Medicare and PBS
Is testosterone treatment covered by Medicare or the PBS in Australia?
This page explains Medicare and PBS rules. It is not a clinic, and it does not prescribe.
Medicare vs PBS — two different bills
Medicare and the PBS are different systems. Medicare, through the Medicare Benefits Schedule, can rebate eligible professional services and some pathology. The PBS can subsidise listed medicines when a restriction is met. Both need eligibility. Neither starts because someone searched for testosterone treatment. A rebated visit does not mean a subsidised product, and a PBS supply does not make the consultation free.
The two bills
- Medicare
- Eligible consults and doctor-requested pathology, billed separately
- PBS
- Authority Required for listed testosterone products
- General co-payment
- Up to $25 from 1 January 2026
- Concessional co-payment
- $7.70, with indexation resuming in 2030
- Low T Check
- Matching only. Nothing is paid on this site
Does Medicare cover the consultation?
Medicare may rebate an eligible attendance. The clinic sets any gap and takes the fee. A bulk-billed visit means the practitioner accepts the Medicare benefit as full payment for that service (Services Australia). Telehealth rules can differ from an in-person visit. This page does not state a rebate dollar amount, because schedule fees change, and it does not claim that partner clinics bulk bill.
Consultation fees are a separate question from medicine subsidies. Use the consultation cost estimator for GP and specialist visit gaps only. If a GP has declined a blood test, see what to do when your GP won't test testosterone.
Does Medicare cover blood tests?
A doctor-requested blood test may be bulk billed when it is clinically indicated and the collector bulk bills. That can mean no out-of-pocket charge for that pathology service. It is not guaranteed. The consultation is a separate bill. Testosterone blood test costs in Australia covers pathology billing. Reading a report is covered in how to read your results. This page does not restate that guide.
When can the PBS subsidise testosterone?
Listed testosterone products on the items below are Authority Required. Authority Required means the doctor needs approval from Services Australia or the Department of Veterans' Affairs, and must state the conditions that apply (PBS: constraints on prescribers). The patient has to meet the clinical criteria on that item. Not every private supply is a PBS supply. The doctor applies. Low T Check does not.
These item pages were checked on 27 October 2026. Each one is Authority Required and lists androgen deficiency among its indications, along with defined paediatric indications where shown:
Open the live item for the form and the expanded restriction. This page does not catalogue brands or doses.
Who usually has to be involved
The November 2025 PBAC public summary document says topical testosterone listings for men are Authority Required and require non-GP specialist treatment, or a consultation with a specialist (PBAC public summary document, November 2025). Restriction summaries also describe an appointment to be assessed by a listed specialist, and the specialist's name on the Authority application. The specialists named on an item can include an endocrinologist, a urologist, a sexual health physician, and paediatric specialists where that indication is listed.
Confirm the exact pathway on the expanded restriction before anyone relies on it. Wording can change. A GP conversation does not, by itself, show that an Authority will be approved.
What the PBS restriction is looking for
There is a pathway for an established pituitary or testicular disorder, and a separate pathway for men without that disorder. The same PBAC document restates the second pathway: androgen deficiency is established on at least two morning blood samples, with a level under 6 nmol/L, or 6 to 15 nmol/L with high luteinising hormone. It also says the restriction does not allow use for low libido caused by ageing only.
Restriction summaries for that second pathway also describe men aged 40 or over, and say the condition is not attributed only to age, obesity, cardiovascular disease, infertility or drugs. Confirm that sentence on the live item. A doctor interprets the samples. This page is not a calculator, and it does not say whether you meet a restriction.
The assessment steps before any treatment decision are on how to get low testosterone treatment in Australia.
What you pay at the pharmacy if the PBS applies
From 1 January 2026 the general patient co-payment is up to $25. The concessional co-payment is $7.70. A brand premium or another allowable charge can sit on top. The Department of Health says the concessional rate continues until 1 January 2030 (PBS co-payments). The PBS fees page says the concessional amount is not indexed on 1 January 2026, remains until 2029, and is indexed again from 1 January 2030 (current patient fees and charges).
From 1 January 2026 the Safety Net threshold is $1,748.20 for general patients. The concessional Safety Net threshold is $277.20. After a family reaches the threshold, later items in that calendar year are charged at a lower rate. Confirm the current figures on those two pages. This page does not list brand prices.
