Information for Pharmacists

• Supplying Medicine – What Pharmacists Need To Know
• How Pharmacists Claim Reimbursement: Information Required
• How Pharmacists Claim Reimbursement: Documents to be Submitted
• Pricing PBS Prescriptions
• Patient Charges for PBS Prescriptions: Example Calculations
• Pharmaceutical Services Federal Committee of Inquiry
• PBS Patient Discounts
• Standard packs and prices
• Container Prices, Fees, Standard Packs and Prices for Ready Prepared Pharmaceutical Benefits
• Standard Packs and Prices for Ready Prepared Pharmaceutical Benefits - Emergency Drug Items
• Standard Packs and Prices for Ready Prepared Pharmaceutical Benefits - General Pharmaceutical Benefits
• Standard Packs and Prices for Ready Prepared Pharmaceutical Benefits - Palliative care
• Extemporaneously-prepared pharmaceutical benefits
• Drug Tariff
• Container Prices
• Standard Formula Preparations
• Table of Codes, Quantities, Repeats

New payments under the Eighth Community Pharmacy Agreement

From 1 April 2024, s90 Approved Pharmacists are entitled to the new Additional Community Supply Support (ACSS) payment for the supply of section 85 PBS and Repatriation PBS medicines.

The ACSS has been legislated in the National Health Act 1953, and has two components:

1. A payment of $5.12 (from 1 July 2026) for each supply of a Commonwealth subsidised PBS or RPBS prescription of a section 85 medicine with increased dispensing quantities by an approved pharmacist, when supplied at the full maximum dispensing quantity; and
2. A payment of $0.13 (from 1 July 2026) for each supply of a Commonwealth subsidised PBS or RPBS prescription of a section 85 medicine dispensed by an approved pharmacist.

Supplies prior to 1 July 2025

For eligible supplies made prior to 1 July 2025, payments have been processed by Services Australia via a quarterly manual bulk adjustment process. Pharmacists must certify and close their claims to receive these payments, as ACSS payments can only be made for supplies in claim periods that have been closed and certified during the manual processing period.

All seven manual ACSS payment cycles have now been completed for eligible PBS supplies between 1 April 2024 and 30 June 2025.

Outstanding manual ACSS payments will not be made until at least 90 days from the date the claim is closed to ensure no further amendments will be made to the claim.

Services Australia will aim to process and issue any eligible ACSS manual payments in due course, noting timeframes may vary depending on processing volumes and validation activities.

Payment notices for ACSS payments are available in the Statements and Subscriptions tile within HPOS.

Completed manual ACSS payment cycle information

Supplies from 1 July 2025

For eligible supplies from 1 July 2025, PBS approved suppliers are now receiving ACSS fees as part of their usual PBS payments. Enquiries can be made via usual escalation channels to Services Australia.

More information on the ACSS payment is available on the Department of Health, Disability and Ageing website or for payment enquiries please contact the PBS general line: 13 22 90 option 1.

PBS Patient Discounts

The Australian Government is committed to easing cost of living pressures and ensuring that all Australians have access to high quality health care. This includes subsidising the cost of medicines through the PBS.

Since 1 January 2023, pharmacists have had the choice to further reduce the cost of PBS medicines for patients. This can only be done by applying both the ‘allowable discount’ and the newer ‘discretionary discount’.

From 1 January 2025, the pre‑existing $1 ‘allowable discount’ started to be phased out while annual adjustments to the PBS patient co-payment amounts in line with the Consumer Price Index (CPI) were frozen. It is reducing by the amount of indexation (in dollars) that would have applied to a patient’s PBS co-payment until it reaches zero.

For the calendar year of 2026, the allowable co-payment discount will be reduced:

• to nil for general patients;
• from 80 cents to 60 cents for concessional patients.

Pharmacists are not permitted to reduce the charge for an over co‑payment prescription any further under any other PBS arrangement.

New discretionary discount for some medicines

From 1 January 2023, pharmacists have had the option to offer general patients an additional discount on prescriptions for specific eligible medicines.

This additional discretionary discount (referred to as ‘increased discount’ under the National Health Act 1953) can be applied when supplying a PBS prescription to a general patient, where the Commonwealth price of the medicine is in the range above the co‑payment amount and the increased discounting upper Commonwealth price. In 2026, the lower threshold will be reduced to $25.00 and the increased discounting upper Commonwealth price will be $51.10. Both of these amounts are normally indexed on 1 January each year. The general patient co-payment will be reduced to $25.00 for the calendar year of 2026.

This discount is not mandatory and is applied at the discretion of the pharmacist.

The discretionary discount is not able to be applied for concessional scripts.