Professional Services Review Recovers Record $32.6 Million
The federal body recovered more than in the previous year after receiving 124 requests for review in the past financial year.
Updated on Nov. 4, 2026 in Healthcare
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Professional Services Review recovered $32.6 million from medical practitioners in the past financial year, exceeding the $31.6 million recovered in 2023-24. The body received 124 requests for review, well above its five-year average of 99.
Why it matters
The figures indicate the scale of Medicare billing reviews and the enforcement tools available to correct inappropriate practice among practitioners. Recovered funds and disciplinary outcomes affect public confidence in how Medicare benefits are claimed.
Of 111 reviews resolved, 57 cases resulted in partial MBS disqualification and one in full disqualification, while 60 practitioners received reprimands and 67 were counselled. The breakdown does not show how many of the 124 requests remain open, and the source does not explain the variation in outcomes.
The players
Professional Services Review
A federal Australian body that reviews Medicare billing by health practitioners and can impose repayments and disqualifications.
The details
Professional Services Review does not start its own investigations and acts only on referrals from the Chief Executive of Medicare. Most resolved cases concluded through Section 92 agreements, in which a practitioner repays amounts and acknowledges inappropriate practice, while seven cases were dismissed without further action.
Timeline
The 2023-24 financial year saw $31.6 million recovered in investigation repayments.
The past financial year produced the record $32.6 million recovery and 124 review requests.
As of 30 June 2026, 82% of active cases were less than one year old.
Healthcare Landscape
Professional Services Review operates within the Medicare Benefits Schedule billing framework established under the Health Insurance Act 1973. Its record recovery sits within that longstanding system of post-payment compliance review.
Patients who see practitioners subject to review may face repayments or changed billing practices. Clinics and practitioners should check billing against MBS requirements to avoid referrals and disqualification.
The takeaway
Accurate MBS billing protects both practitioners and patients from repayment demands and disciplinary action. Practitioners who are unsure of a claim can review MBS item requirements before submitting it.
Further reading
For related coverage, explore Healthcare reporting on the Australian system.
Source note: This article includes information reported by Racgp.
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