Assignment of benefit: 22 questions from practice teams, answered.
Detailed answers to the assignment of benefit questions GP practice teams ask, from verbal consent and SMS replies to enduring agreements and audits.
The key point
Most assignment of benefit questions come back to three rules. Every bulk-billed service needs an agreement recorded in any format before the claim is lodged. Verbal agreement is allowed in any setting until 30 June 2027, as long as it is recorded. The practice keeps each agreement for 2 years from the claim date. The answers below apply those rules to the situations practice teams ask about.
Why do patients have to agree to be bulk billed?
Because bulk billing means the patient’s Medicare benefit is paid to the practitioner instead of to the patient, and the patient has to agree to that.[1][3] The practitioner accepts the benefit as full payment, so the patient pays nothing for the service.[1][3]
This is not new: patients have always had to give this permission.[1] What changed on 1 July 2026 is how the agreement is recorded and who keeps it.[1][2] Our guide to the assignment of benefit changes sets out those changes in full.
Is the DB4E or DB020 form still required?
The forms are no longer required, but they can still be used: the approved-form requirement ended on 1 July 2026.[1][2] Updated DB4E and DB020 forms can be used for post-service agreements.[1][2] DB020 is used only with Health Professional Online Services (HPOS) Bulk Bill Webclaim.[1][2] Any paper or electronic format is also acceptable if it records the required details.[1][2]
For example, a practice can take agreement in its booking system at check-in, by SMS link, on a tablet at reception, or on paper. The format is the practice’s choice; the content is not.
What details must an agreement include?
An episodic agreement needs seven details, set out in section 65C of the Health Insurance Regulations 2018.[1][4] One of them records whether the person agreeing (the assignor) is the patient.[4] An agreement missing any of them is not valid.[1]
The exact elements differ between pre-service and post-service agreements, and the Department’s FAQ sets them out in a table.[1][4] Check your template or software against that table rather than against a vendor summary. The Department cannot approve or certify templates or software, so the practice remains responsible for what its agreement records.[1]
For a GP service, the regulation lists the seven elements as shown below.[4] Pathology and diagnostic imaging services record different service details.[4]
| Data element | Pre-service agreement | Post-service agreement |
|---|---|---|
| Patient | Name of the patient who will receive the service | Name of the patient who received the service |
| Agreement date | Date the agreement is entered into | Date the agreement is entered into |
| Agreement type | States that it is a pre-service agreement | States that it is a post-service agreement |
| Practitioner | Name and practice address, or provider number | Name and practice address, or provider number |
| Service date | Date the service will be provided | Date the service was provided |
| Service | Basic Service Description for the service | Medicare Benefits Schedule (MBS) item number of the service |
| Assignor | Whether the assignor is the patient (yes or no) | Whether the assignor is the patient (yes or no) |
Can a patient agree verbally, and how should reception record it?
Yes, for any bulk-billed service in any setting, until 30 June 2027.[1][6] The agreement must state that verbal agreement was given and the date it was obtained.[6] Everything else is the same as a signed agreement: the same details and the same 2-year retention.[1][6] Services Australia also asks you to explain to the patient how their verbal agreement will be recorded and confirm they agree, and on its own forms to type "assignor verbally agreed" in the assignor signature field.[2]
You do not need to record why a signature was not taken.[6] What you cannot do is treat a conversation as the record. For example, if a patient agrees at the desk, the receptionist completes the agreement in the software, marks it as a verbal agreement with the date, and the record is stored with the claim.
What happens to verbal consent after 30 June 2027?
From 1 July 2027, new agreements need a paper or electronic signature.[1][6] A verbal agreement made before then can still support a claim for a service after that date if the other requirements are met, for example a pre-service agreement for a planned visit.[6]
Verbal enduring agreements are different: they all end at the start of 1 July 2027, whenever they were made.[6] Plan the move to signed consent, and re-sign enduring patients, before that date.
Is an SMS reply of YES enough?
