MBS item 115 === Specialist consultation on day of scheduled surgery ($359.05+) when clinically urgent and unrelated to the operation. Category 1 · Professional attendances[Group A3](/groups/A3)Referred Schedule fee$52.25 100% benefitGP, out of hospital— 85% benefitOut of hospital$44.45 75% benefitIn hospital$39.20 The schedule fee for MBS item 115 is $52.25. Medicare pays $44.45 (85%) out of hospital, or $39.20 (75%) for a privately admitted patient in hospital. Fee effective 1 July 2026. Gap for what you charge ----------------------- Your fee$ Out of hospitalIn hospital (private) Medicare pays$44.45 Patient gap$7.80 Bulk billing means accepting $44.45 as full payment, with no gap and no extra charges. [Add incentives](/bulk-billing?item=115) Extended Medicare Safety Net cap: $156.75 (300% of the schedule fee, up to $500.00). Once a patient reaches the EMSN threshold, the extra benefit for this item is 80% of their out-of-pocket cost, but no more than this cap. [How safety nets work](/guides/medicare-safety-nets) Item descriptor --------------- Professional attendance at consulting rooms or in hospital on a day by a medical practitioner (the attending practitioner) who is a specialist or consultant physician in the practice of the attending practitioner’s specialty after referral of the patient to the attending practitioner by a referring practitioner—an attendance after the initial attendance in a single course of treatment, if: (a) the attending practitioner performs a scheduled operation on the patient on the same day; and (b) the operation is a service to which an item in Group T8 applies; and (c) the amount specified in the item in Group T8 as the fee for a service to which that item applies is $359.05 or more; and (d) the attendance is unrelated to the scheduled operation; and (e) it is considered a clinical risk to defer the attendance to a later day For any particular patient, once only on the same day [Explanatory notes and rules on MBS Online ↗](https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=115) Health fund and DVA rates ------------------------- Total fee each scheme recognises for this item in hospital. StateNSWVICQLDSAWATASACTNT 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=115) before billing. This is a reference tool, not billing or financial advice.