Bulk-billing uptake rises fastest outside of cities: Report

New research by online directory Cleanbill indicates uptake of the expanded bulk-billing incentives is growing disproportionately faster among more rural and remote clinics.  
 
In a report published on Sunday, it suggested the number of fully bulk-billing clinics has risen by around 20 percentage points nationally, with a significantly sharper increase in more remote areas.
 
In small rural towns based in Modified Monash Model 5 (MM5) areas, Cleanbill reports the proportion of fully bulk-billing clinics went from around 21% in January 2025 to 57.8% a year later.
 
In comparison, it found general practices in MM1 metropolitan areas have increased by 16.8 percentage points, the smallest rise in the share of fully bulk billing clinics, to 39.2% in January 2026.
 
For RACGP President Dr Michael Wright, the Cleanbill figures reflect his predictions before the tripled bulk billing incentive expansion came into effect, when he said the funding was particularly likely to have an effect in rural and remote areas.
 
‘When funding better matches the cost of care, bulk billing increases,’ he said.
 
‘This shows why our patients need the funding for their care to be set by an independent pricing authority, which can ensure Medicare funding matches the cost of their care, particularly in areas where costs are higher or the GP workforce is more stretched.’
 
Dr Wright said that while the current Federal Government’s investment reflects the value it places on primary healthcare, ‘this doesn’t guarantee the same level of commitment from future governments’.
 
‘An independent pricing authority would provide transparent, evidence‑based decision‑making that directs funding where it’s most effective and most needed,’ he said.
 
‘This would give GPs the trust and certainty they need when they make financial decisions, including about billing policies.’
 
The tripled bulk billing incentive for a level B consultation varies from $25.70 in inner Metropolitan clinics to $49.45 in the most remote areas.
 
In areas with the highest GP‑to‑population ratios, the rise in share of full bulk billing clinics are among the smallest reported by Cleanbill, while the largest gains are in areas with fewer GPs per person.
 
For Dr Wright, the data undermines the argument for intervening in the market.
 
‘This isn’t about competition between GP clinics,’ he said. ‘It’s about whether Medicare funding comes anywhere close to covering the real cost of providing care.’
 
Last Friday, the Health and Ageing Minister Mark Butler announced that uptake of the expanded bulk billing program was two years ahead of schedule, with more clinics having signed up than was initially projected.
 
An Office of Impact Analysis report into the program released ahead of its announcement in February 2025 published a ‘success metric’ of 3600 Medicare Bulk Billing Practices signed up within two years of its launch.
 
‘Since November 1, more than 3,700 practices are now fully bulk billing. Over 1,400 of these were previously mixed billing practices,’ Minister Butler told newsGP.
 
‘This exceeded government projections that 3,600 Medicare Bulk Billing Practices would be achieved by 2028.
 
‘Doctors and practices are moving back to bulk billing because it works for patients and it works for their practices.’
 
Dr Wright said the Cleanbill figures back the college’s call for a 40% increase in rebates for longer consultations, as well as an independent pricing authority, to give GPs long-term certainty.
 
‘Incentives may shift behaviour in narrow ways, but they don’t fix the system,’ he said.
 
‘If we want sustainable bulk billing and better access to care, Medicare must be properly priced, especially for longer, more complex consultations.’
 
In response to a query about the geographic spread of clinics that have moved to full bulk billing, Minister Butler called the Cleanbill research into question.
 
‘Specific data contained in the Cleanbill analysis cannot be relied upon and should not be reported as accurate,’ he said.

His office did not share further details for uptake across metropolitan, regional and remote areas, but said the next quarterly release on Medicare statistics, due to be published next month, will also include information on registered Medicare Bulk Billing practices.
 
Cleanbill also reports the average out‑of‑pocket costs for patients who are not bulk billed rose by 13.5% to an average of $49.23 nationally.
 
However, Minister Butler’s office said the average cost to patients of the 37.9 million GP services provided from November 2025 to January 2026 decreased by 7.2% to $10.09 when including those that were bulk billed.
 
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