MBS item

10992
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Bulk-billed unreferred medical service provided by an out-of-area practitioner to a non-admitted patient in regional/remote Modified Monash areas 2-7, outside consulting rooms.

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 10992 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=10992)

Item descriptor
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A medical service to which: (a) item 585, 588, 591, 594, 599, 600, 5003, 5010, 5220 or 5260 applies; or (b) item 761 or 772 applies (see the Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Determination 2018); if: (c) the service is an unreferred service; and (d) the service is provided to a person who is not an admitted patient of a hospital; and (f) the service is not provided in consulting rooms; and (g) the service is provided in any of the following areas: (i) a Modified Monash 2 area; (ii) a Modified Monash 3 area; (iii) a Modified Monash 4 area; (iv) a Modified Monash 5 area; (v) a Modified Monash 6 area; (vi) a Modified Monash 7 area; and (h) the service is provided by, or on behalf of, a medical practitioner whose practice location is not in an area mentioned in paragraph (g); and (i) the service is bulk‑billed in relation to the fees for: (i) this item; and (ii) the other item mentioned in paragraph (a) or (b) applying to the service

[Explanatory notes and rules on MBS Online ↗](https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=10992)

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=10992) before billing. This is a reference tool, not billing or financial advice.