> For clean Markdown of any page, append .md to the page URL.
> For a complete documentation index, see https://docs.rebateright.com.au/llms.txt.
> For AI client integration (Claude Code, Cursor, etc.), connect to the MCP server at https://docs.rebateright.com.au/_mcp/server.

# Benefit Calculator

POST https://api.rebateright.com.au/CalculateBenefit
Content-Type: application/json

Returns the benefit Medicare pays for an MBS item. The schedule fee comes back with it.

Every request field is optional. An empty body `{}` is valid: it prices a standard GP
consultation (item `23`) for one patient, out of hospital. The response echoes the values it
used, so you always see which defaults applied.

## What the calculation takes into account

* The benefit and schedule fee published for the item in the MBS in force today. Benefits
  are read from the published amounts rather than worked out as a percentage of the fee, so
  they match what Medicare pays on every item, including the high-fee ones where a
  percentage does not.
* Whether the service is in hospital or out of hospital, for the items that pay differently
  in each.
* How many patients were seen on the occasion, for the attendance items whose fee depends on
  it, such as a general practitioner seeing several residents in one visit to an aged care
  facility. These figures reproduce the official MBS Ready Reckoner exactly.

A request that cannot be priced still returns `200`, with `ReasonCode` and `Reason`
explaining why. Only an unparseable body returns `400`.

To check whether a specific patient can claim an item, use
[Eligibility Check](/api-reference/medicare-eligibility/eligibility-check), which verifies
the patient with Medicare and quotes the same benefit.

Reference: https://docs.rebateright.com.au/api-reference/mbs/benefit-calculator

## Authentication

- `x-api-key` header (required)
- `x-minor-id` header (required)

## Servers

- `https://api.rebateright.com.au` (Production, default)
- `https://test-api.rebateright.com.au` (Test)

## Request

### Body (application/json)

- `ItemNumber` (string, optional) — The MBS item number to price. Defaults to `23` (a standard GP consultation, Level B) when omitted.
- `PatientsSeen` (integer, optional) — How many patients the practitioner sees at the same place on the same occasion. Sets the per-patient fee on the attendance items whose fee depends on it, and multiplies `TotalBenefit` for every item. Defaults to `1` when omitted. A value below `1` returns `200` with `ReasonCode` `InvalidRequest`.
- `InHospitalTreatment` (boolean, optional) — Whether the service is provided to an in-hospital patient. Defaults to false when omitted, and the service is priced out of hospital.

## Response

### 200

OK

- `ItemNumber` (string, required) — The item that was priced, such as `"5010"`, echoed back with the default applied if you omitted it.
- `PatientsSeen` (integer, required) — The patient count used, with the default applied if you omitted it.
- `InHospitalTreatment` (boolean, required) — The setting the calculation used.
- `ScheduleFee` (string, required, nullable) — The MBS schedule fee per patient, in whole dollars and cents such as `"53.35"`. It is `null` when the fee could not be determined.
- `Benefit` (string, required, nullable) — What Medicare pays per patient, in whole dollars and cents such as `"53.35"`. It is `null` when the benefit could not be calculated, and `Reason` says why.
- `TotalBenefit` (string, required, nullable) — `Benefit` multiplied by `PatientsSeen`: what Medicare pays across the whole occasion. It is `null` whenever `Benefit` is.
- `Reason` (string, required) — How the amounts were worked out, in one sentence you can show as it is. Never parse it, because the wording changes.
- `ReasonCode` (string, required) — A code for that reason, for analytics only. | Code | Meaning | |---|---| | `Calculated` | The fee and benefit were calculated. | | `InvalidRequest` | A request value failed validation; `Reason` says which. | | `ItemNotFound` | The item number is not in the current MBS. | | `ScheduleFeeNotAvailable` | The item exists but its fee is not available in the MBS data. | | `FeeDependsOnOtherServices` | The item's fee is derived from details this calculator does not have, such as the other services performed or the time taken. `Reason` quotes the schedule's own rule. | | `BenefitNotDetermined` | The fee is known but the benefit percentage could not be determined. | New codes appear as coverage grows and are not a breaking change.

