Assignment of benefit changes 2026 to 2027: what practices need to know.
What changed in Medicare assignment of benefit on 1 July 2026, what verbal agreement allows until 30 June 2027, and what your practice must record and keep.
The key point
Since 1 July 2026, every bulk-billed Medicare service needs an assignment of benefit agreement that records set details, in any paper or electronic format. The approved DB4E and DB020 forms are no longer required. Until 30 June 2027, patients can agree verbally in any setting; from 1 July 2027, new agreements need a signature. The practice, not the patient, keeps each agreement for 2 years.
What changed on 1 July 2026?
For bulk billing, assignment of benefit is the patient’s agreement for their Medicare benefit to be paid to the provider.[1][3] Patient permission was always required; the change is in how it is recorded and kept.[1]
The rules apply nationally to bulk-billed Medicare services.[1] Services funded by the Department of Veterans’ Affairs (DVA) and the Child Dental Benefits Schedule have separate arrangements.[1][2] For the questions practice teams ask most, see Assignment of benefit: 22 questions from practice teams, answered.
| Area | Before 1 July 2026 | From 1 July 2026 |
|---|---|---|
| Form | An approved form (DB4E or DB020), completed after the service | Any paper or electronic format that records the required details |
| Timing | After the service | Before the service (pre-service) or after it (post-service), as long as it is agreed before the claim is lodged |
| Who signs | The patient signed, the practitioner co-signed, and "patient unable to sign" was accepted | The patient or their assignor (someone who agrees for them, such as a parent or carer); the practitioner does not sign, and "patient unable to sign" is no longer accepted |
| Verbal agreement | Telehealth-only fallback | Any bulk-billed service, any setting, until 30 June 2027 |
| Standing consent | None | Enduring agreements for eligible MyMedicare, aged care and Aboriginal Community Controlled Health Organisation (ACCHO) or Aboriginal Medical Service (AMS) patients |
| Records | The patient kept a copy; practices were only advised to keep one | The practitioner keeps the agreement for 2 years from the claim date |
How the start date moved
The new rules were legislated in 2024 and their start was delayed once, from 9 January 2026 to 1 July 2026.[3] The Department says it will use the transition to explore further regulatory and legislative options, so check the Department’s page for changes before 1 July 2027.[3]
- Act passedThe Assignment of Medicare Benefits Act passed, with a start date of 9 January 2026.
- Agreement details setRegulations set out what an agreement must contain and how long it is kept.
- Start date movedThe start date moved to 1 July 2026.
- Transition announcedThe Government announced a 12-month transition, with verbal agreement allowed for all bulk-billed patients in all settings.
- New requirements startThe new requirements started, including enduring agreements for eligible patients.
- Verbal agreement regulations madeRegulations allowing verbal agreement from 1 July 2026 to 30 June 2027 were made.
- Last day for verbal agreementThis is the last day a verbal agreement can be used.
- Signatures requiredNew agreements need a paper or electronic signature, and verbal enduring agreements end.
Pre-service and post-service agreements
There is no longer a single approved form.[1][2] An agreement can be on paper, in practice software, in an online form or on a payment terminal, as long as it records the particulars set out in the Health Insurance Regulations 2018.[1][2] Services Australia has updated its DB4E and DB020 forms.[1][2] Practices can use either form for a post-service agreement, but they do not have to.[1][2] DB020 is the form for Health Professional Online Services (HPOS) Bulk Bill Webclaim.[1][2]
A pre-service agreement is made at booking, registration or check-in and describes the expected service using the Basic Service Descriptions published on MBS Online, the Medicare Benefits Schedule (MBS) website.[1][4] It can cover several planned services for up to six months, provided the service dates, practitioner and services are known in advance.[1] A post-service agreement is made after the consultation and lists the MBS items.[1][4]
An agreement covers one practitioner.[1] A patient who sees two GPs needs an agreement with each.[1]
For a GP service, section 65C of the regulations lists seven details every episodic agreement must record.[1][4] Pathology and diagnostic imaging services record different service details.[4]
- The name of the patient receiving the service.[4]
- The date the agreement is entered into.[4]
- Whether it is a pre-service or post-service agreement.[4]
- The practitioner’s name and practice address, or their provider number.[4]
- The date the service will be provided (pre-service) or was provided (post-service).[4]
- The service: its Basic Service Description (pre-service) or its MBS item number (post-service).[4]
- Whether the assignor is the patient.[4]
Verbal agreement is allowed until 30 June 2027
From 1 July 2026 to 30 June 2027, a patient or their assignor can verbally agree to be bulk billed for any bulk-billed service.[1][6] Before, verbal consent was only a telehealth fallback.[1][3] A verbal episodic agreement made before 1 July 2027 still covers later services, such as planned pathology or a future consultation, if all other requirements are met.[6]
A verbal agreement is still an agreement and must be recorded.[1][6] The regulation requires the agreement to specify that verbal agreement was given and the date it was obtained.[6] The same details and the same 2-year retention apply as for a signed agreement; the reason for using verbal agreement does not need to be recorded.[1][6]
Verbal agreement changes how the patient agrees, not what the practice keeps: the record must still exist and be retained for 2 years.[1][6]
What counts as a signature
