Most common MBS item numbers for GP consults and after-hours care

Have you ever taken a close look at your medical invoice or a Medicare claim statement? If so, you probably noticed some numbers next to your consultation, which aren't random. These are MBS item numbers, codes from the Medicare Benefits Schedule (MBS), a detailed document of all medical services subsidised by the Australian government.

This schedule is extensive and includes codes for all types of surgeries and minor tests. But general practice is served by a much smaller list of MBS item numbers that GP doctors use daily. These numbers help identify your consultation, how it has been timed and how much of the government rebate you will receive. If you want to understand how these codes translate into out-of-pocket savings across the broader healthcare landscape, our comprehensive bulk billing and Medicare guide provides a full foundational overview.

Explaining MBS codes means showing how a doctor breaks down their time and skill level for invoicing purposes. This method guarantees that healthcare providers utilise a common structure when communicating with government payment systems. For more information about the operation and updating of the schedule, the Department of Health and Aged Care provides official documentation.

Standard vs Long Consults

Deciding on a Medicare time-tier item number after a standard daytime visit is one of the most common questions patients ask. General practice consultations are broken down into a few distinct levels based on the length and complexity of the session.

By far, the "Level B" consultation (or standard consultation) is the most commonly used item number in the country. It is issued when a doctor sees a patient for less than 20 minutes for a simple medical issue, such as a quick check-up, medication prescription, or first diagnosis of a common illness.

On the other hand, if you have a doctor's appointment for a detailed check-up and to discuss your multiple health conditions, a "Level C" consult will be the chosen item number for the doctor, since you would be talking for at least 20 minutes but less than 40 minutes. This enables a doctor to explore the complex issues, check multiple conditions, or have a detailed examination without rushing around. Besides, if you want to understand the impact of doctors' time on patients' out-of-pocket expenses, then you may be interested in the Medicare vs private billing differences explanation.

There are Level D and Level E codes for highly complex cases lasting longer than 40 minutes. It's also worth noting that the government's rebate amount is higher when the appointment lasts longer because the doctor is spending more time with you.

After-Hours MBS Codes

Professionals who work late nights, weekends, and public holidays face different pressures and overhead costs. For these reasons, the Medicare schedule includes special after-hours item numbers to compensate doctors for their work during these unsociable hours.

These after-hours codes are similar to the daytime codes in that they are grouped according to the duration and complexity of the consult, but they also have a higher government rebate. Your after-hours booking may depend heavily on the code on your invoice that corresponds to the exact time of night and the day of the week of your consultation.

To give you an example, the MBS item number for a visit at 2:00 AM on a Wednesday will differ from that for a standard daytime visit. For an in-depth look at how these night-time rebates work, see our explanation of after-hours bulk billing.

MBS Codes for Telehealth

In response to the exponential growth of digital healthcare, the Australian government has issued a range of new item numbers that cover telehealth services. This guarantees that patients receiving healthcare remotely get the same level of support from the government health insurance program as those attending in-person consultations.

Telehealth item numbers usually fall into two groups: video consultations and telephone-only consultations. Because it enables a more thorough clinical assessment, the government strongly recommends video communications. To learn more about how remote consultations use these item numbers, check out our section on bulk billing and telehealth. It is important to keep your personal information up to date to make these digital claims, which you can do via the Services Australia portal.

13CURE Operations and Billing Policy

It can be confusing to figure out how specialised medical services run and bill when your local clinic closes. 13CURE offers a focused community service that works through the tough hours of the night.

13CURE operates from 11 PM through 7 AM daily, providing after-hours telehealth for urgent cases only. Since comprehensive long-term health care depends primarily on your regular doctor, it is best to see the GP for all non-urgent cases, regular check-ups, and chronic disease management. Our After-Hours Urgent Care service is our answer to a sudden, urgent medical need within the framework.

We have a clear billing policy to ensure our urgent services remain affordable for patients who need immediate medical attention. Bulk billing is available in some cases, such as patients from partner practices deputised with 13CURE, infants less than 1 year old, homeless individuals, or those from a disaster area. All other patients will be billed privately. By the way, we only see urgent patients after hours, but for Medical Certificates and related documentation, we see patients privately.

Geographic Availability

Urgent care is the main focus of our service, and we do our best to provide it as fast as possible within our areas. Right now, our operations are confined to certain locations in New South Wales and Queensland. Need an after-hours GP in Sydney or urgent support in Brisbane? No problem, our telehealth team is at your service.

If you are reading this from Victoria, Western Australia, or the Northern Territory, Australia, we haven't launched in these areas yet. Still, we plan to do so in the future and will keep you updated.