Key Points
- ✓Medicare provides approximately $3,720 in rebates for an initial IVF cycle
- ✓You need a valid referral from a GP or doctor to claim rebates
- ✓The Medicare Safety Net provides additional rebates once you hit spending thresholds
- ✓NSW residents may access a $2,000 one-off rebate (means-tested)
Referral Requirements
To access Medicare rebates for fertility specialist consultations and treatments, you need a valid referral from a registered medical practitioner (GP or doctor). This referral:
- •Is valid for 12 months from the date of issue
- •Must be to a specific fertility specialist or clinic
- •Qualifies you for Medicare rebates on eligible services
- •Can be obtained online through telehealth services like HeyDoc
Important: Without a valid referral, you cannot claim Medicare rebates for specialist consultations or fertility treatments.
Medicare Rebates for IVF
Medicare provides rebates for various components of an IVF cycle. The main MBS items for IVF include:
| MBS Item | Description | Medicare Rebate |
|---|---|---|
| 13200 | Superovulated treatment cycle (initial) | $320.70 |
| 13209 | Oocyte retrieval (egg collection) | $503.00 |
| 13215 | In vitro fertilization (IVF laboratory) | $2,897.00 |
| 13218 | Embryo transfer | $313.40 |
| 104 | Specialist consultation (with referral) | $84.15 |
Estimated total rebate for initial IVF cycle: ~$3,720.70
Subsequent cycles: ~$3,486.25 (items 13201, 13209, 13215)
Medicare Safety Net Thresholds (2026)
The Medicare Safety Net provides additional rebates once your out-of-pocket medical costs exceed certain thresholds during a calendar year.
Original Medicare Safety Net (OMSN)
$594.40
Once reached, Medicare covers 100% of the schedule fee for out-of-hospital services for the rest of the year.
Extended Medicare Safety Net (EMSN)
$861.20
Concessional threshold
$2,699.10
General threshold
Tip: Once you reach the EMSN threshold, Medicare covers 80% of out-of-pocket costs for eligible services, significantly reducing your fertility treatment costs for subsequent cycles.
NSW Fertility Treatment Rebate
The NSW Government offers an additional rebate for eligible patients undergoing fertility treatment:
- •Means-tested: Household income ≤ $116,000/year
- •Must be a NSW resident
- •Treatment at an accredited NSW clinic
- •Apply within 90 days of treatment
- •Program runs until August 2028 (or until funds exhausted)
Frequently Asked Questions
Common questions about Medicare rebates for fertility treatment
Yes. You need a valid referral from a GP or doctor to claim Medicare rebates for fertility specialist consultations and IVF treatments. Your referral is valid for 12 months.
Medicare provides approximately $3,720.70 in rebates for an initial IVF cycle (covering items 13200, 13209, and 13215). Subsequent cycles receive approximately $3,486.25.
Once your out-of-pocket medical costs exceed certain thresholds ($594.40 for OMSN, or $861.20/$2,699.10 for EMSN), Medicare covers a higher percentage of future eligible expenses for the rest of the calendar year.
Yes. HeyDoc provides online fertility referrals from AHPRA-registered Australian doctors. Your referral qualifies you for Medicare rebates and is accepted by all fertility clinics in Australia.
Yes. NSW offers a one-off $2,000 Fertility Treatment Rebate for eligible patients. It's means-tested (household income ≤ $116,000/year), and you must apply within 90 days of treatment through Service NSW.
Egg freezing for non-medical reasons is generally not covered by Medicare. However, fertility preservation for medical reasons (such as before cancer treatment) may qualify for rebates.
Your fertility clinic will usually process Medicare claims on your behalf. You'll need your Medicare card and a valid referral. Rebates are typically processed within a few days.
Need a fertility referral?
Get an online referral from an AHPRA-registered doctor in under 24 hours.
Book Consultation - $49Helpful Resources
Look up MBS item rebates
Search current rebate amounts
Check Safety Net thresholds
See current limits and eligibility
Apply for NSW rebate
$2,000 one-off payment (if eligible)
Medicare overview
General Medicare information
Last updated: January 2026. Rebate amounts change periodically — always verify current rates with Services Australia or your healthcare provider.