Palliative care services in Australia

Medicare Benefits Schedule data

The Medicare Benefits Schedule (MBS) is part of Australia’s public health insurance scheme. Through the MBS the Australian Government subsidises the costs of a broad range of health services. The MBS subsidies pay all or part of the costs of these services, dependent on factors such as patient eligibility, the type of service and choices by health practitioners regarding the fees they charge for their services. MBS benefits are claimable only for services rendered by an appropriate health practitioner and which are listed on the MBS. 

Services Australia collects administrative data in processing claims for benefits under the MBS and provides this information to the Australian Government Department of Health, Disability and Ageing. The item numbers and benefits paid by Services Australia are determined based on the MBS, as listed in MBS Online.

The data presented in this report relate to services provided on a ‘fee-for-service’ basis for which MBS benefits were paid, and only for palliative medicine attendances and case conferencing services that are both provided by palliative medicine physicians or specialists, and are claimed under specialist palliative care MBS item numbers.

Patients who are referred to specialists or physicians in palliative medicine usually have:

• intermediate and fluctuating needs that might result in unplanned use of hospital and other services, and/or
• complex and persistent needs (physical, social, emotional, or spiritual) that are not effectively managed through established protocols (PCA 2018).

Information is also provided on the settings where the attendances were provided – in hospital or consulting room, or in other settings, such as attendance at a person’s place of residence, including home, residential aged care or institution (see Table EXP 1). For case conferencing, it refers to community case conference and discharge case conference (see Table EXP 2).

* Items 3003 and 3015 ceased on 31 December 2021, with telehealth services now claimed against relevant item numbers in Group A40.

Note: Refer to the Medicare Benefits Schedule Book July 2024 edition for full item descriptions (pages 308–309) and further information relating to the MBS items for palliative care (pages 118–119).

Note: Refer to the Medicare Benefits Schedule Book July 2024 edition for full item descriptions (pages 309–311) and further information relating to the MBS items for palliative care (pages 118–119).

Palliative care physicians and specialists may at times use other MBS item numbers when attending to palliative care patients. These items are not included in the data in this report, as they are not claimed specifically as a palliative care-related service under the MBS. Further, other medical practitioners (general practitioners and medical specialists) and health professionals also attend to terminally ill patients and provide palliative care, without the service being eligible to be claimed specifically as a palliative care-related service under the MBS. In other words, the reported number of patients who receive a palliative care-related service under the MBS is a known underestimate of total palliative care activity. Further, the data does not include referred attendances by palliative medicine physicians or specialists to public in-patients or public outpatients of hospitals and services funded from the Department of Veterans’ Affairs National Treatment Account.

It should be noted that a patient may access more than one type of these specific MBS items provided by palliative medicine physicians or specialists during the reporting period and that each service is counted separately in this report. 

The MBS data presented in this report (2024–25 and trend data) are based on the date the service was provided rather than the date of service processing, as this more accurately reflects the date a service occurred. This only includes services that were processed on or before 30 Nov 2025. Note that in reports released prior to 2022, the data was based on the date the service was processed by Services Australia and as a result, the data presented since 2022 releases are not comparable with previous releases.

Pharmaceutical Benefits Scheme and Repatriation Pharmaceutical Benefits Scheme data

Services Australia collects administrative data while processing prescriptions dispensed under the Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS) data and provides these data to the Australian Government Department of Health, Disability and Ageing. 

Through the PBS and RPBS data, the Australian Government subsidises the cost of pharmaceutical products listed on the Schedule of Pharmaceutical Benefits. In 2004, the Australian Government introduced Pharmaceutical Benefits for Palliative Care, referred to as the PBS Palliative Care Schedule. The PBS Palliative Care Schedule, which lists medication items available for palliative care, was established as a separate schedule, complementing the General Schedule to improve access to essential and affordable medications for patients receiving palliative care.

Only the medications listed on the PBS Palliative Care Schedule (referred to as palliative care-related prescriptions) and the medications prescribed by palliative medicine specialists are included in this report. 

Palliative care patients who access medications listed on the PBS Palliative Care Schedule can also access medications listed on the General Schedule, for example morphine. The same medications may be listed on the PBS Palliative Care Schedule and the General Schedule, however, medications on the PBS Palliative Care Schedule may be listed with larger quantities and/or more script repeats, making them more suitable for use in palliative care (Department of Health, Disability and Ageing 2016a). This may reduce patient co-payment costs and decrease the frequency of doctor consultations for ongoing symptom management. 

Given the overlap in medication items listed on the different schedules, and because the PBS Palliative Care Schedule is intended to complement the General Schedule, it is likely that some medicines prescribed for palliative care are prescribed from the General Schedule. These prescriptions are not included in the count of palliative care-related prescriptions in this report. In addition, medications prescribed for palliative care purposes in some other instances are not included in this report as well, since PBS and RPBS data do not capture over the counter medicines, medicines supplied to public hospital inpatients, and private prescriptions. For example, if a medicine is not listed under the PBS Schedule for a specific indication, but it has market authorisation by the Therapeutic Goods Administration for sale, it would not be included.

Palliative care prescriptions can also be identified through the prescriber. Palliative medicine specialists may prescribe medicines for a range of reasons, some of which may be for palliative care, and may prescribe from different schedules. This report includes information on medications prescribed by palliative medicine specialists from all schedules (Table 8 in Data tables: PCSiA 2025 Palliative care-related medications) and are therefore likely to include prescriptions prescribed for both palliative care and non-palliative care reasons.

