Health Insurance Legislation Amendment (Indexation) Regulations 2025
I, the Honourable Sam Mostyn AC, Governor‑General of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, make the following regulations.
Dated 20 February 2025
Sam Mostyn AC
Governor‑General
By Her Excellency’s Command
Mark Butler
Minister for Health and Aged Care
1 Name
2 Commencement
3 Authority
4 Schedules
Schedule 1—Amendments
Health Insurance (Diagnostic Imaging Services Table) Regulations (No. 2) 2020
Health Insurance (General Medical Services Table) Regulations 2021
Health Insurance (Pathology Services Table) Regulations 2020
This instrument is the Health Insurance Legislation Amendment (Indexation) Regulations 2025.
(1) Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.
Commencement information | ||
Column 1 | Column 2 | Column 3 |
Provisions | Commencement | Date/Details |
1. The whole of this instrument | 1 July 2025. | 1 July 2025 |
Note: This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.
(2) Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.
This instrument is made under the Health Insurance Act 1973.
Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.
1 Clause 2.4.6 of Schedule 1 (before the table)
Insert:
Note: The fees in Subgroup 1 of Group I4 are indexed in accordance with clause 2.7.1.
2 Clause 2.7.1 of Schedule 1 (heading)
Omit “1 July 2024”, substitute “1 July 2025”.
3 Subclause 2.7.1(1) of Schedule 1
Repeal the subclause, substitute:
(1) At the start of 1 July 2025 (the indexation time), each amount covered by subclause (2) is replaced by the amount worked out using the following formula:
Note: The indexed fees could in 2025 be viewed on the Department’s MBS Online website (http://www.health.gov.au).
4 After subparagraph 2.7.1(2)(a)(iii) of Schedule 1
Insert:
(iiia) Subgroup 1 of Group I4 (nuclear medicine imaging services—non PET);
5 Paragraph 1.2.4(2)(c) of Schedule 1
Omit “$341.75”, substitute “$349.95”.
6 Clause 1.3.1 of Schedule 1 (heading)
Omit “1 July 2024”, substitute “1 July 2025”.
7 Subclause 1.3.1(1) of Schedule 1
Repeal the subclause, substitute:
(1) At the start of 1 July 2025 (the indexation time), each amount covered by subclause (2) is replaced by the amount worked out using the following formula:
Note: The indexed fees could in 2025 be viewed on the Department’s MBS Online website (http://www.health.gov.au).
8 Clause 2.1.1 of Schedule 1 (table 2.1.1)
Repeal the table, substitute:
Table 2.1.1—Amount under clause 2.1.1 | ||||
Item | Column 1 Item of this Schedule | Column 2 Fee | Column 3 Amount if not more than 6 patients (to be divided by the number of patients) ($) | Column 4 Amount if more than 6 patients ($) |
1 | 4 | The fee for item 3 | 30.70 | 2.45 |
2 | 24 | The fee for item 23 | 30.70 | 2.45 |
3 | 37 | The fee for item 36 | 30.70 | 2.45 |
4 | 47 | The fee for item 44 | 30.70 | 2.45 |
5 | 58 | $8.50 | 15.50 | 0.70 |
6 | 59 | $16.00 | 17.50 | 0.70 |
7 | 60 | $35.50 | 15.50 | 0.70 |
8 | 65 | $57.50 | 15.50 | 0.70 |
9 | 124 | The fee for item 123 | 30.70 | 2.45 |
10 | 165 | $88.20 | 15.50 | 0.70 |
11 | 195 | The fee for item 193 | 30.30 | 2.40 |
12 | 414 | The fee for item 410 | 30.20 | 2.40 |
13 | 415 | The fee for item 411 | 30.20 | 2.40 |
14 | 416 | The fee for item 412 | 30.20 | 2.40 |
15 | 417 | The fee for item 413 | 30.20 | 2.40 |
16 | 5003 | The fee for item 5000 | 30.30 | 2.40 |
17 | 5010 | The fee for item 5000 | 54.55 | 3.90 |
18 | 5023 | The fee for item 5020 | 30.30 | 2.40 |
19 | 5028 | The fee for item 5020 | 54.55 | 3.90 |
20 | 5043 | The fee for item 5040 | 30.30 | 2.40 |
21 | 5049 | The fee for item 5040 | 54.55 | 3.90 |
22 | 5063 | The fee for item 5060 | 30.30 | 2.40 |
23 | 5067 | The fee for item 5060 | 54.55 | 3.90 |
24 | 5076 | The fee for item 5071 | 30.30 | 2.40 |
25 | 5077 | The fee for item 5071 | 54.55 | 3.90 |
26 | 5220 | $18.50 | 15.50 | 0.70 |
27 | 5223 | $26.00 | 17.50 | 0.70 |
28 | 5227 | $45.50 | 15.50 | 0.70 |
29 | 5228 | $67.50 | 15.50 | 0.70 |
30 | 5260 | $18.50 | 27.95 | 1.25 |
31 | 5261 | $112.20 | 15.50 | 0.70 |
32 | 5262 | $112.20 | 27.95 | 1.25 |
33 | 5263 | $26.00 | 31.55 | 1.25 |
34 | 5265 | $45.50 | 27.95 | 1.25 |
35 | 5267 | $67.50 | 27.95 | 1.25 |
36 | 90272 | The fee for item 90271 | 30.30 | 2.40 |
37 | 90274 | The fee for item 90273 | 30.30 | 2.40 |
38 | 90276 | The fee for item 90275 | 24.20 | 1.90 |
39 | 90278 | The fee for item 90277 | 24.20 | 1.90 |
9 Clause 2.1.2 of Schedule 1 (table 2.1.2)
Repeal the table, substitute:
Table 2.1.2—Amount under clause 2.1.2 | ||||
Item | Column 1 Item of this Schedule | Column 2 Fee | Column 3 Amount if not more than 6 patients (to be divided by the number of patients) ($) | Column 4 Amount if more than 6 patients ($) |
1 | 181 | The fee for item 179 | 24.60 | 1.95 |
2 | 187 | The fee for item 185 | 24.60 | 1.95 |
3 | 191 | The fee for item 189 | 24.60 | 1.95 |
4 | 206 | The fee for item 203 | 24.60 | 1.95 |
5 | 303 | The fee for item 301 | 24.60 | 1.95 |
10 Schedule 1 (item 111, column 2, paragraph (d))
Omit “$341.75”, substitute “$349.95”.