It can be, if you can show who replied, what they agreed to, and keep an auditable record.[1] An electronic signature must meet the Electronic Transactions Act 1999, which means identifying the person and showing that they agreed.[1]
In practice, that means the SMS should contain or link to the agreement details, the reply should come from the patient’s or assignor’s number on file, and the message, reply and timestamps should be kept with the claim records for 2 years.
Can we take agreement on the EFTPOS terminal with Easyclaim?
Yes. When claiming through Medicare Easyclaim, the patient, or their parent, guardian or other responsible person, can agree by pressing OK or YES on the EFTPOS terminal.[2] That counts as an electronic signature.[1]
Who can sign for a patient, and at what age can a child sign?
The patient, or an assignor acting for them, such as a parent, guardian, carer, partner or relative.[1] Generally, a child aged 14 or older can make their own agreement; children under 14 usually need a parent, guardian or other responsible person.[1]
Age is a guide rather than a strict rule, so use judgement where a young person is managing their own care.[1]
Can reception staff or the GP sign on a patient’s behalf?
No. The treating practitioner and practice staff should not act as the assignor, because it may be a conflict of interest.[1] Services Australia also excludes the health professional who provided the service and their staff from acting as a responsible person for the patient.[2] Without an agreement from the patient or a suitable assignor, the service cannot be bulk billed.[1]
What if a patient does not agree?
Then the service cannot be bulk billed.[1][2] The patient should be billed privately and can claim their Medicare benefit from Services Australia.[1] For unpaid or partly paid accounts, the 90 Day Pay Doctor Cheque Scheme may also be available.[1]
It helps to explain to the patient that agreeing does not cost them anything: it simply lets Medicare pay the practice directly.[1]
Can one agreement cover several visits?
Yes, if the visits are planned. A pre-service agreement can cover services scheduled up to six months ahead, provided the service dates, practitioner and services are known in advance.[1] It stays valid until those services are claimed.[1]
For example, a patient booked for a series of planned visits with the same GP can agree once at booking. An unplanned extra service that the agreement does not describe needs a new agreement before it is claimed.[1]
What if the service or the GP changes, or the agreement needs correcting?
Get a new agreement. A pre-service agreement describes the expected service using a Basic Service Description from MBS Online; if the service delivered falls under a different description, a new agreement is needed.[1] An agreement also covers one practitioner, so a different GP needs a new one.[1]
An agreement cannot be edited once the patient or assignor has agreed: if the assignor, the practitioner or the services change, take a new agreement rather than amending the old one.[1]
The simplest safeguard is a check before claiming: does the service delivered match the description agreed, and is it the same practitioner? If not, take a post-service agreement before the claim goes.
Which patients can have an enduring agreement, and does it cover every GP?
Only three groups: MyMedicare-registered patients, residents of residential aged care homes, and patients of an Aboriginal Community Controlled Health Organisation (ACCHO) or Aboriginal Medical Service (AMS).[1][3][5] For MyMedicare patients, the agreement names one GP at the registered practice, so a patient who sees two GPs needs two agreements.[1][2][3]
One enduring agreement does not cover every GP at the practice: agreements are made per practitioner, and a patient can make several at the same practice.[2][3] The agreement must describe the services it covers, by MBS category, group, subgroup or item.[1][5] Every in-scope service must be bulk billed while it is in effect.[1]
How do we notify MyMedicare patients under an enduring agreement?
In writing, within 24 hours of submitting each Medicare claim, and within 24 hours of finding an error in an earlier notification.[1][5] The notification goes by the method named in the agreement, such as SMS or email.[1]
It must include the practitioner’s name, the patient’s name, the date of the service and the Medicare benefit claimed, and it must be dated.[1][5] Keep copies with the agreement for 2 years.[1] Aged care and ACCHO or AMS enduring agreements do not need these notifications.[1]
How long does an enduring agreement last?
A signed enduring agreement lasts 12 months, and ends then unless it is registered with Services Australia.[2][5] A verbal one ends at the start of 1 July 2027, whenever it was made.[6] This applies to enduring agreements made between 1 July 2026 and 30 June 2027.[5][6]
So a verbal enduring agreement made in May 2027 lasts only one to two months.[6] From 1 July 2027, the practice must lodge each new enduring agreement for registration with Services Australia, or make it in Services Australia software.[5]
Keep a list of every enduring agreement with the date it was made. If an agreement lapses at 12 months and nobody notices, the claims that follow have no valid agreement behind them, and the job usually sits with one person at reception.
