MBS item 12219 ===== Unattended overnight sleep study (minimum 8 hours) for patients aged 12–17 years referred by a medical practitioner to confirm sleep apnoea diagnosis, assess treatment effectiveness, or determine respiratory support needs after clinical change, with… Category 2 · Diagnostic procedures and investigations[Group D1 · subgroup 10](/groups/D1)Referred Schedule fee$455.25 100% benefitGP, out of hospital— 85% benefitOut of hospital$387.00 75% benefitIn hospital— The schedule fee for MBS item 12219 is $455.25. Medicare pays $387.00 (85%) out of hospital. Fee effective 1 July 2026. Gap for what you charge ----------------------- Your fee$ Out of hospital Medicare pays$387.00 Patient gap$68.25 Bulk billing means accepting $387.00 as full payment, with no gap and no extra charges. [Add incentives](/bulk-billing?item=12219) Item descriptor --------------- Overnight investigation of sleep, for at least 8 hours, for a patient aged at least 12 years but less than 18 years, if: (a) the patient is referred by a medical practitioner to a qualified sleep medicine practitioner; and (b) following professional attendance on the patient (either face-to-face or by video conference), the qualified sleep medicine practitioner determines that: (i) the investigation is necessary for a purpose mentioned in paragraph (c); and (ii) an unattended sleep study is appropriate for the investigation; and (c) the purpose of the investigation is documented and is any of the following: (i) to confirm diagnosis of sleep apnoea; (ii) as a repeat investigation to assess treatment effectiveness; (iii) as a repeat investigation to determine respiratory support needs following a significant change in clinical status; and (d) during a period of sleep, there is continuous monitoring and recording of at least the following measures: (i) airflow; (ii) EMG; (iii) ECG or heart rate; (iv) EEG; (v) EOG; (vi) oxygen saturation; (vii) respiratory effort; and (e) the investigation is provided: (i) under the supervision of a qualified sleep medicine practitioner; and (ii) in accordance with current professional guidelines (including in relation to interpreting polygraphic data and preparing a report); and (f) before the investigation commences, a parent or caregiver of the patient is given: (i) written or video instructions on how to monitor the patient overnight; and (ii) a way of contacting a sleep technician to enable trouble shooting overnight; and (g) the equipment is applied to the patient by: (i) a sleep technician; or (ii) the parent or caregiver of the patient if: (A) before the set-up process commences, the parent or caregiver is given written or video instructions for how to apply the equipment; and (B) there is continuous telehealth support from a sleep technician throughout the set-up process; and (C) the use of telehealth is documented; and (h) polygraphic records are: (i) analysed (for assessment of sleep stage, arousals, respiratory events and cardiac abnormalities) using manual scoring, or manual correction of computerised scoring in epochs of not more than 1 minute; and (ii) stored for interpretation and preparation of a report; and (i) interpretation and preparation of a permanent report are provided by a qualified sleep medicine practitioner with personal direct review of raw data from the original recording of polygraphic data from the patient Applicable in relation to the first 3 investigations to which this item or item 12210, 12213 or 12218 applies in any 12 month period [Explanatory notes and rules on MBS Online ↗](https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=12219) 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=12219) before billing. This is a reference tool, not billing or financial advice.