Read the relevant item descriptions, fact sheets and explanatory notes on the MBS Online website.
If you’re an eligible midwife, you can get Medicare benefits for services you provide. These are for clinically relevant services appropriate for treating your patients.
You can request certain pathology and diagnostic imaging services for your patients. You can also refer them to an obstetrician and a paediatrician for a clinical need.
Midwife Medicare Benefits Schedule (MBS) item numbers
You can find midwife items in:
- Category 8 - Miscellaneous services
- Group M13 Midwifery services
- Group M19 Midwifery video and phone services.
The items include services for:
- assessing and preparing a maternity care plan
- antenatal attendances
- intrapartum attendances
- postnatal attendances, up to 6 weeks after delivery.
Midwife services can be performed and billed through telehealth. Read Telehealth MBS items to learn more.
To get a payment, you must perform the service, meet the description and all requirements of the MBS item.
When billing time-based items, you can’t include time the patient wasn’t receiving active attention. This includes the time you take for any of these:
- to travel to the patient’s home
- for a break
- to complete patient records.
Non-billable services
You can’t bill MBS items for either of the following:
- services provided where the patient isn’t in attendance, such as the issuing of repeat prescriptions
- group sessions.
Billing requirements
To bill MBS items for services you provide in private practice all of the following need to apply. You need to:
- have a Medicare provider number for each location you’re practicing at
- have professional indemnity insurance
- be registered with and satisfy the Registration Standards of the Nursing and Midwifery Board of Australia
- be an endorsed midwife who holds an endorsement for scheduled medicines
- work in a private practice or in a public facility that has an exemption under subsection 19(2) of the Health Insurance Act 1973.
The relevant Ahpra endorsement must state that you’re an endorsed midwife qualified to prescribe schedule 2, 3, 4 and 8 medicines and to provide associated services required for midwifery practice in accordance with relevant state and territory legislation.
If you’re an eligible midwife, you may be able to apply online for your additional Medicare provider number and PBS prescriber number. Read more about eligibility and how to apply online.
As an eligible midwife you must have a Medicare provider number to bill MBS items. You need a separate provider number for each location you’re practicing at.
If you can’t apply online, you can use the Application for a Medicare provider number and/or PBS prescriber number for a midwife or nurse practitioner form (HW088).
Private practice
You need to work in private practice or in a public facility that has an exemption under subsection 19(2) of the Health Insurance Act 1973 to bill MBS items. This allows you to either charge your patient a fee, or bulk bill the service.
You’re not working in private practice if you provide a service on behalf of a state or territory government.
You can’t bill a public patient for a service you provide in a public hospital.