## Examples

### Defaults

**Request**

```json
{}
```

**Response**

```json
{
  "ItemNumber": "23",
  "PatientsSeen": 1,
  "InHospitalTreatment": false,
  "ScheduleFee": "45.05",
  "Benefit": "45.05",
  "TotalBenefit": "45.05",
  "Reason": "Medicare item 23 has a schedule fee of $45.05. Medicare pays a benefit of $45.05, as published in the MBS.",
  "ReasonCode": "Calculated"
}
```

**SDK Code**

```python Defaults
import requests

url = "https://api.rebateright.com.au/CalculateBenefit"

payload = {}
headers = {
    "x-api-key": "<apiKey>",
    "Content-Type": "application/json"
}

response = requests.post(url, json=payload, headers=headers)

print(response.json())
```

```javascript Defaults
const url = 'https://api.rebateright.com.au/CalculateBenefit';
const options = {
  method: 'POST',
  headers: {'x-api-key': '<apiKey>', 'Content-Type': 'application/json'},
  body: '{}'
};

try {
  const response = await fetch(url, options);
  const data = await response.json();
  console.log(data);
} catch (error) {
  console.error(error);
}
```

```go Defaults
package main

import (
	"fmt"
	"strings"
	"net/http"
	"io"
)

func main() {

	url := "https://api.rebateright.com.au/CalculateBenefit"

	payload := strings.NewReader("{}")

	req, _ := http.NewRequest("POST", url, payload)

	req.Header.Add("x-api-key", "<apiKey>")
	req.Header.Add("Content-Type", "application/json")

	res, _ := http.DefaultClient.Do(req)

	defer res.Body.Close()
	body, _ := io.ReadAll(res.Body)

	fmt.Println(res)
	fmt.Println(string(body))

}
```

```ruby Defaults
require 'uri'
require 'net/http'

url = URI("https://api.rebateright.com.au/CalculateBenefit")

http = Net::HTTP.new(url.host, url.port)
http.use_ssl = true

request = Net::HTTP::Post.new(url)
request["x-api-key"] = '<apiKey>'
request["Content-Type"] = 'application/json'
request.body = "{}"

response = http.request(request)
puts response.read_body
```

```java Defaults
import com.mashape.unirest.http.HttpResponse;
import com.mashape.unirest.http.Unirest;

HttpResponse<String> response = Unirest.post("https://api.rebateright.com.au/CalculateBenefit")
  .header("x-api-key", "<apiKey>")
  .header("Content-Type", "application/json")
  .body("{}")
  .asString();
```

```php Defaults
<?php
require_once('vendor/autoload.php');

$client = new \GuzzleHttp\Client();

$response = $client->request('POST', 'https://api.rebateright.com.au/CalculateBenefit', [
  'body' => '{}',
  'headers' => [
    'Content-Type' => 'application/json',
    'x-api-key' => '<apiKey>',
  ],
]);

echo $response->getBody();
```

```csharp Defaults
using RestSharp;

var client = new RestClient("https://api.rebateright.com.au/CalculateBenefit");
var request = new RestRequest(Method.POST);
request.AddHeader("x-api-key", "<apiKey>");
request.AddHeader("Content-Type", "application/json");
request.AddParameter("application/json", "{}", ParameterType.RequestBody);
IRestResponse response = client.Execute(request);
```

```swift Defaults
import Foundation

let headers = [
  "x-api-key": "<apiKey>",
  "Content-Type": "application/json"
]
let parameters = [] as [String : Any]

let postData = JSONSerialization.data(withJSONObject: parameters, options: [])

let request = NSMutableURLRequest(url: NSURL(string: "https://api.rebateright.com.au/CalculateBenefit")! as URL,
                                        cachePolicy: .useProtocolCachePolicy,
                                    timeoutInterval: 10.0)
request.httpMethod = "POST"
request.allHTTPHeaderFields = headers
request.httpBody = postData as Data

let session = URLSession.shared
let dataTask = session.dataTask(with: request as URLRequest, completionHandler: { (data, response, error) -> Void in
  if (error != nil) {
    print(error as Any)
  } else {
    let httpResponse = response as? HTTPURLResponse
    print(httpResponse)
  }
})

dataTask.resume()
```

