Anaesthetic fees and gaps
Specialist anaesthesia services attract a separate fee to those charge by the hospital or other doctors caring for you. While the fee will vary depending on the complexity and duration of the anaesthesia, it is possible and expected to obtain an estimate prior to your procedure.
You may be able to claim a rebate for a portion of your anaesthetic fee from Medicare and your private health insurance fund. Often there is an associated out-of-pocket expense and the size of this ‘gap’ varies depending on your fund and your level of coverage. It is your responsibility to pay your anaesthesia fees.
Why is there a "gap"?
Anaesthetic fees are derived from the Medical Benefits Schedule (MBS) or Relative Value Guide. The Commonwealth Medical Benefits Schedule reflects the amount the government is prepared to reimburse people for medial service. It does not reflect the underlying value of the service. The graph above (NOTE: Please use the graph above this paragraph) shows what the level of anaesthesia rebate would be if it were indexed to CPI. This is reflected in the Australian Medical Association (AMA) suggested unit rate of $100.00. While all citizens are reimbursed 75% of the MBS unit value, health insurance funds usually cover the other 25% but this still leaves a gap. Some insurance funds cover part of this gap but the amount varies depending on the fund.
Additional information
- Download the Billing information sheet PDF from the Australian Society of Anaesthetists website.
- View the recent changes to AHSA fund co-payment rule changes and associated rebates from the
Australian Health Service Alliance website. - For more information regarding doctor fees and private health insurance, call the
Private Health Insurance Ombudsman Hotline on 1300 737 299, or visit their website - For your specific fee, call ACT Anaesthesia on (02) 6113 9029