Consultation on a proposed new Private Health Insurance (PHI) classification spreadsheet template

Overview

The Department of Health, Disability and Ageing (the department) is seeking feedback on a proposed new Private Health Insurance (PHI) classification spreadsheet template.  

The proposed template aims to improve the usability and clarity of the PHI spreadsheet and better support stakeholders in implementing Medicare Benefits Schedule (MBS) changes.  

The department has identified opportunities to:  

• reduce duplication with the MBS XML file 

• improve visibility of changes between spreadsheet versions  

• streamline implementation processes for insurers and other stakeholders   

• include the scope of cover Private Health Insurance clinical category definitions document within the PHI spreadsheet.   

It is anticipated that the revised template, incorporating feedback as necessary, will replace the existing spreadsheet format for MBS changes taking effect 1 July 2026. 

Background 

The PHI spreadsheet is published alongside MBS updates to support accurate payments for insurers and medical practitioners by providing information on clinical categories and procedure types.  

Stakeholder feedback and an internal review have identified several limitations with the current format including: 

• duplication of data already available in the MBS XML file (e.g. item descriptors and fees)  

• limited visibility of changes between versions  

• the manual effort required to reconcile updates.  

These challenges are becoming more significant due to:  

• increasing frequency of MBS updates  

• indexation cycles resulting in multiple releases within short timeframes.  

Why your views matter

This consultation seeks stakeholder feedback on the proposed changes to the PHI spreadsheet template. 

Your feedback will:  

• inform refinement of the proposed template  

• support decisions on implementation approach and timing 

• help ensure the template meets stakeholder operational needs.  

You are invited to submit your feedback by completing the survey by Friday 15 May 2026.