### Ready Reckoner

**Request**

```json
{
  "ItemNumber": "5010",
  "PatientsSeen": 3
}
```

**Response**

```json
{
  "ItemNumber": "5010",
  "PatientsSeen": 3,
  "InHospitalTreatment": false,
  "ScheduleFee": "53.35",
  "Benefit": "53.35",
  "TotalBenefit": "160.05",
  "Reason": "Medicare item 5010 has a derived fee: the fee for item 5000 ($34.70), plus $55.95 divided by the number of patients seen (3), rounded to the nearest 5 cents. The schedule fee is $53.35 per patient, and Medicare pays a benefit of 100% of that fee, as published in the MBS Ready Reckoner.",
  "ReasonCode": "Calculated"
}
```

**SDK Code**

```python Ready Reckoner
import requests

url = "https://api.rebateright.com.au/CalculateBenefit"

payload = {
    "ItemNumber": "5010",
    "PatientsSeen": 3
}
headers = {
    "x-api-key": "<apiKey>",
    "Content-Type": "application/json"
}

response = requests.post(url, json=payload, headers=headers)

print(response.json())
```

```javascript Ready Reckoner
const url = 'https://api.rebateright.com.au/CalculateBenefit';
const options = {
  method: 'POST',
  headers: {'x-api-key': '<apiKey>', 'Content-Type': 'application/json'},
  body: '{"ItemNumber":"5010","PatientsSeen":3}'
};

try {
  const response = await fetch(url, options);
  const data = await response.json();
  console.log(data);
} catch (error) {
  console.error(error);
}
```

```go Ready Reckoner
package main

import (
	"fmt"
	"strings"
	"net/http"
	"io"
)

func main() {

	url := "https://api.rebateright.com.au/CalculateBenefit"

	payload := strings.NewReader("{\n  \"ItemNumber\": \"5010\",\n  \"PatientsSeen\": 3\n}")

	req, _ := http.NewRequest("POST", url, payload)

	req.Header.Add("x-api-key", "<apiKey>")
	req.Header.Add("Content-Type", "application/json")

	res, _ := http.DefaultClient.Do(req)

	defer res.Body.Close()
	body, _ := io.ReadAll(res.Body)

	fmt.Println(res)
	fmt.Println(string(body))

}
```

```ruby Ready Reckoner
require 'uri'
require 'net/http'

url = URI("https://api.rebateright.com.au/CalculateBenefit")

http = Net::HTTP.new(url.host, url.port)
http.use_ssl = true

request = Net::HTTP::Post.new(url)
request["x-api-key"] = '<apiKey>'
request["Content-Type"] = 'application/json'
request.body = "{\n  \"ItemNumber\": \"5010\",\n  \"PatientsSeen\": 3\n}"

response = http.request(request)
puts response.read_body
```

```java Ready Reckoner
import com.mashape.unirest.http.HttpResponse;
import com.mashape.unirest.http.Unirest;

HttpResponse<String> response = Unirest.post("https://api.rebateright.com.au/CalculateBenefit")
  .header("x-api-key", "<apiKey>")
  .header("Content-Type", "application/json")
  .body("{\n  \"ItemNumber\": \"5010\",\n  \"PatientsSeen\": 3\n}")
  .asString();
```

```php Ready Reckoner
<?php
require_once('vendor/autoload.php');

$client = new \GuzzleHttp\Client();

$response = $client->request('POST', 'https://api.rebateright.com.au/CalculateBenefit', [
  'body' => '{
  "ItemNumber": "5010",
  "PatientsSeen": 3
}',
  'headers' => [
    'Content-Type' => 'application/json',
    'x-api-key' => '<apiKey>',
  ],
]);

echo $response->getBody();
```

```csharp Ready Reckoner
using RestSharp;

var client = new RestClient("https://api.rebateright.com.au/CalculateBenefit");
var request = new RestRequest(Method.POST);
request.AddHeader("x-api-key", "<apiKey>");
request.AddHeader("Content-Type", "application/json");
request.AddParameter("application/json", "{\n  \"ItemNumber\": \"5010\",\n  \"PatientsSeen\": 3\n}", ParameterType.RequestBody);
IRestResponse response = client.Execute(request);
```

```swift Ready Reckoner
import Foundation

let headers = [
  "x-api-key": "<apiKey>",
  "Content-Type": "application/json"
]
let parameters = [
  "ItemNumber": "5010",
  "PatientsSeen": 3
] as [String : Any]

let postData = JSONSerialization.data(withJSONObject: parameters, options: [])

let request = NSMutableURLRequest(url: NSURL(string: "https://api.rebateright.com.au/CalculateBenefit")! as URL,
                                        cachePolicy: .useProtocolCachePolicy,
                                    timeoutInterval: 10.0)
request.httpMethod = "POST"
request.allHTTPHeaderFields = headers
request.httpBody = postData as Data

let session = URLSession.shared
let dataTask = session.dataTask(with: request as URLRequest, completionHandler: { (data, response, error) -> Void in
  if (error != nil) {
    print(error as Any)
  } else {
    let httpResponse = response as? HTTPURLResponse
    print(httpResponse)
  }
})

dataTask.resume()
```

