The MRAC has officially given the nod for midwives to access hormonal contraceptive insertion and removal MBS items.
The MBS Review Advisory Committee’s long-acting reversible contraceptive working group has directly contradicted RACGP advice in recommending that midwives be able to bill Medicare when inserting or removing IUDs and hormonal implants.
Published by the Department of Health, Disability and Ageing on Wednesday, the committee’s final report concluded that endorsed midwife MBS access was “safe and appropriate” in the context of contraceptive care within and beyond the postpartum period of eight weeks.
However, the working group ultimately decided that midwives should not be able to get MBS rebates for LARC administration in situations beyond contraception – heavy menstrual bleeding, for instance, is out of scope.
The recommendation specifically pertains to endorsed midwives, a subgroup of the profession which only includes midwives who have completed at least 5000 hours of clinical practice and additional post-graduate study.
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It will now be up to the DoHDA as to whether the MRAC recommendation is accepted and put in place; however, it is worth noting that the previous recommendations from this specific working group have already been implemented.
These include fee increases for existing MBS items, the introduction of new MBS items for nurse practitioners providing LARC services and bulk billing loading items.
All three were announced in 2025 as part of a $500 million women’s health funding package.
Responding to the LARC working group’s draft report in November, the RACGP warned that the “invasive” nature of LARC procedures meant that MBS rebates should be limited to “qualified practitioners”.
“Although LARC insertion may appear to be a simple procedure to some patients and non-medical practitioners, the RACGP highlights that it involves inherent clinical risks and may present substantial procedural complexity in particular circumstances or patient population risk,” it wrote.
The final MRAC report notes that endorsed midwives “have access to the same training available to other providers wanting to train in insertion and removal of LARC”.
In line with advice from medical groups, though, the working group did recommend against extending MBS access for LARC items to any other provider groups.
