MBS Updates
Stay up to date with the latest changes to the Medicare Benefits Schedule (MBS) affecting pathology services. This page provides clear, practical information on new and updated MBS items, helping you make informed decisions and continue delivering high‑quality patient care.
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General Pathology
Test MBS Item(s) & Eligibility Criteria Introduced / Amended Rebate Status Faecal Calprotectin Testing • 66525 (New Item)
Faecal calprotectin test for the management of a symptomatic patient with diagnosed inflammatory bowel disease, requested by or on behalf of a specialist or consultant physician.1 Nov 2025 Fully Medicare-rebatable, subject to patient eligibility criteria. Vitamin B12 Testing • 66838 (Amended Item)
Quantification of either or both of total vitamin B12 and holotranscobalamin.
Applicable not more than once in 11 months.
• 66839 (Amended Item)
Quantification of methylmalonic acid or homocysteine, rendered in the same patient episode as a service to which item 66838 applies if the result of that service is inconclusive or abnormal.
Applicable not more than once in 11 months.1 July 2025 Fully Medicare-rebatable, subject to patient eligibility criteria. Urine Testing • 69333 (Amended Item)
Urine examination (including serial examinations), if:
(a) the patient has symptoms of urinary tract infection or kidney disease, or is a clinically‑indicated asymptomatic patient who is:
(i) pregnant; or
(ii) less than 16 years of age; or
(iii) a renal transplant recipient; or
(iv) suffering from recurrent urinary tract infections; or
(v) being investigated or monitored for kidney disease; or
(vi) undergoing urinary tract instrumentation, a urological procedure or transurethral resection of the prostate; and
(b) the examination is performed by any means other than simple culture by dip slide, including:
(i) cell count; and
(ii) culture; and
(iii) colony count; and
(iv) (if performed) stained preparations; and
(v) (if performed) identification of cultured pathogens; and
(vi) (if performed) antibiotic susceptibility testing; and
(vii) (if performed) examination for pH, specific gravity, blood, protein, urobilinogen, sugar, acetone or bile salts.1 July 2025 Fully Medicare-rebatable, subject to patient eligibility criteria. BNP Testing • 66829 (New Item)
Quantitation of BNP or NT-proBNP for the exclusion of a diagnosis of heart failure in a patient presenting in a non-hospital setting to assist in decision-making regarding the clinical necessity of an echocardiogram, where heart failure is suspected based on signs and symptoms but diagnosis is uncertain.
Applicable once in any 12-month period.1 Nov 2024 Fully Medicare-rebatable, subject to patient eligibility criteria. BNP Testing • 66586 (New Item)
Quantification of BNP or NT-proBNP testing in a patient with diagnosed pulmonary arterial hypertension to monitor for disease progression.
Applicable 4 times in any 12-month period.1 July 2024 Fully Medicare-rebatable, subject to patient eligibility criteria. BNP Testing • 66585 (New Item)
Quantification of laboratory-based BNP or NT-proBNP testing in a patient with systemic sclerosis (scleroderma) to assess risk of pulmonary arterial hypertension.
Maximum of 2 tests in a 12-month period.1 Nov 2023 Fully Medicare-rebatable, subject to patient eligibility criteria. PSA Testing • 66654 (New Item)
PSA quantitation in the monitoring of high-risk patients.
For any particular patient, applicable not more than once in 11 months.
• 66655 (Amended Item)
PSA quantitation.
For any particular patient, applicable not more than once in 23 months.
• 66656 (Amended Item)
PSA quantitation in the monitoring of previously diagnosed prostatic disease (including prostate cancer, prostatitis or a premalignant condition such as atypical small acinar proliferation).
• 66659 (Amended Item)
Prostate specific antigen (PSA), quantitation of 2 or more fractions of PSA and any derived index, including, if performed, a test described in item 66656, in the follow up of a PSA result under item 66654 or 66655 that lies at:
(a) more than 2.0 ug/L but less than or equal to 5.5 ug/L for patients with a family history of prostate cancer; or
(b) more than 3.0 ug/L but less than or equal to 5.5 ug/L for patients who are at least 50 years of age but under 70 years of age; or
(c) more than 5.5 ug/L but less than or equal to 10.0 ug/L for patients who are at least 70 years of age
For any particular patient, applicable not more than once in 11 months.
