Category 8 - MISCELLANEOUS SERVICES
MN.13.14
Time Limits Applicable to Lodgement of Claims for Assigned Benefits
A time limit of 1 year applies to making claims with Medicare under the direct billing (assignment of benefit) arrangements. This means that Medicare benefits are not payable for any service where the service was rendered more than 1 year earlier than the date the claim was made with Medicare. For services rendered prior to 5 September 2025, this timeframe is up to 2 years from the date of service.
Provision exists whereby in certain circumstances (e.g. hardship cases), the Minister may waive the time limits. Special forms for this purpose are available, if required, from the processing centre to which assigned claims are directed.
Legend
- Assist - Addition/Deletion of (Assist.)
- Amend - Amended Description
- Anaes - Anaesthetic Values Amended
- Emsn - EMSN Change
- Fee - Fee Amended
- Renum - Item Number Change (renumbered)
- New - New Item
- NewMin - New Item (previous Ministerial Determination)
- Qfe - QFE Change