Nurse Practitioner Billing and Medicare: The 2024 Changes

In November 2024, the Australian Government expanded Medicare rebates for Nurse Practitioner services, introducing new MBS item numbers, increasing rebate values, and broadening the range of services eligible for bulk billing. For eligible patients at Abby Health, this means more consultations and services can now be bulk billed for eligible patients — without any change to how you book or who you see.

Why the Government changed NP Medicare billing

For most of the history of Nurse Practitioners in Australia, their Medicare billing arrangements reflected an older view of the profession — as a secondary or supplementary role rather than an independent clinical one. The 2024 reforms, developed by the Department of Health and Aged Care (DoHAC) in consultation with the nursing sector, were designed to close that gap.

The changes recognised that Nurse Practitioners now fill critical primary care roles — particularly in rural and remote areas, aged care, and community health — and that patients seeing an NP should not face greater out-of-pocket costs or reduced Medicare support than patients seeing a GP for the same type of presentation. Closing that gap was the policy intent.

The reforms are also part of a broader Government agenda to expand the primary care workforce and address the shortage of GPs in underserved communities, including those in regional and remote Australia (Department of Health and Aged Care).

What changed in November 2024: the key reforms

New MBS item numbers for Nurse Practitioner consultations

Prior to November 2024, Nurse Practitioners billed under a limited set of MBS items that did not fully reflect the range of services they provide. The November 2024 changes introduced a revised and expanded set of item numbers through the MBS Online schedule, better aligned with the consultation types, durations, and clinical complexity that Nurse Practitioners routinely manage.

These new items apply across telehealth and in-person consultations. For telehealth specifically — video and phone — this means that NP consultations conducted online now attract Medicare rebates at the updated rates, consistent with in-person equivalents where applicable.

Increased rebate values

The Schedule Fee (the base from which Medicare calculates its rebate) was increased for many Nurse Practitioner items. This increase reduces the gap between what Medicare contributes toward an NP consultation and what it contributes toward a comparable GP consultation. For patients at clinics that bulk bill for eligible patients, the practical effect is that fewer services require an out-of-pocket contribution.

Services Australia administers the payment of Medicare benefits under the Health Insurance Act 1973. Rebate amounts are updated periodically through the MBS Review process and are publicly accessible through the Services Australia Medicare portal and MBS Online.

Broadened scope of rebatable services

The 2024 changes extended which services Nurse Practitioners can provide within the Medicare Benefits Schedule. Key areas of expansion include:

Longer consultations billed at appropriate complexity levels — where a Nurse Practitioner conducts a detailed or complex consultation, the updated item numbers better reflect that clinical work and are rebated accordingly.

Mental health services — Nurse Practitioners gained access to expanded mental health-related MBS items, enabling them to provide assessment, support, and certain referral pathways under the MBS framework. Note: Mental Health Care Plans under Medicare's Better Access initiative remain the domain of GPs and psychiatrists. For clarity on what each clinician can do in mental health, see when you'll see an NP vs a GP at Abby.

Chronic disease management services — Nurse Practitioners can now participate in a wider range of Medicare-rebated chronic disease management items, supporting patients with ongoing conditions through structured care planning and reviews.

Allied health referrals and care coordination — Certain NP-initiated referral pathways have been extended, enabling Nurse Practitioners to directly connect patients with allied health professionals within rebated frameworks.

What this means for patients at Abby

For patients at Abby Health, the November 2024 changes have practical effects on which services are available without an out-of-pocket cost. Consultations that previously may have required a gap payment — or which could only be managed by a GP under the Medicare schedule — can now be bulk billed for eligible patients with a Nurse Practitioner.

This matters particularly for the patients Abby was built to serve: those in rural and remote communities where GP access is limited, Australians managing cost-of-living pressures, and patients who need continuity of primary care without financial friction at every step.

Abby Health operates as one of Australia's largest online-first clinics, with 300+ clinicians available 7 days a week, 365 days a year (Abby Health internal data, Q1 2026). With the 2024 changes, more of that capacity is now covered by Medicare for eligible patients — meaning access extends further without cost acting as a barrier.

The relationship between NP billing and PBS prescribing

The November 2024 Medicare reforms focused on MBS consultation items — the rebates patients receive for seeing a clinician. These are separate from the Pharmaceutical Benefits Scheme (PBS), which governs prescribing subsidies.

Nurse Practitioners have PBS prescribing authority for medications within their scope. This predates the 2024 changes and was not directly altered by them — though the broader expansion of NP scope that the 2024 reforms reflect is consistent with the policy trajectory toward full NP prescribing authority within defined practice areas.

For a full picture of what Nurse Practitioners can and cannot prescribe, see what Nurse Practitioners can and can't do and what a Nurse Practitioner is in Australia.

How to check current MBS item numbers

MBS item numbers and Schedule Fees are updated periodically. The most current information is always available at MBS Online, the official Government resource for Medicare Benefits Schedule information. Services Australia also publishes guidance on how Medicare rebates are calculated at servicesaustralia.gov.au/medicare.

If you have a specific question about the cost of your appointment at Abby, the booking confirmation will confirm whether your consultation will be bulk billed for eligible patients. You can also contact Abby's patient support team before booking.

NP billing in the context of Abby's care model

Abby's model pairs Nurse Practitioners and Specialist GPs within a single care network — not as competing options, but as complementary clinicians serving different clinical needs. Abby AI, our medical AI, prepares a consult-ready brief before every appointment, surfacing patient history, medications, and risk signals so the clinician — whether NP or GP — begins already informed. It supports the clinician. It does not diagnose, prescribe, or replace clinical judgment.

The result is a care model where the right clinician, informed by the patient's full history, can provide high-quality primary care at no out-of-pocket cost for eligible patients. The 2024 Medicare changes bring that model further into alignment with the Medicare framework — so that more patients benefit from the same level of rebate support, regardless of which type of clinician they see.

71% of Abby patients rebook with the same clinician (Abby Health internal data, Q1 2026). Continuity of care is not incidental to this model — it is the point.

Frequently asked questions

When exactly did the November 2024 NP Medicare changes take effect?

The expanded Nurse Practitioner MBS items and increased rebate values came into effect in November 2024, following a period of consultation and development by the Department of Health and Aged Care. The current schedule is available at MBS Online.

Do the 2024 changes affect telehealth NP consultations?

Yes. The updated item numbers apply to telehealth (video and phone) consultations as well as in-person consultations, consistent with the Government's permanent expansion of telehealth Medicare items from 2022.

Can a Nurse Practitioner now bulk bill for everything a GP can?

Not for every item. The 2024 reforms significantly narrowed the gap between NP and GP Medicare arrangements, but some items — including Mental Health Care Plans — remain specific to GPs. For most standard primary care consultations at Abby, eligible patients will find the appointment is bulk billed for eligible patients regardless of whether they see an NP or a GP.

How do I know if I'm eligible for bulk billing at Abby?

Medicare eligibility applies to Australian citizens, permanent residents, and people from countries with reciprocal healthcare agreements. If you hold a current Medicare card, you are generally eligible. Eligibility for specific MBS items may depend on your clinical circumstances. The booking flow will confirm billing at the time you book.

Where can I find the specific NP item numbers?

Current item numbers are published at MBS Online. Nurse Practitioner items are listed under their own section of the Schedule. Services Australia's website also provides guidance on how rebates are calculated.

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