AHSA has updated the Access Gap Cover (AGC) fee schedules to accommodate changes as a result of the latest MBS Update. As further MBS changes are announced, the AGC fee schedules may be amended to reflect the changes.
Please choose your State schedule based on the practice address of the provider number used to make claims.
If you have never submitted a claim using AGC, it is highly recommended that you read these files before preparing to claim.
Reminder: HBF participates in AGC for all states except WA.
AGC benefits and the allowable patient co-payment (where the doctor charges a co-payment) are maximum fees only under the terms of AGC and are not prescribed or recommended fees. Doctors must make their own independent decisions as to whether and to what extent they participate in AGC, and also as to the level at which they set their fees.
If further assistance is required, please contact us.