Can an enduring agreement be cancelled or paused?
It can be cancelled, but not paused.[1] Any party (the patient, the assignor or the practitioner) can end it by written notice, and it ends 2 business days after notice is given.[5] There is no way to suspend an enduring agreement and resume it later, so a new agreement is needed.[1]
A MyMedicare enduring agreement also ends automatically if the patient is no longer registered with MyMedicare or the named GP is no longer at the practice.[1][5]
Do we send agreements to Services Australia?
For electronic claims, no: the agreement stays with the practice.[1] For manual pre-service or post-service claims, yes: a copy goes with the claim.[1] When a claim is lodged electronically, through practice software or Medicare Easyclaim, the agreement is kept with the records supporting the claim and produced only if Services Australia asks for it.[1]
For a manual claim under an enduring agreement, do not send the agreement: write "enduring assignment provided" in the assignor signature field.[2] Completed agreements never go to the Department of Health.[1]
How long do we keep agreements, and who is responsible if a vendor stores them?
Two years from the date the claim is made, on paper or electronically, secure and retrievable.[1][2] The practitioner must give the patient a copy if they ask.[1][2]
Responsibility stays with the claiming practitioner even when a booking, SMS or payments vendor holds the record.[1] Before relying on a vendor, check that you can retrieve any agreement for any claim within the 2 years.
Do telehealth consultations need a different agreement?
No. Telehealth now follows the same rules as face-to-face care: pre-service or post-service agreement, the same details, the same signature rules and 2-year retention.[1] Verbal agreement for telehealth is available only until 30 June 2027, like any other service.[1][6] MyMedicare and aged care enduring agreements can cover telehealth consultations with the named GP.[1]
What if our software is not ready?
Digital systems are not mandatory.[1] A practice can use paper agreements, the updated Services Australia forms, the Department’s optional templates, or its own compliant agreement.[1] Whatever the format, agreements must be kept for 2 years.[1]
Paper works, but it is manual on every visit: printing, signing, filing or scanning, then finding the right agreement for a claim when Services Australia asks. For a busy front desk that adds up quickly, which is why consent is worth moving into booking, SMS or practice software as soon as it is ready.
What happens if we cannot produce an agreement in an audit?
The benefit paid for that claim may be recovered.[1] Services Australia can request agreements for audits, reviews and payment checks.[1] The Department describes a risk-based approach that starts with education during the transition, but that does not remove the need to hold a valid agreement for every bulk-billed claim.[1][3]
Claims made with the old "patient unable to sign" indicator after 1 July 2026 may need to be corrected and resubmitted.[2]
If you are not sure every bulk-billed claim since 1 July 2026 has a valid agreement behind it, find out now rather than in an audit. A billing review shows where claims need a closer look before they are questioned. Request a free billing optimisation report ↗
Do pathology request forms issued before 1 July 2026 still work?
Yes, for a limited time. A pathology request with a valid assignment issued before 1 July 2026 can still be relied on during the transition, but not after 1 July 2027.[1][2] Requests issued on or after 1 July 2026 must meet the new requirements, but GPs do not need new request forms immediately.[1]
Check your team
Further reading
References checked on 5 September 2026.
- [1] Department of Health: assignment-of-benefit FAQ, 27 August 2026 ↗
- [2] Services Australia: assignment of benefit for bulk bill claims ↗
- [3] Department of Health: improving the assignment of benefit process ↗
- [4] Federal Register of Legislation: Assignment of Medicare Benefits and Other Measures Regulations 2025 (F2025L00983) ↗
- [5] Federal Register of Legislation: enduring agreements regulations, explanatory statement (F2026L00824) ↗
- [6] Federal Register of Legislation: verbal agreement regulations 2026, explanatory statement (F2026L01041) ↗
Disclaimer: this guide is general information for Australian general practices. It is not clinical, legal or billing advice for your circumstances; check MBS Online and Services Australia before you bill.
