Updated (1 July 2026): Since this article was first published, the Department of Health, Disability and Ageing has announced a 12-month transition period. From 1 July 2026, verbal consent remains accepted in all settings during the transition, enduring Assignment of Benefit has been brought forward for eligible patients and the Department has confirmed its initial compliance approach will focus on prevention and education. This article has been updated to reflect these changes.
If your practice bulk bills, the way you collect and store patient consent is about to change. From 1 July, there are new requirements for how an “assignment of benefit” is obtained, and, importantly, how long you need to keep evidence of it.
There’s been a lot of noise about this one, and we’ve had plenty of questions from practices who aren’t quite sure what they need to do. We’ll cover what assignment of benefit actually is, why it’s changing, how it’s changing, and the concrete steps to take before and after 1 July.
I’d like to present some reassurance up front: We’ve been working closely with our practice management system partners, and all of them either already have the tools you need, or have updates releasing shortly to make assignment of benefit easy to collect and store. Additionally, the only change you must have in place on day one is the record-keeping. Everything else can be phased in at a pace that suits your practice. More on that below.
What is an assignment of benefit?
As a practitioner, when you fully bulk bill a patient for an invoice, you’re not waiving a fee. You’re accepting the Medicare benefit as full payment, and the patient agrees to “assign” their Medicare benefit to you so you can claim it directly. The patient pays $0 out of pocket, and you bill Medicare for the invoice.
That agreement, the patient handing their benefit over to you, is the assignment of benefit. It’s a long-standing requirement under the Health Insurance Act 1973, so it isn’t new. What’s changing is how you can capture it, and who’s responsible for holding onto the proof.
Up until now, assignment was collected on a specific approved form (the DB4e or DB020), signed by the patient after the consult. In some settings, like telehealth, verbal consent was accepted. And the onus sat with the patient to keep the evidence that they’d assigned their benefit, which, in reality, often meant nobody kept it at all.
Why is assignment of benefit changing?
The short version: this is the long-promised modernisation of bulk billing consent, and it has a bit of a backstory.
During the COVID-19 pandemic, the department issued temporary guidance allowing doctors to collect verbal consent to assign the benefit for MBS telehealth items, recorded in the patient’s notes during the consult. In January 2023, the Australian National Audit Office made note of this in its report on Medicare telehealth services, finding there was no clear legal basis for it and that it created a fraud risk. Without the patient acknowledging the consult took place, in theory, benefits for services that didn’t take place could be claimed.
In September 2023 the department tightened things up. Verbal consent for telehealth stayed available, but it now had to be followed up with a completed approved form sent to the patient. Understandably, many GPs and practices pushed back against the added paperwork, in response, the health minister promised a modernised, digital-friendly process.
The 1 July changes are the result. The original intent was to bring the verbal-consent era to a close for bulk billing across the board, though, as we’ll see, a late concession has kept verbal consent alive for a 12-month transition. Through its submission to the DoHDA, the RACGP has advocated to make a digital signature just as legally valid as a pen-and-paper one, which is genuinely useful.
The intent is good: a consent process that produces a verifiable record, which works with modern digital workflows practices expect.
The catch, and the reason there’s been so much chatter, is that a number of practical scenarios (particularly around vulnerable patients) seemed to conflict with the new methods and requirements. The good news is that the late-June concessions have gone a long way to addressing them. We’ll come back to that.
How is it changing?
Here are the core changes coming on 1 July.
The record-keeping onus shifts to practices and clinicians. This is the big one. Your practice, not the patient, now needs to retain evidence that the patient assigned their Medicare benefit, and you need to keep that record for two years. You also need to provide a copy to the patient if they ask for one.
Verbal consent isn’t disappearing just yet. Following significant feedback, the Department of Health, Disability and Ageing introduced a 12-month transition period. From 1 July 2026 to 30 June 2027, practices can continue to obtain verbal Assignment of Benefit in all settings while transitioning to the new consent requirements. The Department has today (July 1) released detailed guidance on how verbal Assignment of Benefit should be documented. When verbally assigning, you must explain to the patient how you will fill in the signature field, and you will need to enter “assignor verbally agreed” in the assignor signature field. You must then send a copy of the submitted AoB form to the patient, this is in addition to keeping your own record for 2 years.
