Informed financial consent for anaesthetists: what to include, and when.
Informed financial consent (IFC) is a written estimate of your anaesthetic fee, the expected Medicare and health fund benefits and the patient’s out-of-pocket gap, given before surgery so the patient can agree to it. The Medical Board expects timely fee information, and the Medibank, Bupa and nib known-gap schemes make IFC a condition of known-gap billing.
Four sources set the expectation.
No single law sets out IFC for every anaesthetic, and none sets a number of days. The expectation comes from the code of conduct, professional guidance and the terms of the funds’ gap schemes. Together they point the same way: good practice is to tell the patient your fee in writing, well before the day.
Fees, in a timely manner
The code of conduct (section 4.5.3) expects doctors to make sure patients are informed about their fees and charges in a timely manner, so they can decide whether to proceed. It sets no number of days and doesn’t say the information must be in writing. Good medical practice, effective 1 October 2020.
In writing, from each practitioner
IFC should be given in writing, ideally before the procedure, and each associated practitioner, including the anaesthetist, is responsible for their own. Email, SMS and apps are acceptable. AMA: Informed financial consent 2024.
A written estimate is the gold standard
ASA-PS04 describes a written estimate of the anaesthesia fee, with a range acceptable, given before the day of the procedure. A first fee discussion at the pre-anaesthesia visit is “less than ideal” for elective cases. ASA-PS04.
A condition of known-gap billing
Medibank GapCover and nib MediGap require the gap to be given to the patient in writing; Bupa’s Medical Gap Scheme requires IFC at the first consultation and evidence of it on audit. Each caps the known gap at $500. Check the terms of the patient’s fund.
Fund terms: Medibank GapCover (19 Dec 2023) · Bupa Medical Gap Scheme (1 Feb 2025) · nib MediGap (15 Jul 2026).
What an anaesthetic IFC should contain.
| Include | Why it matters |
|---|---|
| Your name and practice contact | The patient needs to know who will bill them and who to call with questions. |
| Likely MBS item numbers | Lets the patient check their Medicare and fund benefits. For anaesthesia, include the expected units or time. |
| Estimated fee, or a range | Anaesthesia fees depend on duration, so a range is acceptable. |
| Expected Medicare benefit | For a private in-hospital service, Medicare pays 75% of the MBS schedule fee. |
| Expected fund benefit and scheme | Say whether you are billing no-gap, known-gap or outside the fund’s scheme. |
| The out-of-pocket gap | The ASA calls this the most important figure for patients. |
| What could change the fee | A longer operation, an extra procedure, a complication or an after-hours or emergency start. |
| When and how to pay | Whether you ask for prepayment, and the payment options. |
| A check-your-cover note | Patients should confirm their entitlements with Medicare and their fund. |
| The patient’s acceptance | A record that they received and agreed to the estimate. |
Based on the AMA 2024 position statement, ASA-PS04 and Avant’s guidance for anaesthetists (Feb 2026).
What the patient should see.
An illustrative estimate for a knee arthroscopy for a Bupa member in Victoria, billed under the fund’s known-gap scheme. The figures match the default example in our patient fee estimator.
| Estimated anaesthesia units (base and time) | 6 units |
|---|---|
| Anaesthetist’s fee (6 × $65) | $390.00 |
| MBS schedule fee (6 × $23.70) | $142.20 |
| Medicare benefit (75% of schedule fee) | −$106.65 |
| Bupa benefit under its gap scheme | −$128.85 |
| Estimated out-of-pocket gap | $154.50 |
The fee could be higher if the operation takes longer than expected. If a separate pre-anaesthesia consultation is needed, it may be billed separately (MBS items 17610–17625). Please confirm your cover with Medicare and your fund.
When IFC should reach the patient.
- At booking
Get the surgical details
The surgeon’s item numbers and expected duration let you estimate units. Private hospitals must already tell patients that the anaesthetist may bill separately, so your estimate should follow.
- Before the day
Send the written estimate
Early enough for the patient to read it, ask questions or change their mind. We send ours seven days before surgery, with a prepayment request where the anaesthetist wants one.
- Before the day
Record the acceptance
Keep the patient’s acceptance with the account. Bupa’s scheme, for example, can ask for evidence of IFC on audit.
- On the day
Confirm, don’t introduce
Use the pre-anaesthesia visit to confirm the estimate and answer questions, not to raise the fee for the first time.