Private supply that is not on the PBS
If the restriction is not met, or the doctor uses a private supply instead of PBS Authority, the pharmacy charges its own price. That charge is not a Medicare rebate for the product. Low T Check does not set it and does not publish it.
Does private health insurance cover testosterone treatment?
Funds generally cannot pay extras toward a medicine you can get as a PBS benefit. Examples of how funds explain that limit are published by HCF and ahm. A supply that is not on the PBS may attract a pharmacy extra only if your policy includes it. Waiting periods, schedules and exclusions differ. Hospital cover is not an outpatient pharmacy benefit. Check your fund. This page does not promise a benefit from any insurer.
How this sits with Low T Check
The ADAM symptom check on the home page takes about 2 minutes. It is a screening tool, not a diagnosis. If you request a call, a partner clinic calls within 48 hours. The Low T Check team does not make that call. The doctor decides what, if anything, happens next, explains any consult fee, and takes that fee. Low T Check does not prescribe, does not apply for PBS Authority, and does not bill Medicare. Nothing is paid on this website. For the full flow, see how Low T Check works.
This service is not for emergencies. If you need urgent help, call 000.
Frequently asked questions
Is testosterone on the PBS in Australia?
Some testosterone products are PBS-listed as Authority Required for defined indications, including androgen deficiency. A listing is not an automatic subsidy for every patient. A doctor applies for Authority when the restriction criteria are met. The live PBS item page states the current restriction.
Does Medicare pay for testosterone medicine?
Medicare, through the Medicare Benefits Schedule, mainly rebates eligible professional services and some pathology. When a subsidy applies to a listed testosterone product, it is through the PBS. There is no general rule that Medicare pays for the product itself.
Can my GP arrange PBS-listed testosterone?
A medical practitioner may prescribe under PBS rules. Authority criteria for androgen deficiency typically require specialist treatment, a consultation with a specialist, or an appointment for assessment. Confirm the process with the prescribing doctor and the live PBS restriction. Low T Check does not apply for Authority.
Does private health insurance cover testosterone treatment?
Funds generally cannot pay extras for a product available as a PBS benefit. A supply that is not on the PBS may attract limited extras if the policy includes pharmacy cover. Check the fund. Insurance is not a substitute for clinical criteria, and hospital cover is not the same thing as an outpatient pharmacy benefit.
What is the PBS co-payment in 2026?
From 1 January 2026 the general patient co-payment is up to $25. The concessional co-payment is $7.70. A brand premium or another allowable charge can be added. Safety Net thresholds from that date are $1,748.20 for general patients and $277.20 for concession patients.
Does Low T Check bulk bill or apply for PBS Authority?
No. Low T Check is a matching service, not a clinic. It does not prescribe, apply for PBS Authority, or bill Medicare. The partner clinic and its doctor handle clinical decisions, fees, and any Authority application. Nothing is paid on this website.
Official sources
Checked 27 October 2026, except where a page shows an older updated date. These documents do not endorse Low T Check.
- Pharmaceutical Benefits Scheme — Testosterone item 10378F, Authority Required
- Pharmaceutical Benefits Scheme — Testosterone item 10205D, Authority Required
- Pharmaceutical Benefits Scheme — Testosterone item 8830R, Authority Required
- Pharmaceutical Benefits Scheme — Testosterone item 11740X, Authority Required
- Pharmaceutical Benefits Scheme — Current patient fees and charges
- Department of Health, Disability and Ageing — PBS co-payments from 1 January 2026
- Pharmaceutical Benefits Scheme — Constraints on prescribers, including Authority Required benefits
- Pharmaceutical Benefits Advisory Committee — Testosterone public summary document, November 2025
- Services Australia — Bulk billing: eligibility and what it covers
- Ahpra — Advertising guidelines for regulated health services
- Therapeutic Goods Administration — Rules on advertising medicines to the public
Get matched with a men's health doctor for low testosterone
A partner clinic will call you within 48 hours.
Take the 2-minute symptom check
The ADAM symptom check shows whether your symptoms may be worth discussing with a doctor. You can also request a callback to get matched with a men's health doctor at a partner clinic, by telehealth or in person, for an assessment.
Start the 2-minute symptom checkWant to talk to someone first? Read how getting matched with a doctor works.
*Blood tests may be bulk billed where eligible, subject to doctor assessment and clinical indication.