If your practice bulk bills, there are important changes coming to how you collect and store patient consent.
From July 1 2026, new requirements will apply to the process known as “assignment of benefit”. They update the evidence you need to collect, and how long you must keep it.
The changes modernise consent processes and better align with digital workflows.
Introduction of these changes also may present challenges for practices working in aged care, palliative care, disability settings or with other vulnerable patient groups. We know there has been a lot of discussion and uncertainty about this, and we are expecting clarification from the Department of Health in the near future.
Here we outline what assignment of benefit is, what’s changing, and the practical steps your practice can take now.
What is assignment of benefit?
When you bulk bill, you are accepting the Medicare benefit as full payment for a service. For this to happen the patient agrees to assign their Medicare benefit to you. Your practice then claims this directly from Medicare. The patient pays nothing more.
This agreement is called assignment of benefit. It has always been a requirement under Medicare legislation, but the new process changes how consent is captured and who is responsible for keeping the record.
What’s changing from 1 July?
The key updates are:
- Practices must keep the record
Responsibility for retaining evidence of assignment of benefit shifts to the practice. You must now keep this evidence for two years. - Verbal consent will no longer be accepted
A signature, physical or electronic, is now required for all bulk billed services. Verbal consent alone is no longer sufficient in any setting, including telehealth. - Approved forms are being replaced
The existing forms (DB4e and DB020) are being retired. An ‘approved form’ is no longer required. Consent must now include the required dataset, which is outlined in the relevant legislation and reproduced in the FAQ section of this article. - Flexible formats are allowed
There is no single mandated template. Consent can be captured on paper or electronically, as long as it includes the required information and a valid signature. - Consent can be collected before or after the consult
There are significant clinical considerations involved in when consent is requested – read on for details – but it is essential that it is in place before the claim is submitted to Medicare. - Consent is required for each episode of care
Each bulk billed service requires its own assignment of benefit. Ongoing or “standing” consent is not currently available but there are plans for introduction in 2027.
Important considerations for practices
Pre-service consent requires accuracy
If you collect consent before the consultation, it must reflect the service delivered. If the service changes (for example, from a standard consult to a care plan), you will need to obtain new consent. The same applies if a claim is rejected and needs to be resubmitted with a different item number.
Supporting vulnerable patients
The requirements may present challenges for patients who are unable to provide a signature. A representative, such as a family member, carer or person with power of attorney, can sign on their behalf.
However, where no representative is available, there is currently no clear compliant pathway for bulk billing.
Practices working in aged care, palliative care or disability settings may need to plan for how this will be managed and monitor for further guidance.
Implications for fully bulk billing practices
Practices that bulk bill all services — including those participating in the Bulk Billing Practice Incentive Payment — will need to ensure assignment of benefit is collected and stored for every consultation.
If consent is not obtained, practices may need to consider alternative billing arrangements, because Medicare claims cannot be processed without a valid assignment.
Practical steps for your practice
To prepare for the changes, consider:
- Reviewing your current workflow for capturing assignment of benefit
- Confirming your practice management system can record and store consent in line with the new requirements
- Updating your record-keeping processes to ensure evidence is retained for two years
- Building consent checks into billing and reconciliation processes
- Planning for patients who may not respond to digital consent requests
- Identifying patient groups who may require alternative consent arrangements
- Communicating changes with your team and patients to support a smooth transition.
Frequently asked questions
Can we still use DB4e or DB020 forms?
No. These will no longer meet requirements from 1 July 2026. Practices must use a format that includes the required data set.
Can patients give consent verbally?
No. Verbal consent will no longer be accepted. A physical or electronic signature is required.
Do we have to use a specific template?
No. There is no mandatory template, but all required information must be included.
What is the required dataset?
Dataset contents are outlined in the Department of Health Disability and Ageing’s relevant frequently asked questions document (on page eight).
GPs must collect patient name, date and type of assignment, assignor, details of the professional, date of service, and basic service description. For post-consult collection, MBS item/s must also be added.
Can we collect consent before the appointment?
Yes. Pre-service assignment is allowed, provided all required information is included.
What if the service changes?
A new agreement may be required if the service is different from what was originally agreed.
What if a patient refuses to assign their benefit?
You cannot bulk bill. The patient must be privately billed and claim Medicare themselves.
How long do we need to keep records?
Records must be retained for two years and available if requested.
What if a patient cannot sign?
An appropriate, authorised representative, such as a carer or guardian, can sign on their behalf.
Useful links
- Improving the assignment of benefit process | Australian Government Department of Health, Disability and Ageing
- Assignment of Medicare Benefits for Bulk Billing – Frequently Asked Questions | Australian Government Department of Health, Disability and Ageing
- Assignment of Benefit – Simplified Billing Legislation changes (presentation slides for practice managers) | Australian Government Department of Health, Disability and Ageing
- Medicare Assignment of Benefit changes for bulk billing: a guide for practices | Tyro Health
Education and training
- Assignment of Benefit Changes FAQs | Best Practice Software
- Preparing your practice for the new Assignment of Benefit changes (webinar, 24 June 2026) | Cubiko
- Assignment of Benefit changes | Zedmed
- Medicare Assignment of Benefits (AoB) changes | Healthengine
Support for practices
NWMPHN is working closely with practice management system providers. Most systems already have, or will shortly release, functionality to support compliant consent collection and storage.
We recognise these changes will require adjustments in practice workflows. While the policy intent is to support a more reliable and modern consent process, there are still areas where further clarification is expected, particularly for vulnerable patient groups.
We will continue to share updates and practical guidance as more information becomes available.
If you would like support reviewing your practice processes or preparing for these changes, please contact the NWMPHN team on primarycare@nwmphn.org.au 03 9347 1188 or request a visit.
