Medicare Benefits Schedule - Note MN.14.9

Assignment of Benefit (Bulk-Billing) Arrangements

Under the Health Insurance Act 1973, the assignment of benefit (bulk-billing) facility for professional services is available to all eligible persons under the Medicare program.

Where a nurse practitioner elects to bulk-bill, the nurse practitioner agrees to accept the relevant Medicare benefit as full payment for the service rendered. No additional charges relating to that service (regardless of their purpose or description) may be levied on the patient.

From 1 July 2026, a patient’s benefit can be assigned either before or after a service is rendered. The Health Insurance Regulations 2018 Part 65C outlines the information that must be recorded in an agreement in writing (physically or electronically):

For a pre-episodic assignment agreement for all nurse practitioner MBS items (i.e. a patient’s assignment is obtained before a service is rendered), the following information is required:

(i) name of the individual who will receive the service;

(ii) name and practice address OR provider number of the professional who will render the service;

(iii) that the agreement is a pre-episodic assignment;

(iv) date on which the agreement is made;

(v) date the service will be rendered;

(vi) the Basic Service Description;

(vii) whether the assignor is the patient (yes or no);

(viii) be signed by the patient (or their assignor).

 

For a post-episodic assignment agreement (i.e. a patient’s assignment is obtained after a service is rendered):

(i) name of the individual who will receive the service;

(ii) name and practice address OR provider number of the professional who will render the service;

(iii) that the agreement is a post-assignment;

(iv) date on which the agreement was made;

(v) date the service was rendered;

(vi) the MBS item;

(vii) whether the assignor is the patient (yes or no);

(viii) be signed by the patient (or their assignor).

Where a patient is unable to sign the assignment agreement, an ‘assignor’ can sign on the patient’s behalf (for example, a partner, parent, guardian, carer or person with Power of Attorney).  Staff employed in medical facilities where patients receive care should not act as an assignor unless they would otherwise meet the cost of the patient’s care. An assignment agreement is not complete unless signed by the patient or the patient’s assignor.

Services Australia is responsible for administering bulk-billing arrangements under Medicare and the payment of Medicare benefits on patient claims. All enquiries regarding these matters should be directed to Services Australia. 

The bulk-billing stationary required for nurse practitioners is available from Services Australia. For more details about obtaining bulk-billing stationary, you can contact Services Australia on 132 150.

Recordkeeping Obligations

From 1 July 2026, patients are to be provided with a copy of the assignment only upon request. Participating nurse practitioners must retain all Medicare claim documentation for a minimum of two years from the date of claim submission.

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