### In Hospital

**Request**

```json
{
  "ItemNumber": "104",
  "InHospitalTreatment": true
}
```

**Response**

```json
{
  "ItemNumber": "104",
  "PatientsSeen": 1,
  "InHospitalTreatment": true,
  "ScheduleFee": "103.95",
  "Benefit": "78.00",
  "TotalBenefit": "78.00",
  "Reason": "Medicare item 104 has a schedule fee of $103.95. The service is in hospital. Medicare pays a benefit of $78.00, as published in the MBS.",
  "ReasonCode": "Calculated"
}
```

**SDK Code**

```python In Hospital
import requests

url = "https://api.rebateright.com.au/CalculateBenefit"

payload = {
    "ItemNumber": "104",
    "InHospitalTreatment": True
}
headers = {
    "x-api-key": "<apiKey>",
    "Content-Type": "application/json"
}

response = requests.post(url, json=payload, headers=headers)

print(response.json())
```

```javascript In Hospital
const url = 'https://api.rebateright.com.au/CalculateBenefit';
const options = {
  method: 'POST',
  headers: {'x-api-key': '<apiKey>', 'Content-Type': 'application/json'},
  body: '{"ItemNumber":"104","InHospitalTreatment":true}'
};

try {
  const response = await fetch(url, options);
  const data = await response.json();
  console.log(data);
} catch (error) {
  console.error(error);
}
```

```go In Hospital
package main

import (
	"fmt"
	"strings"
	"net/http"
	"io"
)

func main() {

	url := "https://api.rebateright.com.au/CalculateBenefit"

	payload := strings.NewReader("{\n  \"ItemNumber\": \"104\",\n  \"InHospitalTreatment\": true\n}")

	req, _ := http.NewRequest("POST", url, payload)

	req.Header.Add("x-api-key", "<apiKey>")
	req.Header.Add("Content-Type", "application/json")

	res, _ := http.DefaultClient.Do(req)

	defer res.Body.Close()
	body, _ := io.ReadAll(res.Body)

	fmt.Println(res)
	fmt.Println(string(body))

}
```

```ruby In Hospital
require 'uri'
require 'net/http'

url = URI("https://api.rebateright.com.au/CalculateBenefit")

http = Net::HTTP.new(url.host, url.port)
http.use_ssl = true

request = Net::HTTP::Post.new(url)
request["x-api-key"] = '<apiKey>'
request["Content-Type"] = 'application/json'
request.body = "{\n  \"ItemNumber\": \"104\",\n  \"InHospitalTreatment\": true\n}"

response = http.request(request)
puts response.read_body
```

```java In Hospital
import com.mashape.unirest.http.HttpResponse;
import com.mashape.unirest.http.Unirest;

HttpResponse<String> response = Unirest.post("https://api.rebateright.com.au/CalculateBenefit")