The approved forms are being updated, not scrapped. The DB4e and DB020 aren’t disappearing, they’re being updated to include the new required data set, the defined set of information the person assigning the benefit has to see and agree to. Your current versions stop being valid on 1 July, so you can’t keep using existing stock. The updated forms are due on the Services Australia website from 1 July 2026, but you don’t have to use them, your own paper or electronic form is fine as long as it captures the required data set.
There’s no mandatory template. As long as the agreement contains all the required information and the assignor has agreed, it’s valid, whether it’s on paper or electronic, and whatever the format. Services Australia has said it will publish optional example templates, but you don’t have to use them.
Consent can be collected before or after the consult. You can now obtain assignment either before the service (pre-service assignment) or after it (post-service assignment), as long as agreement is in place before invoices are batched to Medicare.
Consent is per episode of care, but enduring assignment is now arriving sooner than expected. As a default, each assignment covers a single episode of care, so patients consent each time you bulk bill them. The other big change from the 18 June announcement is that an “enduring” assignment (a standing consent) will be available from 1 July 2026, not 2027 as previously flagged, for three groups of patients:
- Patients registered with MyMedicare can make one enduring agreement covering all GPs at their MyMedicare practice, if the practice offers it. If they update their nominated MyMedicare practice, the agreement automatically ends with the previous practice.
- Residents of residential aged care homes can make multiple enduring agreements with different practitioners.
- Patients of an Aboriginal Community Controlled Health Organisation or Aboriginal Medical Service can make an enduring agreement with the organisation, and can hold agreements with more than one.
For everyone else, it remains per episode of care for now, with the Department using the transition period to look at whether this can be broadened.
Pre-service Assignment of Benefit comes with a catch. If you collect consent before the consult, you’ll need to estimate the broad service group of the item you expect to bill. If the service changes during the consult, say a standard consultation turns into a care plan, the original assignment no longer matches what you delivered, and you’ll need a fresh assignment that reflects the actual service. The same goes if a claim is rejected and you need to change the MBS item number, that needs a new assignment too.
The focus is on education, not catching practices out. The Department has confirmed its initial compliance approach will prioritise prevention and education while practices transition to the new requirements. That doesn’t mean you should wait until June 2027 to make changes. Use the 12-month transition period to test your workflows, train your team and embed new processes, so you’re confident and ready well before the transition ends.
Vulnerable patients: clearer than it was
When the changes were first announced, one of the biggest questions was how they would work for patients who couldn’t easily provide a signature, particularly in aged care settings. The transition arrangements have gone a long way to addressing those concerns.
Because the original rules required a signature, the obvious problem was: what happens when a patient can’t sign? Two things now help. First, verbal assignment is accepted in all settings for the 12-month transition, so a signature isn’t the only path from day one. Second, the new enduring assignment option is tailored to exactly these settings: residents of aged care homes can make multiple enduring agreements with different practitioners, and patients of an ACCHO or AMS can make an enduring agreement with the organisation. In all cases, an “assignor”, a parent, partner, carer, relative, person with power of attorney, or friend, can sign on the patient’s behalf.
There are still some unanswered questions around patients who can’t provide consent, don’t have an enduring agreement in place and don’t have an available assignor. The Department has indicated it will continue exploring these scenarios during the transition period. In the meantime, now is a good opportunity to identify patients who may benefit from an enduring Assignment of Benefit and put those agreements in place where appropriate.
How does assignment of benefit interact with the recent introduction of the bulk billing practice incentive?
