MBS item 6023 ==== Initial assessment by addiction medicine specialist (minimum 45 minutes) for a patient with 2+ morbidities, including comprehensive history, physical assessment, differential diagnoses, and complex management plan provided to referring practitioner;… Category 1 · Professional attendances[Group A31 · subgroup 1](/groups/A31)Referred Schedule fee$320.55 100% benefitGP, out of hospital— 85% benefitOut of hospital$272.50 75% benefitIn hospital$240.45 The schedule fee for MBS item 6023 is $320.55. Medicare pays $272.50 (85%) out of hospital, or $240.45 (75%) for a privately admitted patient in hospital. Fee effective 1 July 2026. Gap for what you charge ----------------------- Your fee$ Out of hospitalIn hospital (private) Medicare pays$272.50 Patient gap$48.05 Bulk billing means accepting $272.50 as full payment, with no gap and no extra charges. [Add incentives](/bulk-billing?item=6023) Extended Medicare Safety Net cap: $500.00 (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 by an addiction medicine specialist in the practice of the addiction medicine specialist's specialty of at least 45 minutes for an initial assessment of a patient with at least 2 morbidities, following referral of the patient to the addiction medicine specialist by a referring practitioner, if: (a) an assessment is undertaken that covers: (i) a comprehensive history, including psychosocial history and medication review; and (ii) a comprehensive multi or detailed single organ system assessment; and (iii) the formulation of differential diagnoses; and (b) an addiction medicine specialist treatment and management plan of significant complexity that includes the following is prepared and provided to the referring practitioner: (i) an opinion on diagnosis and risk assessment; (ii) treatment options and decisions; (iii) medication recommendations; and (c) an attendance on the patient to which item 104, 105, 110, 116, 119, 132, 133, 6018, 6019, 91825, 92422, 92423, 92440 or 92443 applies did not take place on the same day by the same addiction medicine specialist; and (d) a service to which this item or item 132 applies has not been provided to the patient by the same addiction medicine specialist in the preceding 12 months [Explanatory notes and rules on MBS Online ↗](https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=6023) 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=6023) before billing. This is a reference tool, not billing or financial advice.