MBS item 18375 ===== Intravesical botulinum toxin A injection via cystoscopy for neurogenic detrusor overactivity incontinence (MS, spinal cord injury, or spina bifida) in adults aged 18+ who failed anticholinergics (≥14 episodes/week) and can self-catheterise; repeatabl… Category 3 · Therapeutic procedures[Group T11](/groups/T11) Schedule fee$275.15 100% benefitGP, out of hospital— 85% benefitOut of hospital— 75% benefitIn hospital$206.40 The schedule fee for MBS item 18375 is $275.15. Medicare pays $206.40 (75%) for a privately admitted patient in hospital. Fee effective 1 July 2026. Gap for what you charge ----------------------- Your fee$ In hospital (private) Medicare pays$206.40 Fund pays (minimum)$68.75 Patient gap$0.00 Assumes a privately admitted patient whose hospital cover includes this service. The fund must pay at least 25% of the schedule fee. Pick a fund rate below to see its no-gap or known-gap split. Item descriptor --------------- Botulinum Toxin Type A Purified Neurotoxin Complex (Botox), intravesical injection of, with cystoscopy, for the treatment of urinary incontinence, including all such injections on any one day, if: (a) the urinary incontinence is due to neurogenic detrusor overactivity as demonstrated by urodynamic study of a patient with: (i) multiple sclerosis; or (ii) spinal cord injury; or (iii) spina bifida and who is at least 18 years of age; and (b) the patient has urinary incontinence that is inadequately controlled by anti-cholinergic therapy, as manifested by having experienced at least 14 episodes of urinary incontinence per week before commencement of treatment with botulinum toxin type A; and (c) the patient is willing and able to self-catheterise; and (d) the requirements relating to botulinum toxin type A under the Pharmaceutical Benefits Scheme are complied with; and (e) treatment is not provided on the same occasion as a service described in item 104, 105, 110, 116, 119, 11900 or 11919 For each patient - applicable not more than once except if the patient achieves at least a 50% reduction in urinary incontinence episodes from baseline at any time during the period of 6 to 12 weeks after first treatment (Anaes.) [Explanatory notes and rules on MBS Online ↗](https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=18375) 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=18375) before billing. This is a reference tool, not billing or financial advice.