I was recently at the RACGP Practice Owners and Business for Doctors conferences, and this is a hypothetical that came up a few times with various practice owners and managers. Let’s pause for the world’s quickest recap of the incentive. The Bulk Billing Practice Incentive Payment (BBPIP) was introduced in November of 2025, and effectively provides a 12.5% total additional payment split between practices and practitioners who fully bulk bill all GP non-referred attendance items. It’s designed to incentivise bulk billing and expand accessibility of care while making bulk billing more financially viable.
The reason practices are worried about assignment of benefits here is that if they are fully bulk billing to qualify for the incentive, this means they will need to acquire and store the assignment of benefit for every single appointment.
So what happens when patients inevitably forget to complete the assignment, ignore the follow up text, or simply decline to assign the benefit? A fully bulk billing practice is faced with either privately billing the patient, forfeiting the 12.5% BBPIP for all services, or accept that they won’t be able to correctly invoice Medicare, receiving a rejection and $0 for the appointment.
The 18 June announcement takes some of the heat out of this. For practices leaning into full bulk billing, enduring assignment is the key tool: a patient registered with your MyMedicare practice can give one standing consent that covers all your GPs, so your regulars aren’t asked to re-consent at every visit. Verbal consent being acceptable through the transition year also means a forgotten text message doesn’t immediately turn into a rejected claim. It doesn’t make the problem vanish, if a patient actively declines to assign, your options are still to privately bill them (they can then claim the rebate back from Services Australia) or forgo the service, but it makes the day-one reality far more manageable than it looked in May.
What you need in place before 1 July
Let’s start with the most important point, because it cuts through a lot of the worry: the only change you must action on day one is the record-keeping requirement. You don’t have to roll out pre-service assignment or a fully digital workflow on 1 July if it doesn’t suit you. You can phase those in. What you can’t skip is keeping evidence, for two years, that you obtained assignment of benefit for each bulk-billed service.
If anything, the 18 June concessions make this phased approach more achievable: verbal consent is accepted through the transition, and the Department has said its compliance focus will be on prevention and education while practices adjust. The record-keeping requirement is still the thing to nail first.
With that in mind, we’ve put together a practical checklist your practice can work through to get ready, and we’ve made it a free download so you can share it with your team and tick things off as you go.
It walks you through the key actions step by step: getting your systems and record-keeping ready, deciding on the workflow that suits your practice, building assignment checks into your billing and reconciliation, clearing outstanding billing items before 1 July, reviewing your digital consent and communication tools, planning for patients who don’t respond, handling patients who need alternative consent arrangements, and bringing your team and patients along with you.
A few specific items on the list are worth calling out now:
- Update your practice management software. Make sure you’re on the version your PMS vendor has released for assignment of benefit, so capturing and storing consent is built into your day-to-day workflow rather than bolted on.
- Set up a Sender ID register. If you’re sending consent requests by SMS, register a recognisable sender ID so the message clearly comes from your practice, patients are far more likely to action a text they trust than one from an unknown number.
- Log verbal consent. With verbal assignment accepted through the transition, make sure your team has a consistent way to record it in the patient file, an unlogged verbal consent is the same as no consent when it comes to your two-year record. Ensure that however you’re storing these records, there’s a clear pathway for auditing so you can monitor your compliance / success rate.
- Keep MyMedicare registrations moving. The more eligible regular patients you have registered, the more patients can benefit from enduring Assignment of Benefit, reducing the need to collect consent at every visit.
In conclusion
Assignment of benefit isn’t new, but from 1 July the responsibility for proving it, and keeping that proof for two years, is shifting. The one mandatory change on day one is record-keeping. Pre-service assignment, digital workflows, and the rest can come in at a pace that works for your practice, and the late-June concessions, a 12-month transition for verbal consent and enduring assignment for your regular bulk-billed patients, give you more room to get there than it first appeared.
Get your record-keeping sorted, confirm your software and comms tools are ready, brief your team, prepare your patients, and keep a close eye on the claims that don’t go through cleanly. The practices that sail through this will be the ones that treat it as an operational and financial change to manage, not just a form to fill in.
If you’d like a hand staying on top of the numbers through the transition, that’s exactly what we’re here for.