• 66660 (Amended Item)
Prostate specific antigen (PSA), quantitation of 2 or more fractions of PSA and any derived index, in the monitoring of previously diagnosed prostatic disease, including, if performed, a test described in item 66656, if the current PSA level lies at:
(a) more than 2.0 ug/L but less than or equal to 5.5 ug/L for patients with a family history of prostate cancer; or
(b) more than 3.0 ug/L but less than or equal to 5.5 ug/L for patients who are at least 50 years of age but under 70 years of age; or
(c) more than 5.5 ug/L but less than or equal to 10.0 ug/L for patients who are at least 70 years of age
For any particular patient, applicable not more than 4 times in 11 months.1 Nov 2023 Fully Medicare-rebatable, subject to patient eligibility criteria. Faecal Calprotectin Testing • 66522 (New Item)
Faecal calprotectin test for the diagnosis of inflammatory bowel disease, if all the following apply:
- the patient is under 50 years of age;
- the patient has gastrointestinal symptoms suggestive of inflammatory or functional bowel disease of more than 6 weeks' duration;
- infectious causes have been excluded;
- the likelihood of malignancy has been assessed as low;
- no relevant clinical alarms are present.
• 66523 (New Item)
Faecal calprotectin test for the diagnosis of inflammatory bowel disease, if all the following apply:
- the results of a service to which item 66522 applies were inconclusive for the patient (that is, the results showed a faecal calprotectin level of more than 50 μg/g but not more than 100 μg/g);
- the patient has ongoing gastrointestinal symptoms suggestive of inflammatory or functional bowel disease;
- the service is requested by a specialist or consultant physician practising as a specialist gastroenterologist; - the request indicates that an endoscopic examination is not initially required;
- no relevant clinical alarms are present.1 Nov 2021 Fully Medicare-rebatable, subject to patient eligibility criteria. -
Genetics
Test MBS Item(s) & Eligibility Criteria Introduced / Amended Rebate Status DPYD Gene • 73322 (New Item)
Genetic testing in the DPYD gene to diagnose or predict fluoropyrimidine-induced toxicity in a patient, if:
(a) the service is requested by a specialist or consultant physician; and
(b) the service is rendered before, during or after systemic administration of chemotherapy or radio-sensitisation, with a fluoropyrimidine, to the patient; and
(c) genotyping is performed to detect DPYD variants linked to reduced or absent dihydropyrimidine dehydrogenase activity.
Applicable only once per lifetime.1 Nov 2025 Fully Medicare-rebatable, subject to patient eligibility criteria.
Cholangiocarcinoma Test Panel (DNA) • 73319 (New Item)
Detection in tumour tissue of isocitrate dehydrogenase 1 (IDH1) variant status, in a patient with histologically confirmed cholangiocarcinoma, to determine eligibility for a relevant treatment listed under the Pharmaceutical Benefits Scheme.
Applicable only once per lifetime.1 July 2025 Fully Medicare-rebatable, subject to patient eligibility criteria. Genetic Carrier Screening • 73451 (New Item)
Testing of a patient (who is pregnant or planning pregnancy) to identify carrier status for pathogenic or likely pathogenic variants in a gene mentioned in paragraph (a), (b) or (c), to determine:
(a) for the cystic fibrosis transmembrane conductance regulator (CFTR) gene—reproductive risk of cystic fibrosis;
(b) for the survival motor neuron 1 (SMN1) gene—reproductive risk of spinal muscular atrophy;
(c) or the fragile X mental retardation 1 (FMR1) gene—reproductive risk of fragile X syndrome; (other than a service associated with a service to which item 73300, 73305, 73345, 73346, 73347, 73348, 73349 or 73350 applies).
One test per lifetime.
