MBS item 18360 ===== Botulinum toxin injection for moderate to severe focal spasticity in adults with neurological disorder, as second-line or adjunctive therapy, targeting one functional muscle group; maximum 4 sets per day (2 per limb). Category 3 · Therapeutic procedures[Group T11](/groups/T11) Schedule fee$149.45 100% benefitGP, out of hospital— 85% benefitOut of hospital$127.05 75% benefitIn hospital$112.10 The schedule fee for MBS item 18360 is $149.45. Medicare pays $127.05 (85%) out of hospital, or $112.10 (75%) for a privately admitted patient in hospital. Fee effective 1 July 2026. Gap for what you charge ----------------------- Your fee$ Out of hospitalIn hospital (private) Medicare pays$127.05 Patient gap$22.40 Bulk billing means accepting $127.05 as full payment, with no gap and no extra charges. [Add incentives](/bulk-billing?item=18360) Item descriptor --------------- Botulinum Toxin Type A Purified Neurotoxin Complex (Botox), or Clostridium Botulinum Type A Toxin Haemagglutinin Complex (Dysport), injection of, for the treatment of moderate to severe focal spasticity, if: (a) the patient is at least 18 years of age; and (b) the spasticity is associated with a previously diagnosed neurological disorder; and (c) treatment is provided as: (i) second line therapy when standard treatment for the conditions has failed; or (ii) an adjunct to physical therapy; and (d) the treatment is for all or any of the muscles subserving one functional activity and supplied by one motor nerve, with a maximum of 4 sets of injections for the patient on any one day (with a maximum of 2 sets of injections for each limb), including all injections per set; and (e) the treatment is not provided on the same occasion as a service mentioned in item 18365 [Explanatory notes and rules on MBS Online ↗](https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=18360) 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=18360) before billing. This is a reference tool, not billing or financial advice.