The PBS and RPBS data presented in this report (2024–25 and trend data) are based on the date of supply, which is when the prescription was dispensed to the patient. The report includes all prescriptions supplied during 2024-25 financial year that were processed on or before 30 November 2025.

Types of palliative care-related prescriptions

Previously, this report has defined types of palliative care-related medicines by categories based on the Anatomical Therapeutic Chemical (ATC) classification system (WHO 2022). Since 2022, this report has used an updated method to report types of palliative care-related prescriptions, with the categories based on the Palliative Care publication of the Australian Therapeutic Guidelines (Therapeutic Guidelines Limited 2021). Therefore, the medication types (at the ATC level 2) in editions before 2022 are not directly comparable with the ‘medication group’ in this report.

Table EXP 3 lists the medication items from the PBS Palliative Care Schedule with their corresponding medication groups and ATC codes at levels 2, 3 and 5. Note that most of these medicines are listed in multiple areas in PBS and RPBS, and are not specific to the Palliative Care Schedule. In this report, data extracted using ATC codes for medication groups was filtered by program type (Palliative Care Schedule) to report on all palliative care-related prescriptions.

*Hyoscine Butylbromide can also be used to manage respiratory secretions.

**These PBS items are listed on the PBS as Restricted Benefit which can only be prescribed for specific therapeutic uses.

Relevant changes to the Pharmaceutical Benefits Scheme and Repatriation Pharmaceutical Benefits Scheme over time

Reporting of ‘subsidised’ and ‘under co-payment’ prescription data

The maximum co-payment a patient pays depends on their level of entitlement, which is determined by the patient’s concessional status and whether they have qualified for the PBS safety net. Current and historical co‑payments can be found on the PBS website.

Since 2022, this report combines under co-payment and subsidised data in most tables. An additional table by patient beneficiaries shows the palliative care data by co-payment type in a single table for 2024–25 (Table 4 in Data tables for Palliative care-related medications), rather than including this split in every table.

Changes to restriction levels on the Palliative Care Schedule

On 1 June 2016, as part of the Post-market Review of Authority Required PBS Listings, changes were made to items listed on the Palliative Care Schedule. The restrictions for a number of Palliative Care Schedule items were changed and some medications were added or deleted. The restriction level of certain Palliative Care Schedule items, specifically those in the ‘pain relief’ and ‘gastrointestinal symptoms’ categories, were changed, in many cases from ‘Authority Required (STREAMLINED)’ to ‘Restricted Benefit’, reducing the level of restriction. Certain versions of medications were delisted due to initial and continuing treatment restrictions being simplified and merged under a single item code. 

It should also be noted that data from 2016–17 onwards are not comparable with previous years, given the above-mentioned changes to the PBS restriction level from June 2016 and new listings of medications in the PBS Palliative Care Schedule (Department of Health, Disability and Ageing 2016b).

National Hospital Cost Data Collection

The National Hospital Cost Data Collection (NHCDC) is an annual collection of public hospital cost data in Australia, managed by the Independent Health and Aged Care Pricing Authority (IHACPA), and is the primary data collection used to develop the National Efficient Price (NEP) and National Efficient Cost (NEC) Determinations for the funding of public hospitals services.

IHACPA uses classifications to categorise, cost and price hospital activity. Hospital activity relates to the management of (diagnostics and interventional) and the resources used by the patient in relation to their treatment. Classification systems are used to describe activity related to the following types of patient care: admitted acute care, subacute and non-acute care, non-admitted care, emergency care and mental health care. Palliative care belongs to subacute care, a specialised multidisciplinary care in which the primary need for care is optimisation of the patient’s functioning and quality of life. Note that not all hospitals submitting data to IHACPA report subacute data (including palliative care). The data presented in this report are related to records and costs that are linked and in scope for NHCDC reporting only, unless otherwise stated.

In this report:

• admitted patient palliative care includes either palliative care episodes or palliative care phases, which are identified by using the 'Care type' as 'Palliative care'
• non-admitted patient palliative care refers to palliative care service events, which are identified by using either 'Care type' as 'Palliative care', or ‘Tier 2 Non-Admitted Services classification’ as ‘Palliative care’ in Medical Consultation Classes or in Allied Health and/or Clinical Nurse Specialist Interventions Classes.

Note that expenditure for non-admitted patient palliative care, defined by 'Tier 2 Clinic Codes', does not specifically capture non-specialist care that falls outside these codes.

Also note, the expenditure data on admitted and non-admitted patient palliative care in this report may not match jurisdiction reported palliative care costs in other reports, as the definitions for palliative care between the AIHW and Budget Estimates differ.

The health departments of Australia’s states and territories submit their cost data to IHACPA. Taken together, the collection represents the primary source of information about the cost of treating patients in Australian hospitals. To support consistency in the costing process, IHACPA works with stakeholders to develop and implement national costing standards. The Standards prescribes the set of line items and cost centres used for mapping hospital costs. IHACPA then creates cost buckets as cost pools within the hospital, by combining line items and cost centres, which are made up of:

• Line items: these represent types of costs (for example, salaries and wages or goods and services) incurred by hospitals which are reported on in the general ledgers of hospitals.
• Cost centres: these represent departmental cost, objects within a hospital that relate to a particular function of the hospital – for example, the hospital operating room (IHACPA 2023).

The current version of the standards is the Australian Hospital Patient Costing Standards Version 4.1. For more information about data specifications, see IHACPA's Data collection page.