MBS item

18227
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Initial intrathecal, spinal-epidural or epidural infusion of therapeutic substance during labour, provided between 8 pm–8 am weekdays or anytime weekends/public holidays, with medical practitioner attendance beyond first hour.

Category 3 · Therapeutic procedures[Group T7](/groups/T7)In hospital only (H)

Schedule fee—

100% benefitGP, out of hospital—

85% benefitOut of hospital—

75% benefitIn hospital—

MBS item 18227 has no fixed schedule fee.

Derived fee

The fee for item 18226 plus $34.25 for each additional 15 minutes or part there of beyond the first hour of attendance by the medical practitioner.

Item descriptor
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Intrathecal, combined spinal‑epidural or epidural infusion of a therapeutic substance, initial injection or commencement of, if continuous attendance by a medical practitioner extends beyond the first hour—for a patient in labour, if the service is provided between 8 pm to 8 am on any weekday, or on a Saturday, Sunday or public holiday (H)

[Explanatory notes and rules on MBS Online ↗](https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=18227)

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=18227) before billing. This is a reference tool, not billing or financial advice.