or provide ongoing mental health consultation for a patient’s mental health;
  • Making minor administrative amendments to fix and clean up chronic condition management (CCM) changes implemented on 1 July 2025;
  • Adding nine new phone MBS items for specialists and consultant physicians;
  • Extending the eligibility criteria for MBS GP telehealth items to include MyMedicare as an alternative pathway for patients to qualify for MBS GP telehealth consultations; make nurse practitioner telehealth items subject to the eligible telehealth practitioner criteria unless the service is exempt;
  • Amending MBS items 23010 and 42773 to include 85% benefit;
  • Adding “H” flag for MBS item 22032;
  • Restricting cardiothoracic procedure items co-claimed with MBS items 30621, 48406 and 48409;
  • Adding co-claiming restriction to colonoscopy items 32084, 32087 with endoscopic mucosal resection (EMR) item 32230; and
  • Clarifying the claiming restriction for MBS item 15946.

Changes to diagnostic imaging services

From 1 November 2025, changes will be made relating to diagnostic imaging services. These include:
  • Implementing provider claiming restrictions to therapeutic nuclear medicine services (Category 3, Group T3);
  • Adding new MBS items 16051 and 61530 for 177Lutetium Dotatate Octreotate (177Lu-DOTA-octreotate) treatment for advanced neuroendocrine and other high somatostatin receptor expressing tumours;
  • Expansion of ultrasound requesting rights for Midwives;
  • Removing four non-requested ‘NR-type’ MBS items (55889, 55891, 55893 and 55895 ) from the list of items that can be requested by a podiatrist;
  • Amending X-Ray MBS items 57512 and 57515;
  • Amending the Positron Emission Tomography (PET) comprehensive facility and statutory declaration requirements;
  • Expand ultrasound performing rights for MBS items 55282 and 55284 for Sexual Health Physicians; and
  • Adding new ultrasound MBS item (55080) for complex gynaecological conditions including severe endometriosis.

Changes to pathology services

From 1 November 2025, changes will be made relating to pathology services. These include:
  • Enabling midwives to request MBS items 73420 and 73421 for Rhesus D (Rh D) non-invasive prenatal testing (NIPT) of eligible, pregnant patients;
  • Amending MBS items 73374, 73375, 73376 for somatic gene testing of sarcomas;
  • Amending the complexity levels for MBS items for clinically indicated gross and histologic examination of placentas in perinatal deaths;
  • Adding a MBS item for Fibroblast growth factor 23 (FGF-23) testing;
  • Amending MBS items for non-small cell lung cancer (NSCLC) patients;
  • Adding a new MBS item for DPYD (Dihydropyrimidine Dehydrogenase) genotyping to predict fluoropyrimidine-induced toxicity; and
  • Adding a new MBS item for faecal calprotectin testing for managing disease in symptomatic patients with Irritable Bowel Disease (IBD).

Relevant legislation

Please note links will be added as they become available on the Federal Register of Legislation

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