Guaranteeing Medicare – Medical Benefits Schedule Review – Chemotherapy Services

The Australian Government is making changes to Medicare-funded Chemotherapy services to support best practice treatment and improve patient experience and safety. These changes follow recommendations from the Medicare Benefits Schedule (MBS) Review Taskforce (the Taskforce).

Page last updated: 17 December 2019

Guaranteeing Medicare – Medical Benefits Schedule Review – Chemotherapy Services (PDF 133 KB)
Guaranteeing Medicare – Medical Benefits Schedule Review – Chemotherapy Services (Word 76 KB)

What are the changes?

From 1 November 2020, Medicare-funded chemotherapy will move to a single service replacing the current time-tiered approach.

The Taskforce reviewed 12 chemotherapy items and made recommendations to simplify chemotherapy administration by introducing a single MBS service to cover each occasion chemotherapy is administered to a patient.

The changes will simplify the way chemotherapy is funded under Medicare to better reflect the modern clinical practice of chemotherapy. Removing time-tiering based on the number of hours over which a single treatment is administered will enable doctors to focus on patients receiving the most appropriate treatment.

Why are these changes being made?

These changes were recommended by the independent MBS Review Taskforce, following a comprehensive review of the MBS items by clinicians, health system experts and consumers.

The revised item descriptors better reflect the procedures being performed by practitioners and contemporary best-practice. These changes will also ensure that claims are consistent and appropriate.

What does this mean for patients and providers?

Patients and providers will benefit from a simplified MBS structure for chemotherapy procedures, which more accurately reflects medical professional involvement in the oversight and management of therapeutic agents and their associated (side) effects on patients, as opposed to the physical administration of chemotherapy.

Further detail will be available on MBS Online website.

The Medicare Benefits Schedule Review Taskforce - Report from the Oncology Clinical Committee 2018 can be downloaded from the Department’s website.