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Bulk Bill Claim — Pathology

How do I lodge a bulk bill claim for pathology services?

Use this endpoint, with serviceTypeCode: P. The referral requirement is below.

Submit a bulk bill claim for pathology services.

See the Bulk bill claims guide for claim structure and assignment of benefit.

Pathology services cannot share a medical event with specialist or diagnostic-imaging services. Submit specialist and diagnostic-imaging services through the Specialist endpoint.

📋 Referral requirement

Every medical event must satisfy one of the following, or Medicare rejects the claim with 2030:

OptionHow to send it
A request existsreferral with typeCode of P
No request is requiredreferralOverrideCode of N
The provider self-deems the serviceselfDeemedCode of SD on at least one service

SS is not permitted for pathology, and selfDeemedCode cannot be combined with referralOverrideCode.

🧪 Fields this endpoint does not accept

Several service fields belong to general and specialist claims only. A pathology claim that carries any of them is rejected with 2030: aftercareOverrideInd, duplicateServiceOverrideInd, fieldQuantity, lspNumber, multipleProcedureOverrideInd, numberOfPatientsSeen, restrictiveOverrideCode and timeDuration.

📐 Claim limits

LimitValue
Medical events per claim80
Services per medical event14
Claims per day, per payee provider and location2,500

📅 How far back you can claim

medicalEventDate must not be in the future. A service rendered on or after 5 September 2025 can be claimed up to one year after the date of service. A service rendered before 5 September 2025 can be claimed up to 2 years after the date of service. A date outside its window is rejected with 9202.

🕑 Time zones

Every date-time you send must carry an Australian UTC offset (for example +10:00, +09:30). A UTC Z value is rejected. If your serialiser produces UTC, convert to Australian local time before serialising.

📑 Error codes

Failures return 400. Each entry in serviceMessage[] names the faulting medical event in its reason text, and the faulting service where there is one.

CodeConditionWhat to do
9202A field value is the wrong format, length or rangeCorrect the named field and resubmit
2030A field is valid on its own but breaks a cross-field ruleRead the reason text, which states the rule
2025More than 80 medical events in the claimSplit the claim
2032More than 14 services in a medical eventSplit the medical event
9777Medicare has already received a claim with this correlationId, so it treats this request as a duplicateIf you resent a claim that got no response, Medicare received the first attempt, and the processing report for that correlationId has the outcome. Otherwise, send the claim with a new correlationId
3004The reason starts “Maximum number of”: this payee provider and location have reached the limit of 2,500 claims a dayResubmit the next day with a new correlationId
3004The reason starts “An unexpected error has occurred”: a system error at MedicareResubmit with a new correlationId. If the error persists, call Medicare eBusiness on 1800 700 199

For any code not listed, look it up in Medicare Online and ECLIPSE return codes (Services Australia).

A 503 from RebateRight, or a 5xx from Medicare with no serviceMessage, means the outcome is unknown. See When a claim gets no response. If Medicare’s response body is not JSON, RebateRight returns it as {"invalidResponseFromServicesAustralia": true, "body": "…"} with Medicare’s status.

Authentication

x-api-keystring
API Key authentication via header
x-minor-idstring

Your Minor ID is 3 uppercase letters followed by 5 digits, such as MDE00000. Send the Minor ID exactly as issued. A malformed value returns 400 with the text The Minor ID is not valid. on every endpoint.

Headers

x-minor-idstringRequired

The Minor ID of the clinic you act for. See Keys, Minor ID and environments.

Request

This endpoint expects an object.
claimobjectRequired
correlationIdstringOptionalformat: "^urn:uuid:[A-Z]{3}[0-9]{5}[A-Za-z0-9]{16}$"=33 characters

Your identifier for this claim. It is echoed on the response, and you use it to fetch the claim’s processing and payment reports. Send your own, and store it with the claim before you send. If you omit it, RebateRight generates one and returns it on the response.

The value is exactly 33 characters: the literal prefix urn:uuid:, then the Minor ID you send in x-minor-id, then 16 letters or digits. Despite the prefix, this is not a standard UUID, and a plain UUID is rejected.

urn:uuid:MDE00000a1b2c3d4e5f6a7b8
└───┬───┘└──┬───┘└──────┬───────┘
  prefix  Minor ID   your 16

Use a new value for every claim, including a corrected one. Reuse a value only as Correlation ID describes.

Response

Claim accepted by Medicare for store-and-forward processing. Fetch the assessment outcome from the Bulk Bill Processing Report with the claim’s correlationId and payee provider.

claimIdstring

Claim identifier assigned by Medicare, shown on the processing and payment reports. The reports are fetched with the claim’s correlationId, not with this value.

It has 6 characters: a prefix, 4 digits, then @. The prefix is a letter for services rendered out of hospital (F3850@) and # for services rendered to an admitted patient (#9876@).

A claim ID is unique per lodgement date and payee provider, so two claims lodged on the same date for different payee providers at one location can share it.

statusstring

Transmission status. SUCCESS on a successful submission.

correlationIdstring

The correlationId you supplied, or the one RebateRight generated for you. Store it with the claim, because you need it to fetch the processing and payment reports.

Errors

400
Bad Request Error