Medicare rebate

Medicare rebate refers to the amount reimbursed to a patient or provider for qualifying medical services as outlined in the Medicare Benefits Schedule (MBS). 

The difference between the benefit and the fee 

• The difference lies between the fee charged and the rebate provided. 

• The fee is what the service provider bills. 

• The rebate is a predetermined amount set by Medicare. 

• If the provider’s fee exceeds the rebate, a gap fee applies. 

• Bulk billing indicates there is no gap fee. 

How to claim a rebate 

To claim a rebate, patients can either have it claimed automatically by the provider or pay upfront and then claim via: 

• Medicare app 

• MyGov 

• Medicare service centre 

Factors influencing rebate amounts  

• The type of service and MBS item number 

• Provider setting (whether in-person or via telehealth) 

• Concession status does not affect the value of the rebate. 

• Annual indexation might also come into play. 

Medicare rebates help Australians minimise out-of-pocket medical expenses.