  .header("x-api-key", "<apiKey>")
  .header("Content-Type", "application/json")
  .body("{\n  \"ItemNumber\": \"104\",\n  \"InHospitalTreatment\": true\n}")
  .asString();
```

```php In Hospital
<?php
require_once('vendor/autoload.php');

$client = new \GuzzleHttp\Client();

$response = $client->request('POST', 'https://api.rebateright.com.au/CalculateBenefit', [
  'body' => '{
  "ItemNumber": "104",
  "InHospitalTreatment": true
}',
  'headers' => [
    'Content-Type' => 'application/json',
    'x-api-key' => '<apiKey>',
  ],
]);

echo $response->getBody();
```

```csharp In Hospital
using RestSharp;

var client = new RestClient("https://api.rebateright.com.au/CalculateBenefit");
var request = new RestRequest(Method.POST);
request.AddHeader("x-api-key", "<apiKey>");
request.AddHeader("Content-Type", "application/json");
request.AddParameter("application/json", "{\n  \"ItemNumber\": \"104\",\n  \"InHospitalTreatment\": true\n}", ParameterType.RequestBody);
IRestResponse response = client.Execute(request);
```

```swift In Hospital
import Foundation

let headers = [
  "x-api-key": "<apiKey>",
  "Content-Type": "application/json"
]
let parameters = [
  "ItemNumber": "104",
  "InHospitalTreatment": true
] as [String : Any]

let postData = JSONSerialization.data(withJSONObject: parameters, options: [])

let request = NSMutableURLRequest(url: NSURL(string: "https://api.rebateright.com.au/CalculateBenefit")! as URL,
                                        cachePolicy: .useProtocolCachePolicy,
                                    timeoutInterval: 10.0)
request.httpMethod = "POST"
request.allHTTPHeaderFields = headers
request.httpBody = postData as Data

let session = URLSession.shared
let dataTask = session.dataTask(with: request as URLRequest, completionHandler: { (data, response, error) -> Void in
  if (error != nil) {
    print(error as Any)
  } else {
    let httpResponse = response as? HTTPURLResponse
    print(httpResponse)
  }
})

dataTask.resume()
```

### Invalid Request

**Request**

```json
{
  "ItemNumber": "23",
  "PatientsSeen": 0
}
```

**Response**

```json
{
  "ItemNumber": "23",
  "PatientsSeen": 0,
  "InHospitalTreatment": false,
  "ScheduleFee": null,
  "Benefit": null,
  "TotalBenefit": null,
  "Reason": "PatientsSeen must be 1 or more.",
  "ReasonCode": "InvalidRequest"
}
```

