Telehealth and Medicare: The 12-Month Rule, Exemptions and MyMedicare Explained

Medicare covers GP telehealth consultations, but usually only if you’ve had a face-to-face visit with the same practice in the past 12 months. This is called the “established clinical relationship” rule. There are some exemptions, including for children under 12 months, people experiencing homelessness and sexual or reproductive health consultations. If no exemption applies, a telehealth GP you haven’t seen in person will usually charge a private fee with no Medicare rebate.

This article explains how the rule works, the main exemptions, how MyMedicare fits in, and why Teldoc’s general consultations are private. Information is current as at October 2026.

The 12-month rule explained

For most GP telehealth services, Medicare requires an established clinical relationship. According to the Department of Health’s AskMBS advisory, this means one of the following:

• the GP providing the telehealth consultation has given you a face-to-face service, billed to Medicare, in the past 12 months
• another doctor or health professional at the same practice has seen you face to face in the past 12 months
• the GP works for an approved after-hours deputising service that has an arrangement with a practice that has seen you face to face in the past 12 months

The rule is designed to support continuity of care, so that telehealth is mostly provided by a practice that knows you and has your records.

Exemptions to the 12-month rule

Medicare-funded GP telehealth doesn’t need an established clinical relationship in some situations, including:

• children under 12 months
• people experiencing homelessness
• patients of an Aboriginal Medical Service or Aboriginal Community Controlled Health Service
• people affected by a declared natural disaster
• urgent after-hours services
• certain blood-borne virus, sexual and reproductive health consultations

Exemptions can change, so check with the practice or Services Australia if you’re unsure.

Mental health: what changed in November 2025

Mental health planning services used to be exempt from the 12-month rule. From 1 November 2025, that exemption was removed, and Medicare benefits for a Mental Health Treatment Plan now generally require the plan to be prepared by your MyMedicare practice or your usual GP. Our article on the November 2025 MBS changes for Mental Health Treatment Plans explains this in detail.

What is MyMedicare?

MyMedicare is a voluntary program that lets you register with your regular general practice. According to the Department of Health’s MyMedicare patient FAQs:

• you generally need two face-to-face visits with the practice in the past 24 months to register (one visit if you live in a remote or very remote area)
• you can only be registered with one practice at a time, but you can change practices
• registering doesn’t stop you seeing other GPs or practices
• there’s no cost to register

For telehealth, MyMedicare registration gives you access to longer Medicare-funded phone consultations with your registered practice. It’s also linked to some other services, such as chronic condition management plans and Mental Health Treatment Plans.

Why Teldoc’s general consultations are private

Teldoc is a telehealth-only practice, so most of our patients haven’t had a face-to-face visit with us in the past 12 months. That means Medicare doesn’t cover most of our general consultations, and we can’t offer a Medicare rebate on them.

Instead, we charge a set private fee: $55 on weekdays and $75 on weekends and public holidays. You won’t be able to claim any of this back from Medicare.

Where a Medicare exemption applies, we bulk bill eligible patients with a valid Medicare card. This includes:

• sexual health consultations, including STI testing and treatment and contraception
• consultations for babies under 12 months
• patients experiencing homelessness

Pregnancy consultations are $95 every day, with a $47 Medicare rebate. See our bulk billed online doctor page and fees page for full details.

Choosing between your regular GP and telehealth

Your regular GP is the best place for ongoing care, health checks, chronic condition management and mental health plans. If you’ve seen them in person in the past year, they may be able to bulk bill a telehealth consultation too.

A telehealth service like Teldoc can help when your usual GP isn’t available, you need care quickly, or you’d rather discuss something sensitive with a doctor you don’t know. Common reasons include prescriptions, medical certificates, referrals and sexual health concerns. Our article What telehealth can and can’t do explains its limits.

For the bigger picture on bulk billing, including the incentives introduced from 1 November 2025, read Bulk billing in Australia: pressures, changes and what they mean for you.

Telehealth isn’t for emergencies. If you’re seriously unwell, call 000.

Frequently asked questions

What is the 12-month rule for telehealth?

Medicare usually only covers a GP telehealth consultation if you’ve had a face-to-face visit with the same practice in the past 12 months. This is called the established clinical relationship rule.

Who is exempt from the 12-month rule?

Exemptions include children under 12 months, people experiencing homelessness, patients of Aboriginal Medical Services, people affected by declared natural disasters, urgent after-hours services, and certain blood-borne virus, sexual and reproductive health consultations.

Why can’t I get a Medicare rebate for a Teldoc general consultation?

Teldoc is a telehealth-only practice, so most patients haven’t seen us in person in the past 12 months. Without an established clinical relationship or an exemption, Medicare doesn’t cover the consultation, so we charge a private fee.

Do I need to register with MyMedicare to use telehealth?

No. MyMedicare is voluntary. Registering with your regular practice gives you access to longer Medicare-funded phone consultations with that practice, but it doesn’t stop you using other GPs or telehealth services.

Are mental health telehealth consultations still exempt from the 12-month rule?

No. From 1 November 2025, telehealth Mental Health Treatment Plan services are no longer exempt, and plans generally need to be prepared by your MyMedicare practice or usual GP.

This article is general health information and isn’t a substitute for advice from your own doctor. If you’re worried about your health, speak to a GP. In an emergency, call 000.

Medically reviewed by Dr Vafa Derakshan (MBBS, FRACGP), September 2026