Know what Medicare pays for an item.
Give an MBS item number, the number of patients seen and the setting. The Benefit Calculator returns the schedule fee, the benefit for each patient and the total, with how each figure was worked out.
- Schedule fee
- $53.35per patient
- Benefit
- $53.35per patient
- Setting
- Out of hospital
Medicare item 5010 has a derived fee: the fee for item 5000 ($34.70), plus $55.95 divided by the number of patients seen (3), rounded to the nearest 5 cents. The schedule fee is $53.35 per patient, and Medicare pays a benefit of 100% of that fee, as published in the MBS Ready Reckoner.
Type the item and the patients seen. RebateRight works out the amount.
Watch the web app price a sample item, from the first number typed to what Medicare pays.
- Home
- Connection Settings
- Patient Verification
- Eligibility Check
- Bulk Eligibility Check
- MBS Item Lookup
- Benefit Calculator
- RebateRight Insights
Enter an item number above and select Calculate to see the benefit.
- Schedule fee
- $53.35per patient
- Benefit
- $53.35per patient
- Setting
- Out of hospital
Medicare item 5010 has a derived fee: the fee for item 5000 ($34.70), plus $55.95 divided by the number of patients seen (3), rounded to the nearest 5 cents. The schedule fee is $53.35 per patient, and Medicare pays a benefit of 100% of that fee, as published in the MBS Ready Reckoner.
- Rules engineMBS rules, turned into code
- MBS itemsAbout 6,000 items and rules
-
Type the item number and the patients seen.
-
Click Calculate.
-
See what Medicare pays, and how.
Every figure shows its working.
The result carries one sentence on how the amount was reached, which you can show to staff or a patient as it is.
Published fee
The benefit is the amount the MBS publishes for the item. Where an item pays differently in and out of hospital, the setting decides which amount applies.
Derived fee
Some attendance items, such as a general practitioner seeing several residents in one aged care visit, have a fee that depends on the patients seen. The fee follows the item’s rule in the MBS Ready Reckoner.
One question, answered on its own.
No patient needed
The Benefit Calculator answers what an item pays. To know whether a particular patient may claim it, run an eligibility check, which returns the benefit for each item too.
In the web app and the API
Booking and billing staff use it in the web app, under Benefit Calculator. Your own software sends the same request to the RebateRight API.
The Benefit Calculator is in every plan.
You pick the volume you need. The features stay the same.
Answered, in full.
Does the Benefit Calculator need patient details?
No. It needs the MBS item number, the number of patients seen and whether the service is in hospital. To know whether a particular patient may claim the item, run an eligibility check.
What if there is no figure for the item?
The benefit is empty, and the reason says why it cannot be worked out.
Where can I use it?
In the web app, under Benefit Calculator, and through the RebateRight API. Both are in every plan. The docs show the request and the response.
Know the amount before you bill.
For 14 days you have the web app, the API and the test environment, with unlimited requests and no card.