MBS item

10991
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Bulk-billed unreferred service at a Modified Monash 2 area practice location for a non-admitted patient, excluding general practice support and MyMedicare services.

Category 8 · Miscellaneous services[Group M1 · subgroup 1](/groups/M1)

Schedule fee$13.35

100% benefitGP, out of hospital—

85% benefitOut of hospital$11.35

75% benefitIn hospital—

The schedule fee for MBS item 10991 is $13.35. Medicare pays $11.35 (85%) out of hospital. Fee effective 1 July 2026.

Gap for what you charge
-----------------------

Your fee$

Out of hospital

Medicare pays$11.35

Patient gap$2.00

Bulk billing means accepting $11.35 as full payment, with no gap and no extra charges. [Add incentives](/bulk-billing?item=10991)

Item descriptor
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A medical service to which an item in this Schedule (other than this item) applies, if: (a) the service is an unreferred service; and (b) the service is provided to a person who is not an admitted patient of a hospital; and (d) the service is bulk-billed in relation to the fees for: (i) this item; and (ii) any other item in this Schedule applying to the service; and (e) the service is provided at, or from, a practice location in a Modified Monash 2 area; other than a service associated with a service: (f) to which another item in this Group applies; or (g) that is a general practice support service; or (h) that is a MyMedicare service

[Explanatory notes and rules on MBS Online ↗](https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=10991)

Guides
------

- [How Medicare benefits work: schedule fees, 75%, 85% and 100%](/guides/how-medicare-benefits-work)
- [Medicare safety nets explained: original and extended (EMSN) thresholds for 2026](/guides/medicare-safety-nets)
- [In-hospital billing: the 75% benefit, the 25% fund benefit, and no-gap and known-gap schemes](/guides/in-hospital-billing-and-gap-cover)
- [Bulk billing incentives and BBPIP explained: 2026 amounts by MM area](/guides/bulk-billing-incentives)
- [The MBS multiple operation rule and surgical assistant fees](/guides/multiple-operation-rule)
- [Assignment of benefit for bulk billing: the changes from 1 July 2026](/guides/assignment-of-benefit-2026)
- [MBS telehealth rules: the eligible telehealth practitioner and phone items](/guides/mbs-telehealth-rules)
- [GP chronic condition management plans: items 965 and 967 explained](/guides/chronic-condition-management-plans)
- [Medicare billing compliance: claim time limits, records and the 80/20 rule](/guides/medicare-billing-compliance)

Data source: [Australian Government Medicare Benefits Schedule](https://www.mbsonline.gov.au/) · Record updated 1 September 2026. Health fund rates come from each fund's published schedule. Verify item descriptors, rules and fees on [MBS Online](https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=10991) before billing. This is a reference tool, not billing or financial advice.