Bulk Billing in Australia: Pressures, Changes and What They Mean for You

Bulk billing means your doctor accepts the Medicare benefit as full payment, so you pay nothing for an eligible service. For years, rising practice costs and Medicare rebates that didn’t keep pace put bulk billing under pressure, and many practices moved to charging a gap fee. Since 1 November 2025, the Australian Government has expanded bulk billing incentives to all Medicare-eligible patients and introduced a new incentive for practices that bulk bill everyone.

Here’s what changed, why, and what it means when you see a GP, in person or by telehealth. Information is current as at October 2026.

What is bulk billing?

When a GP bulk bills, they claim the Medicare benefit directly and accept it as full payment. When they don’t, you pay the practice’s fee and may be able to claim part of it back from Medicare. The difference is called a gap fee or out-of-pocket cost. healthdirect has a clear explanation of bulk billing and gap payments.

Bulk billing is a choice each practice makes. Some bulk bill everyone, some bulk bill certain groups, and some charge all patients a fee.

Why bulk billing came under pressure

• Rebates didn’t keep up with costs. Medicare rebates were frozen for several years in the 2010s and, even after indexation resumed, many practices said rebates no longer covered the cost of running a clinic.
• Practice costs rose. Wages, rent, insurance, technology and administration all became more expensive.
• Workforce shortages. Fewer GPs in some areas, especially regional and rural communities, meant less competition and longer waits.
• A shift to mixed billing. Many practices began bulk billing children and concession card holders but charging other patients a gap fee.

The result was that out-of-pocket costs became a barrier for some people, who delayed seeing a GP or went to an emergency department instead.

What the government has changed

Tripled incentives for children and concession card holders

From November 2023, the bulk billing incentive that practices receive for bulk billing children under 16 and Commonwealth concession card holders was tripled for most GP consultations.

Incentives extended to everyone from 1 November 2025

From 1 November 2025, bulk billing incentives were extended to all Medicare-eligible patients, not just children and concession card holders. This means a practice now receives an extra payment when it bulk bills any eligible patient. The government’s stated aim is for 9 out of 10 GP visits to be bulk billed by 2030.

The Bulk Billing Practice Incentive Program

Also from 1 November 2025, practices can join the Bulk Billing Practice Incentive Program (BBPIP). Practices that join receive an extra 12.5% payment on the Medicare benefits for eligible services, shared between the GP and the practice. To take part, a practice must:

• bulk bill every eligible patient for every eligible service
• be registered for MyMedicare
• be listed as a fully bulk billing practice in the National Health Services Directory
• display Medicare bulk billing signage

Practices can choose whether to join. Some practices still charge fees, particularly where their costs are higher than the combined Medicare payments.

What this means for you

• Ask before you book. Billing policies vary, so check whether a practice bulk bills and for which services.
• Look for fully bulk billing practices. healthdirect’s service finder lists GP practices and can show which bulk bill.
• Consider registering with MyMedicare. Registering with your regular practice can support continuity of care and is needed for some services. It doesn’t stop you seeing other GPs.
• Bulk billing still depends on Medicare rules. A service must be eligible for a Medicare benefit before it can be bulk billed.

Bulk billing and telehealth

The incentives above apply to Medicare-eligible services, including eligible telehealth consultations. However, Medicare generally only covers a GP telehealth consultation if you’ve seen that practice in person in the past 12 months, or an exemption applies. This is why many telehealth-only services charge a private fee for general consultations. Our article Telehealth and Medicare: the 12-month rule and MyMedicare explained covers these rules and exemptions in detail.

How Teldoc bills

Teldoc is a telehealth-only practice, so most patients haven’t had a face-to-face visit with us. Our general consultations are private: $55 on weekdays and $75 on weekends and public holidays, with no Medicare rebate.

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

• sexual health consultations, such as STI testing and treatment and contraception. Read about Medicare bulk billing for sexual health
• consultations for babies under 12 months
• patients experiencing homelessness

See our bulk billed online doctor page and fees page for full details.

Frequently asked questions

What changed with bulk billing on 1 November 2025?

Bulk billing incentives were extended to all Medicare-eligible patients, and a new Bulk Billing Practice Incentive Program began, paying an extra 12.5% to practices that bulk bill every eligible patient for every eligible service.

Does every GP now have to bulk bill?

No. Bulk billing is still a choice each practice makes. The incentives encourage bulk billing, but some practices continue to charge fees.

Can telehealth consultations be bulk billed?

Yes, if the consultation is eligible for Medicare. This usually means you’ve seen the practice in person in the past 12 months, or an exemption applies, such as sexual and reproductive health consultations or children under 12 months.

How do I find a bulk billing GP?

Ask your local practice about its billing policy, or use healthdirect’s service finder, which lists GP practices and their billing information.

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