• 73452 (New Item)
Testing of the reproductive partner of a patient who has been found to be a carrier of a pathogenic or likely pathogenic variant in the CFTR or SMN1 gene identified by testing under item 73451, for the purpose of determining the couple’s reproductive risk of cystic fibrosis or spinal muscular atrophy.
One test per condition per lifetime.1 Nov 2023 Fully Medicare-rebatable, subject to patient eligibility criteria. EndoPredict • 73306 (New Item)
Gene expression profiling testing using EndoPredict, for the purpose of profiling gene expression in formalin‑fixed, paraffin‑embedded primary breast cancer tissue from core needle biopsy or surgical tumour sample to estimate the risk of distant recurrence of breast cancer within 10 years, if:
(a) the sample is from a new primary breast cancer, which is suitable for adjuvant chemotherapy; and
(b) the sample has been determined to be oestrogen receptor positive and HER2 negative by IHC and ISH respectively on surgically removed tumour; and
(c) the sample is axillary node negative or positive (up to 3 nodes) with a tumour size of at least 1 cm and no more than 5 cm determined by histopathology on surgically removed tumour; and
(d) the sample has no evidence of distal metastasis; and
(e) pre‑testing of intermediate risk of distant metastases has shown that the tumour is defined by at least one of the following characteristics:
(i) histopathological grade 2 or 3;
(ii) one to 3 lymph nodes involved in metastatic disease (including micrometastases but not isolated tumour cells); and
(f) the service is not administered for the purpose of altering treatment decisions
Applicable once per new primary breast cancer diagnosis for any particular patient.1 Nov 2023 Partial Medicare rebate available.
Click here for further details, including current pricing.Somation Mutation Testing for NSCLC • 73437 (New Item)
A nucleic acid-based multi-gene panel test of tumour tissue from a patient with a new diagnosis of non-small cell lung cancer requested by, or on behalf of, a specialist or consultant physician, if the test is:
(a) to detect variants in at least EGFR, BRAF, KRAS and MET exon 14 to determine eligibility for a relevant treatment under the Pharmaceutical Benefits Scheme; and
(b) to detect the fusion status of at least ALK, ROS1, RET, NTRK1, NTRK2 and NTRK3 to determine eligibility for a relevant treatment under the PBS; and
(c) not associated with a service to which item 73438, 73439, 73337, 73341, 73344, 73436 or 73351 applies.
• 73438 (New Item)
A DNA-based multi-gene panel test of tumour tissue from a patient with a new diagnosis of non-small cell lung cancer requested by, or on behalf of, a specialist or consultant physician, if the test is:
(a) to detect variants in at least EGFR, BRAF, KRAS and MET exon 14; and
(b) to determine eligibility for a relevant treatment under the Pharmaceutical Benefits Scheme; and
(c) not associated with a service to which item 73437, 73337, 73436 or 73351 applies.
• 73439 (New Item)
A nucleic acid-based multi-gene panel test of tumour tissue from a patient with a new diagnosis of non-small cell lung cancer and with documented absence of activating variants of the EGFR gene, KRAS, BRAF and MET exon14, requested by, or on behalf of, a specialist or consultant physician, if the test is:
(a) for fusion status of at least ALK, ROS1, RET, NTRK1, NTRK2, and NTRK3 to determine eligibility for a relevant treatment under the Pharmaceutical Benefits Scheme; and
(b) not associated with a service to which item 73437, 73341, 73344 or 73351 applies.1 Nov 2023 Fully Medicare-rebatable, subject to patient eligibility criteria
Related Pages
Bulk-Billed Genetic Carrier Screening
Associate Professor Mirette Saad provides details on routine bulk-billed genetic carrier screening for CF, SMA, and FXS, including Medicare eligibility criteria and result interpretation.
Understanding BNP Testing
Dr David Deam highlights the clinical utility of a new Medicare item number for BNP testing for the exclusion of a diagnosis of heart failure, which broadens the range of clinical situations in which the test can be ordered.
Calprotectin & IBD
In this clinical article, Associate Professor Louise Smyth discusses the role of calprotectin testing in the diagnosis and management of IBD.