Information for pharmacists
Page last updated: 1 January 2025
- 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
- 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
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:
- A payment of $4.79 (in 2024-25) 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
- A payment of $0.78 (in 2024-25) for each supply of a Commonwealth subsidised PBS or RPBS prescription of a section 85 medicine dispensed by an approved pharmacist.
Payments will be processed by Services Australia via a quarterly manual bulk adjustment process, until a PBS online system solution becomes available. Pharmacists will need to 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.
|
Cycle |
ACSS fee for supplies made during |
Claims closed and certified by |
Bulk Adjustment Paid by |
|---|---|---|---|
|
Cycle 1 |
1 April 2024 to 30 June 2024 |
30 June 2024 |
30th October 2024 |
|
Cycle 2 |
1 April 2024 to 30 September 2024 |
30 September 2024 |
30th January 2025 |
|
Cycle 3 |
1 April 2024 to 31 December 2024 |
31 December 2024 |
30th April 2025 |
|
Cycle 4 |
1 April 2024 to 30 March 2025 |
30 March 2025 |
30th July 2025 |
|
Cycle 5 |
1 April 2024 to 30 June 2025 |
30 June 2025 |
30th October 2025 |
Payment notices for ACSS payments will be available in the Statements and Subscriptions tile within HPOS.
It is anticipated that ACSS payments will be automated by 1 July 2025.
Payments for the periods ending 30 March 2025 and 30 June 2025 will be made manually,
after the PBS online system payments solution is in place (as indicated for Cycles
4 and 5 in the above table).
More information on the ACSS payment is available on the Department of Health and Aged Care website or for payment enquiries please contact the PBS general line: 13 22 90 option 2.
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 pre‑existing $1 ‘allowable discount’ and the newer ‘discretionary discount’.
From 1 January 2025, the $1 ‘allowable discount’ will be phased out while annual adjustments to the PBS patient co-payment amounts in line with the Consumer Price Index (CPI) are frozen. It will reduce 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 2025, the allowable co-payment discount will decrease by:
- $0.90 from $1.00 to $0.10 for general patients
- $0.20 from $1.00 to $0.80 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 2025, the lower threshold will remain at $31.60 and the increased discounting upper Commonwealth price will be $49.50. Both of these amounts are normally indexed on 1 January each year. The general patient co-payment will not be indexed in 2025 and remain at the amount of $31.60 for the calendar year of 2025.
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.