- After the procedure
Explain any change
If the fee rises above the estimate, tell the patient why before or with the account. In an emergency, give fee information as soon as practicable afterwards.
Where the usual process bends.
Emergencies
The AMA, the ASA and the Commonwealth Ombudsman expect fee information as soon as practicable after urgent treatment, and the Department of Health, Disability and Ageing accepts that prior IFC may not be possible.
Covering a colleague’s list
Avant advises that if you take over a list, you generally charge the fee the patient was already quoted, and charge more only after full and timely disclosure.
DVA, workers’ compensation and TAC
These schemes have their own fee rules. For example, TAC lets a practitioner charge the difference when their fee is above TAC’s. Check the scheme’s rules before quoting or charging any gap.
Long cases and the $500 cap
Because anaesthesia is time-based, a long case can push a known gap past the scheme cap. Build the likely range into the estimate, and know what the patient’s fund does if the cap is exceeded.
Before you send an estimate.
- Item numbers and estimated units checked against the surgeon’s booking
- Fee or range, Medicare benefit, fund benefit and gap all shown
- The fund’s gap scheme and its cap checked for this patient
- What could change the fee explained in plain words
- Payment timing and options stated, including any prepayment
- Sent in writing, with time for the patient to respond
- The patient’s acceptance recorded with the account
IFC checklist for anaesthetists
One printable page: what to include, when to send it, and the special cases.
IFC is part of every list we bill.
When your operating lists come to us from the surgical rooms, we prepare each patient’s estimate from your fee schedule and their fund. We send the IFC seven days before surgery, with a prepayment request where you want one, and patients can complete their pre-anaesthetic questionnaire on their phone at the same time. After the case, you submit your codes and times; we invoice within 48 hours and follow up any rejected claims every week.
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Common questions
Is informed financial consent a legal requirement for anaesthetists?
The Medical Board’s code of conduct expects doctors to tell patients about their fees and charges in a timely manner, and the AMA says IFC should be in writing. If you bill a known gap under a health fund’s gap scheme, the scheme terms make IFC a condition: Medibank and nib require it in writing, and Bupa requires it at the first consultation.
Does the surgeon’s quote cover the anaesthetist’s fee?
No. The AMA’s 2024 position statement makes each practitioner involved in the care, including the anaesthetist, responsible for providing IFC for their own fees, or for giving their fees to the treating practitioner to pass on.
When should an anaesthetist send IFC?
Before the day of surgery, early enough for the patient to ask questions or change their mind. No law sets a number of days. The ASA describes discussing fees for the first time at the in-hospital pre-anaesthesia visit as less than ideal for elective cases. Fast Tracking sends IFC to patients seven days before surgery.
Can I give a range instead of an exact fee?
Yes. Anaesthesia fees depend on how long the procedure takes, so the ASA accepts a range. Explain what would move the fee within or above that range, such as a longer operation, an extra procedure or an after-hours start.
What about emergencies?
When IFC isn’t possible before urgent treatment, the AMA, the ASA and the Commonwealth Ombudsman expect fee information to be given as soon as practicable after the service, and the Department of Health, Disability and Ageing accepts that prior IFC may not be possible.
What is the maximum known gap under the main gap schemes?
Medibank GapCover, Bupa’s Medical Gap Scheme, HCF’s Medicover and nib MediGap each cap the known gap at $500, and nib GapSure allows a known gap of up to $500 only for services of 5 or more base units. Access Gap Cover, used by GMHBA and by HBF outside Western Australia, caps it at $500 per episode ($800 for obstetrics). In WA, HBF has its own Medical Gap Agreement with no known-gap option. Always check the current terms of the patient’s fund.
Where this comes from
- Medical Board of Australia, Good medical practice: a code of conduct for doctors in Australia (1 October 2020), section 4.5.3
- AMA, Informed financial consent position statement (April 2024)
- Australian Society of Anaesthetists, ASA PS04 Informed Financial Agreement (revised May 2019)
- Commonwealth Ombudsman, Informed financial consent factsheet (updated January 2026)
- Department of Health, Out-of-pocket costs
- Avant, Informed financial consent: why it matters for anaesthetists (February 2026)
- Fund terms: Medibank GapCover, Bupa Medical Gap Scheme, nib MediGap
This page is general information for practitioners, not legal advice. Sources checked 24 October 2026.
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