The 1 January 2026 MBS files are available on the January 2026 Downloads Page.
Summary of Changes for 1 January 2026
From 1 January 2026 the Extended Medicare Safety Net (EMSN) will be indexed. Details of these changes are provided below:
Extended Medicare Safety Net (EMSN)
The EMSN provides an additional Medicare benefit once an annual threshold in out-of-pocket costs for out-of-pocket hospital services has been reached. Out-of-hospital services include general practitioner, specialist and allied health attendances as well as many pathology and diagnostic imaging services. The Original Medicare Safety Net (OMSN) and EMSN thresholds are indexed annually on 1 January in line with the CPI (September 2025 Quarter). In addition to applying indexation, the latest changes also include:
- · indexing the fixed dollar EMSN benefit cap;
· adding EMSN benefit caps to six MBS items for intravitreal eye injections;
· removing the EMSN benefit cap from 29 MBS items that are in-hospital only service and therefore, no longer eligible for the EMSN; and
· making other administrative amendments, including removing the EMSN benefit cap from now ceased MBS items.
| 2025 Medicare Safety Nets Thresholds | Threshold amount | Who it’s for | What counts towards the threshold | What benefit you’ll get back |
| Original Medicare Safety Net (OMSN) | $594.40 | Everyone in Medicare | Your gap amount for the calendar year. | 100% of the schedule fee for out of hospital services. |
| Extended Medicare Safety Net (EMSN)- General | $2,699.10 | Everyone in Medicare | Your out of pocket amount for the calendar year. | 80% of out of pocket costs or the EMSN benefit caps for out of hospital services. |
| Extended Medicare Safety Net (EMSN) - Concessional and Family Tax Benefit Part A | $861.20 | Concession cardholders and families eligible for Family Tax Benefit Part A | Your out of pocket amount for the calendar year. | 80% of out of pocket costs or the EMSN benefits caps for out of hospital services. |
Relevant legislation
- · Health Insurance (Extended Medicare Safety Net) Amendment (Indexation No.2) Determination 2025
· Health Insurance (Extended Medicare Safety Net) Amendment (Indexation) Determination 2025
Please note that this news page is correct at the date of publication listed under “Page last updated” and does not account for any updates to the MBS since this date