**SDK Code**

```python Invalid Request
import requests

url = "https://api.rebateright.com.au/CalculateBenefit"

payload = {
    "ItemNumber": "23",
    "PatientsSeen": 0
}
headers = {
    "x-api-key": "<apiKey>",
    "Content-Type": "application/json"
}

response = requests.post(url, json=payload, headers=headers)

print(response.json())
```

```javascript Invalid Request
const url = 'https://api.rebateright.com.au/CalculateBenefit';
const options = {
  method: 'POST',
  headers: {'x-api-key': '<apiKey>', 'Content-Type': 'application/json'},
  body: '{"ItemNumber":"23","PatientsSeen":0}'
};

try {
  const response = await fetch(url, options);
  const data = await response.json();
  console.log(data);
} catch (error) {
  console.error(error);
}
```

```go Invalid Request
package main

import (
	"fmt"
	"strings"
	"net/http"
	"io"
)

func main() {

	url := "https://api.rebateright.com.au/CalculateBenefit"

	payload := strings.NewReader("{\n  \"ItemNumber\": \"23\",\n  \"PatientsSeen\": 0\n}")

	req, _ := http.NewRequest("POST", url, payload)

	req.Header.Add("x-api-key", "<apiKey>")
	req.Header.Add("Content-Type", "application/json")

	res, _ := http.DefaultClient.Do(req)

	defer res.Body.Close()
	body, _ := io.ReadAll(res.Body)

	fmt.Println(res)
	fmt.Println(string(body))

}
```

```ruby Invalid Request
require 'uri'
require 'net/http'

url = URI("https://api.rebateright.com.au/CalculateBenefit")

http = Net::HTTP.new(url.host, url.port)
http.use_ssl = true

request = Net::HTTP::Post.new(url)
request["x-api-key"] = '<apiKey>'
request["Content-Type"] = 'application/json'
request.body = "{\n  \"ItemNumber\": \"23\",\n  \"PatientsSeen\": 0\n}"

response = http.request(request)
puts response.read_body
```

```java Invalid Request
import com.mashape.unirest.http.HttpResponse;
import com.mashape.unirest.http.Unirest;

HttpResponse<String> response = Unirest.post("https://api.rebateright.com.au/CalculateBenefit")
  .header("x-api-key", "<apiKey>")
  .header("Content-Type", "application/json")
  .body("{\n  \"ItemNumber\": \"23\",\n  \"PatientsSeen\": 0\n}")
  .asString();
```

```php Invalid Request
<?php
require_once('vendor/autoload.php');

$client = new \GuzzleHttp\Client();

$response = $client->request('POST', 'https://api.rebateright.com.au/CalculateBenefit', [
  'body' => '{
  "ItemNumber": "23",
  "PatientsSeen": 0
}',
  'headers' => [
    'Content-Type' => 'application/json',
    'x-api-key' => '<apiKey>',
  ],
]);

echo $response->getBody();
```

```csharp Invalid Request
using RestSharp;

var client = new RestClient("https://api.rebateright.com.au/CalculateBenefit");
var request = new RestRequest(Method.POST);
request.AddHeader("x-api-key", "<apiKey>");
request.AddHeader("Content-Type", "application/json");
request.AddParameter("application/json", "{\n  \"ItemNumber\": \"23\",\n  \"PatientsSeen\": 0\n}", ParameterType.RequestBody);
IRestResponse response = client.Execute(request);
```

```swift Invalid Request
import Foundation

let headers = [
  "x-api-key": "<apiKey>",
  "Content-Type": "application/json"
]
let parameters = [
  "ItemNumber": "23",
  "PatientsSeen": 0
] as [String : Any]

let postData = JSONSerialization.data(withJSONObject: parameters, options: [])

let request = NSMutableURLRequest(url: NSURL(string: "https://api.rebateright.com.au/CalculateBenefit")! as URL,
                                        cachePolicy: .useProtocolCachePolicy,
                                    timeoutInterval: 10.0)
request.httpMethod = "POST"
request.allHTTPHeaderFields = headers
request.httpBody = postData as Data

let session = URLSession.shared
let dataTask = session.dataTask(with: request as URLRequest, completionHandler: { (data, response, error) -> Void in
  if (error != nil) {
    print(error as Any)
  } else {
    let httpResponse = response as? HTTPURLResponse
    print(httpResponse)
  }
})

dataTask.resume()
```