Paper and electronic signatures both count.[1][2] An electronic signature must meet the Electronic Transactions Act 1999: it has to identify the person and show that they agreed.[1] The Department lists options such as a signature pad or tablet, a typed name or checkbox, a digital signature platform, and Easyclaim on an EFTPOS terminal.[1][2] An SMS reply of "YES" can work if the practice can show who replied and what they agreed to, and keeps an auditable record.[1]
The patient can agree, or an assignor such as a parent, guardian, carer or partner.[1] The treating practitioner and practice staff should not act as the assignor.[1][2] Generally, a child aged 14 or older can make their own agreement.[1]
Enduring agreements for eligible patients
An enduring agreement lets an eligible patient agree once to have future in-scope services bulk billed.[1][5] Only three groups can use it.[1][3][5]
| Patient group | Who the agreement names | Notes |
|---|---|---|
| MyMedicare-registered patients | One GP at the registered practice | Ends if the patient leaves MyMedicare or the GP is no longer at the practice |
| Residents of residential aged care homes | The GP | A resident can have more than one agreement |
| Patients of an ACCHO or Aboriginal Medical Service | The ACCHO or AMS | Covers practitioners the service employs |
- One agreement per GP: a patient who sees two GPs at the practice needs an enduring agreement with each.[1][2][3]
- Every in-scope service must be bulk billed while the agreement is in effect.[1] To change the scope, end the agreement and make a new one.[1]
- If the practitioner ends an agreement, the termination takes effect two business days after notice is given.[1][5]
- For MyMedicare enduring agreements, the practice must send the patient a written notification within 24 hours of each claim, and within 24 hours of finding an error in an earlier one, by the method named in the agreement.[1][5] Keep copies with the agreement.[1]
How long an enduring agreement lasts
Enduring agreements made before 1 July 2027 must be registered with Services Australia within 12 months to remain valid; one that is not registered in that time ends automatically.[2] Enduring agreements made by verbal agreement end at the start of 1 July 2027, whenever they were made, so a verbal enduring agreement made in May 2027 lasts only one to two months.[2][6]
From 1 July 2027, an enduring agreement must be lodged with Services Australia for registration, or made in Services Australia software.[5] Services Australia points practices to the Department’s Improving the assignment of benefit process page for updates during the transition.[2]
| How it was made | Lasts until |
|---|---|
| Signed (paper or electronic) | Until 12 months after it was made, unless it is registered with Services Australia within that time |
| Verbal | The start of 1 July 2027, whenever it was made |
Keep the record connected to the claim
The practitioner must keep a copy of each agreement for 2 years from the date the claim is made, and give the patient a copy if they ask.[1][2] Patients no longer need to keep one.[2]
A practice should check its software, records process and staff instructions together, rather than updating a form in isolation. For electronic claims, you do not send agreements to Services Australia.[1] For a manual claim, or when Services Australia asks, you may need to send one.[1]
Telehealth follows the same rules
Telehealth no longer has its own consent process.[1] The same details, pre-service and post-service options, signature rules and 2-year retention apply.[1] Verbal agreement for telehealth continues only until 30 June 2027.[1][6] MyMedicare and aged care enduring agreements can cover telehealth consultations with the named GP.[1]
Compliance starts with education, but claims can be recovered
The Department describes a risk-based approach that starts with education during the transition.[1][3] Services Australia can still ask for agreements during audits, and a claim without a valid agreement may be recovered.[1] 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 ↗
Follow one appointment through the practice
A useful operational check is to follow an appointment from booking to claim submission. At each step, ask what the next person can see and what happens if information is missing. A completed form is only useful if the billing team can find and understand it.
- Capture the appropriate agreement and link it to the patient and service.
- Make the agreement status visible before submitting the claim.
- Give missing, unclear or expired agreements a named owner.
- Keep a retrievable record and a process for providing a copy when requested.
- Train staff on the exception path as well as the routine one.
A checklist for each role
What each person in the practice needs to check, from booking to the 1 July 2027 deadline.
- Practice manager: confirm how each bulk-billed service gets an agreement, pre-service at booking or check-in, or post-service after the consult.
- Practice manager: check that your software records every required detail, including "verbal agreement" and the date when consent is verbal.[6]
- Practice manager: list MyMedicare, aged care and ACCHO or AMS patients who could use an enduring agreement, one per GP.[1] For MyMedicare enduring agreements, set up the 24-hour notification.[1]
- Practice manager: record the date each signed enduring agreement was made and who will register it with Services Australia; one not registered within 12 months ends automatically.[2]
- Practice manager: plan the move to signed consent before 1 July 2027, whether by SMS, tablet, Easyclaim or paper. Paper works, but each agreement has to be filled in, matched to its claim and kept for 2 years.[1]
- Reception: when consent is verbal, record that it was verbal and the date in the agreement itself, and do not act as the assignor.[1][6]
- GPs: each GP needs their own agreement with the patient, and every in-scope service is bulk billed while an enduring agreement is in effect.[1]
- Owner: budget for signature tools before 1 July 2027 and watch for updates during the transition.
Further reading
References checked on 3 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.
