Service or technology types
The service or technology in your application may be therapeutic, investigative or consultative. See the:
- full definition of each type
- regulatory processes that may apply to therapeutic goods and investigative services.
Funding sources
We only accept applications (including referrals) for funding sources for which we provide advice. The below table lists the main funding programs we assess applications for. We may also assess applications for funding from other sources not listed here.
| Funding source | Is a referral needed? |
|---|---|
| Medicare Benefits Schedule (MBS) | No. You do not need a referral to apply for a new or amended MBS item. This includes MBS items for professional services related to a codependent technology. |
| National Diabetes Services Scheme (NDSS) | No. You do not need a referral to apply for NDSS funding. |
National Health Reform Agreement (NHRA) Funding is available under this agreement for high cost, highly specialised therapies (HST). | No. You can apply if you think your application may meet the HST definition in Appendix A of the agreement. The NHRA Joint Chairs’ Group will confirm which committee should assess the application for a new drug or therapy, where it is likely to be delivered in a public facility. |
| Newborn Bloodspot Screening (NBS) programs | Yes. In line with the NBS decision-making pathway, you should apply to the NBS when the public is invited to identify new conditions for consideration. The health ministers may refer your application to us if it needs a health technology assessment (HTA). To find out more, contact the NBS team. |
| Health screening programs | Yes. You need a referral from the relevant policy team. |
Private health insurance companies pay benefits for medical devices and human tissue products on this list. | No, but some Prescribed List applications may be referred to us. You can lodge an application with us if you think your device or product needs an MBS item to facilitate its use or you consider a full HTA is required. You will still need to lodge a Prescribed List application. For more detail, including applying for MBS items for related professional services, see medical devices and human tissue products below. |
The blood and blood-related products on this list are funded under the national blood arrangements. | Yes. You should first propose a change to the National Blood Authority (NBA). The NBA submits all proposals to the Jurisdictional Blood Committee (JBC). The JBC decides if you need to lodge an application with us for an HTA. |
Medicare Benefits Schedule (MBS) items
Most of the applications we assess are for the MBS, to either:
- fund new health services and technologies through a new MBS item
- amend existing MBS items.
This includes MBS items for professional services that relate to a codependent technology. For example, a service related to a device on the Prescribed List.
Not all MBS items are within our scope. For example, we do not assess applications to expand the scope of practice of allied health professionals. If you have any questions, please get in touch.
Health delivery programs
We assess applications for funding of health delivery programs. This can include programs to screen for diseases, monitor health conditions, or improve public health. Examples of programs we have assessed include:
- National Cervical Screening Program
- National Lung Cancer Screening Program
- Newborn Bloodspot Screening programs.
Policy teams in government bodies usually refer these types of applications to us. We also assess applications to amend existing public health programs that already receive funding.
Codependent health technologies
Codependent technologies (including services) are those that need to be combined to work as intended. For example:
- an imaging service that identifies patients who may benefit from targeted radiotherapy
- a test that identifies which patients may benefit from a specific medicine
- a medical procedure to give a medicine in a way that improves the medicine’s effectiveness
- a surgical procedure to implant an artificial joint.
To receive public funding, the relevant committee must assess each technology. This usually means you need to apply to us and another committee – these are called codependent applications. Sometimes, both technologies in a codependent application fall under our terms of reference, so we can assess them together.
The most common codependent applications we receive also need consideration by either the:
- Pharmaceutical Benefits Advisory Committee (PBAC) – to find out how we work with PBAC to ensure the process is as smooth as possible, see PBAC codependent applications
- Medical Devices and Human Tissue Advisory Committee (MDHTAC) – see medical devices and human tissue products and related MBS services.
High cost, highly specialised therapies (HST)
The Australian and state and territory governments jointly fund HSTs under the National Health Reform Agreement.
For the definition of an HST, see appendix A of the National Health Reform Agreement (NHRA). If your application is for a potential HST, you can apply directly to us. The NHRA Joint Chairs’ Group will confirm which committee should assess the application for a new drug or therapy, where it is likely to be delivered in a public facility.
As part of the assessment process, the state and territory health officials will provide consultation input on HST applications. Find out more about the MSAC process for HSTs.
Blood and blood-related products
The blood and blood-related products on the National Product Price List are provided at no direct cost to patients under the national blood arrangements. We will only assess applications for funding under these arrangements if you have a referral from the Jurisdictional Blood Committee (JBC).
Find out how to propose a change to the National Product Price List. All proposals go to the JBC for consideration.
Diabetes-related products
The National Diabetes Services Scheme (NDSS) subsidises products to help people manage life with diabetes. No referral is required.
Find out more about NDSS-subsidised products.
Medical devices and human tissue products
We only assess medical devices and human tissue products for the Prescribed List if a full HTA is appropriate. This is the Tier 3: Full HTA Pathway set out in the Draft Prescribed List Guide. If you:
- decide on this pathway, you must lodge a Prescribed List application and an MSAC application
- are referred to us after lodging a Prescribed List application, you must lodge an MSAC application.
See the Draft Prescribed List Guide for more about the Tier 3 pathway, including:
- examples of devices assessed under Tier 3
- the information and documentation requirements
- the timing options of lodging your Prescribed List and MSAC applications.
We use our usual process to oversee the full HTA and provide our advice to the Medical Devices and Human Tissues Advisory Committee (MDHTAC). Our advice informs the MDHTAC’s decision on the Prescribed List application.
If you have read the guide and are not sure whether your application will need a full HTA, contact the Prescribed List team.
MBS services related to your device or product
All devices and human tissue products on the Prescribed List must have at least one related professional service on the MBS.
You can apply to us as usual to add or amend an MBS item for a related professional service.
If there is no current MBS item for a related service, MDHTAC will not make a decision on the Prescribed List application until we have finalised our assessment of the new MBS item. Our secretariat will work with the MDHTAC secretariat to coordinate timing.
Advice on suitability for applicants
If you are not sure your service or technology is suitable or has an appropriate funding source, get in touch. Our secretariat may be able to assist with general advice. After you lodge an application form, the pre-assessment phase will confirm if your application is suitable for MSAC, taking account of the specific information you provide in the application form.
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