11 Schedule 1 (item 115, column 2, paragraph (c))
Omit “$341.75”, substitute “$349.95”.
12 Schedule 1 (item 117, column 2, paragraph (e))
Omit “$341.75”, substitute “$349.95”.
13 Schedule 1 (item 120, column 2, paragraph (d))
Omit “$341.75”, substitute “$349.95”.
14 Subclause 2.20.2(1) of Schedule 1 (table 2.20.2)
Repeal the table, substitute:
Table 2.20.2—Amount under clause 2.20.2 | ||||
Item | Column 1 Item of this Schedule | Column 2 Fee | Column 3 Amount if not more than 6 patients (to be divided by the number of patients) ($) | Column 4 Amount if more than 6 patients ($) |
1 | 2723 | The fee for item 2721 | 30.30 | 2.40 |
2 | 2727 | The fee for item 2725 | 30.30 | 2.40 |
3 | 2741 | The fee for item 2739 | 30.30 | 2.40 |
4 | 2745 | The fee for item 2743 | 30.30 | 2.40 |
15 Subclause 2.20.2A(1) of Schedule 1 (table 2.20.2A)
Repeal the table, substitute:
Table 2.20.2A—Amount under clause 2.20.2A | ||||
Item | Column 1 Item of this Schedule | Column 2 Fee | Column 3 Amount if not more than 6 patients (to be divided by the number of patients) ($) | Column 4 Amount if more than 6 patients ($) |
1 | 285 | The fee for item 283 | 24.25 | 1.90 |
2 | 287 | The fee for item 286 | 24.25 | 1.90 |
3 | 311 | The fee for item 309 | 24.25 | 1.90 |
4 | 315 | The fee for item 313 | 24.25 | 1.90 |
16 Subclause 2.30.1(1) of Schedule 1
Omit “$62.65”, substitute “$64.15”.
17 Subclause 2.30.1(2) of Schedule 1
Omit “$45.50”, substitute “$46.60”.
18 Subclause 5.7.1(1) of Schedule 1 (paragraph (b) of the definition of amount under clause 5.7.1)
Omit “$21.65”, substitute “$22.15”.
19 Subclause 5.7.1(2) of Schedule 1 (paragraph (b) of the definition of amount under clause 5.7.1)
Omit “$32.60”, substitute “$33.40”.
20 Clause 5.9.1A of Schedule 1
Omit “an item in Group T10”, substitute “this Division”.
21 Clause 5.9.1A of Schedule 1 (definition of base unit)
Omit “$22.55”, substitute “$23.10”.
22 Clause 5.9.2 of Schedule 1 (paragraph (a) of the definition of amount under clause 5.9.2)
Omit “$112.85”, substitute “5 base units”.
23 Schedule 1 (items 51300, 51303, 51800 and 51803, column 2)
Omit “$636.05” (wherever occurring), substitute “$651.30”.
24 Clause 2.1.2 of Schedule 1 (before the table)
Insert:
Note: The fees in Group P1 are indexed in accordance with clause 2.14.1.
25 Clause 2.4.2 of Schedule 1 (before the table)
Insert:
Note: The fees in Group P4 are indexed in accordance with clause 2.14.1.
26 Clause 2.5.6 of Schedule 1 (before the table)
Insert:
Note: The fees in Group P5 are indexed in accordance with clause 2.14.1.
27 Clause 2.6.2 of Schedule 1 (note)
Repeal the note, substitute:
Note 1: The fees in Group P6 are indexed in accordance with clause 2.14.1.
Note 2: See clause 2.5.4 in relation to the restriction that applies if certain services in Groups P5 and P6 are performed in a single patient episode.
28 Clause 2.8.1 of Schedule 1 (before the table)
Insert:
Note: The fees in Group P8 are indexed in accordance with clause 2.14.1.
29 Clause 2.14.1 of Schedule 1 (heading)
Omit “1 July 2024”, substitute “1 July 2025”.
30 Subclause 2.14.1(1) of Schedule 1
Repeal the subclause, substitute:
(1) At the start of 1 July 2025 (the indexation time), each amount covered by subclause (1A) is replaced by the amount worked out using the following formula:
Note: The indexed fees could in 2025 be viewed on the Department’s MBS Online website (http://www.health.gov.au).
(1A) The amounts covered by this subclause are the fee for each item in the following:
(a) Group P1 (haematology services);
(b) Group P4 (immunology services);
(c) Group P5 (tissue pathology services);
(d) Group P6 (cytology services);
(e) Group P8 (infertility and pregnancy test services);
(f) Group P12 (management of bulk‑billed services).