Private Health Insurance classification of MBS items 1 March 2025

The ‘Private Health Insurance classification of MBS items 1 March 2025’ (the ‘PHI Spreadsheet’) released on 19 February 2025, is derived from the MBS XML Data file ‘MBS-XML-20250301 (XML 7958 KB)’ released on 12 February 2025, effective 1 March 2025.

Reflected in the ‘PHI Spreadsheet’ are MBS 1 March 2025 changes to the General Medical Services Table (GMST), Pathology Services Table (PST) and the Diagnostic Imaging Services Table (DIST). 

Key MBS item changes of potential interest to stakeholders are summarised below, and outlined in the MBS Online - March 2025 News:

• over 800 items in the MBS will be amended to remove the 85% out of hospital benefit.
• amendments to all telehealth items currently specified as ‘telehealth attendances’ to instead use ‘video attendance’. 
• amendments to General medical services
• amendments to Pathology services 
• amendments to Diagnostic Imaging services
• Other administrative and machinery changes.

Further information including fact sheets and quick reference guides is at MBS Online.

PHI Spreadsheets reflect the assignment of MBS items by clinical category and procedure type set out in the Private Health Insurance Legislation Amendment Rules for 1 March 2025 which will be published on the Federal Register of Legislation following the finalisation of regulatory approval processes. Details of the changes will be available in the Explanatory Statement that will accompany the Amendment Rules.

Formal notification of the Amendment Rules registration from the Department of Health and Aged Care will be via Private Health Insurance Circular.

Receive notification of updates to PHI Spreadsheets, and other PHI information, by emailing PHI@health.gov.au requesting subscription to the email newsletter.

For previous versions of PHI Spreadsheet publications, review the Private health insurance clinical category and procedure type collection, or visit the National Library's web archive.