Department of Health

Fees for patients not covered by Medicare

Hospital and health service costs for Medicare ineligible patients.

Health services are required to set their own fees for patients who are not covered by Medicare, including overseas patients. Where possible, ineligible patients should be charged the full cost of their care.

When charging fees, hospitals should be aware that some overseas patients are entitled to financial assistance (for example because of Reciprocal Health Care Agreements).

Fees will vary between hospitals and may be determined on a Diagnostic Related GroupExternal Link (DRG) or bed day basis. Fees raised on a DRG basis may be calculated using the national weighted activity unit (NWAU) price weight.

Note: This is a guideline only and fees charged to Medicare ineligible patients are to be determined by individual health services.

Accommodation charge: fee per day

Patient classification typeEstimated average costs for 2024-25Estimated average costs for 2025-26
Same day: single room$403$424
Same day: shared ward$281$295
Overnight: single room$908$954
Overnight: shared ward$783$823
Intensive Care Unit: 1-4 days$6,325$6,648
Intensive Care Unit: 5+ days$5,816$6,113
Coronary Care Unit: 1-4 days$2,372$2,493
Coronary Care Unit: 5+ days$1,388$1,459
Emergency department: admitted$1,537$1,615
Emergency department: non-admitted$592$622
Hospital in the home$420$441

Outpatient charge: fee per encounter

Patient classificationEstimated average costs for 2024-25Estimated average costs for 2025-26
Medical$355$373
Allied health$205$215

Postnatal care charge: hourly rate

Patient classificationEstimated average costs for 2024-25Estimated average costs for 2025-26
Medical$107$112

More information

The accommodation charges are based on the 2020-21 Victorian Cost Data Collection.

The non-admitted charges are based on prior year's charges.

The fee for postnatal care is based on community health nursing hourly rates, as average cost cannot be calculated with the available data.

These charges include an allowance for indexation and depreciation to estimate bed day and encounter costs for 2025-26.

A number of costs are excluded. Health services should ensure that they also charge for the following items:

  • Medical costs billed separately by the treating medical practitioner
  • Diagnostics, which should be charged at 100 per cent of the Medicare Benefits Schedule rate
  • Prostheses, in line with the Commonwealth’s schedule rate
  • Drugs, which should be charged at cost (only when a bed day fee applies – fees determined on a DRG basis already include costs for drugs).
  • Theatre fees. These are based on the TAC Schedule of Fees for Private Hospital Services (non-arrangement).External Link

Reviewed 30 June 2025

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Mailing address: GPO Box 4057, Melbourne, Victoria 3001, Melbourne, VIC 3000
Phone 1300 650 172
abf@health.vic.gov.au
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