MBS Update - Need for Documented Consent for Bulk-Billed Services

There have been recent changes to MBS requirements for obtaining consent for bulk billing claims (links below). The following information has been prepared by Dr Troy Gianduzzo, as ANZAUS Chair.

The requirement that consent is obtained for each bulk-billing episode has not changed. The key takeaway is that consent will now require an electronic or physical signature, rather than verbal consent. The changes will come into effect from 1 July 2026. I encourage members to familiarise themselves with these changes to ensure compliance with the new requirements.

Two potential issues have been drawn to my attention:

1) Public hospitals: This change should not impact public patients but could impact private patients in a public hospital. Public sector patients should not be bulk-billed unless the instances comply with the specific NHRA business rules. The FAQs for the Assignment of Medicare Benefits for Bulk Billing note: Public services provided to public patients are funded under the National Health Reform Agreement (NHRA). All components of an episode of public patient care must be provided free of charge and no claims should be made against the Medicare Benefits Schedule (MBS). If the incoming consent changes were to impact public patients in public hospitals, then that would be a matter for those hospitals' executives to address.

2) Multidisciplinary Team (MDT) meetings: The relevant item numbers are MBS Item 871 and Item 872. The explanatory notes are very specific in what the billing requirements for these items are. The full details are provided in the links above. However, the principal requirements are:

• The case conference must last at least 10 minutes.
• The multidisciplinary team must consist of at least 4 medical practitioners from different areas of medical practice and, in addition, allied health or other relevant health professionals.
• The billing practitioner (item 871 the lead practitioner, item 872 the other attending practitioners of that care team) must be a treating doctor of the patient and should generally have treated or provided a formal diagnosis of the patient's cancer in the past 12 months or expect to do so within the next 12 months.
• Attending non-treating clinicians are not eligible to bill the item.
• Each billing practitioner must ensure that their patient is informed that a charge will be incurred for the case conference for which a Medicare benefit will be payable.

The requirement that "each billing practitioner must ensure that their patient is informed that a charge will be incurred for the case conference for which a Medicare benefit will be payable" has not been altered and was already applicable before this change. Verbal consent at least from each separate billing doctor was already required for bulk-billing purposes. Accordingly, if practitioners of a patient’s care team do not each individually obtain consent from the patient that the patient will be bulk-billed, then that would not comply with the explanatory notes for these item numbers. What is changing is that the consent from each treating practitioner must now be an electronic or physical signature rather than verbal.

Further information about assignment of benefit for bulk billing claims is available on the Services Australia website.