Crackdown on non-GP specialist fees ‘on the table’

Claiming to have ‘turned the corner on bulk billing for GP visits’, the Health Minister is shifting his attention to non-GP specialists, flagging that a fee crackdown is on the way.
 
Federal Health and Ageing Minister Mark Butler says he is now looking at all options, including legal changes, to reduce out-of-pocket costs for patients.
 
Minister Butler said his top priority in this term of government was to ‘turn around bulk billing in general practice’, which he says is progressing, despite rates lifting only slightly since 1 November changes were rolled out.
 
Now, his second term priority is addressing ‘out of control’ non-GP specialist fees.
 
‘It is completely a rip-off sometimes because there is no rhyme or reason to it,’ he told ABC Radio.
 
‘A colonoscopy in Sydney would cost an average of $300 in out-of-pockets right now, but some people, some surgeons, are charging nothing, and some are charging $800.
 
‘There’s no difference in quality between these two things – it’s just because some of them can.
 
‘Traditionally, doctors have been allowed to charge a modest fee on top of the Medicare rebate, but it’s gone well beyond that in some areas.’
 
According to the most recent Medicare data, GPs’ average bulk-billing rate for July to September 2025 sat at 77.6%, with an average out-of-pocket cost of $50.49 for patients.
 
For specialist attendances, the bulk-billing rate was 28.1% with an average out-of-pocket cost of $128.19, and the bulk-billing rate for anaesthetists was 9.1% with a $246.58 out-of-pocket cost.
 
But Minister Butler’s proposal has been met with swift backlash from some specialties.
 
Australian Society of Anaesthetists President Dr Vida Viliunas said ‘attempts to reduce the work of medical specialists to simplistic cost comparisons or commodity-style metrics ignore the breadth of expertise required to safely care for patients’.
 
‘Anaesthesia is not a commodity. It is a highly specialised medical discipline that requires years of training, real-time decision-making, and substantial clinical judgement,’ she said.
 
‘Our role is to assess risk, manage pain, ensure safety, and intervene immediately if complications arise.
 
‘These are not tasks that can be trivialised or reduced to soundbites.’
 
A recent Grattan Institute report found more than 20% of Australians who saw a specialist in 2023 were charged an ‘extreme fee’ – fees that are, on average, more than three times the schedule.
 
‘The average out-of-pocket cost for a single consultation with an extreme-fee-charging specialist exceeded $200 for almost every specialty in 2023. Some are even higher,’ it said.
 
‘A single consultation with an extreme fee-charging psychiatrist was $670 in 2023, and $350 for endocrinologists and cardiologists.
 
‘In 2023, 240,000 patients saw a dermatologist charging an extreme fee; 132,000 people saw an extreme-fee obstetrician or gynaecologist, and 92,000 people saw an extreme-fee ear, nose, and throat specialist.’
 
Minister Butler said he is now investigating several options, including legal changes, and that ‘all options were on the table’.
 
However, he admitted there are restrictions in Australia’s Constitution on ‘what we can force doctors to do’.
 
‘We’re going to look at other options to potentially control fees,’ Minister Butler said.
 
‘This is now not just a serious affordability question, it is also now starting to impact access to healthcare.
 
‘We’re determined over this term of Parliament – we think we’ve turned the corner on bulk billing for GP visits. This is now one of my big priorities.’
 
RACGP President Dr Michael Wright added that while ‘access to general practice is good’, the health system as a whole remains under pressure.
 
‘We know that Medicare fees haven’t kept up with the cost of care and that’s putting more pressure on all of us working in the health system,’ he told newsGP.
 
Ahead of the May 2025 Federal Election, Minister Butler vowed to overhaul Medical Costs Finder, a website using Medicare data to show the average cost of common specialist consultations and services.
 
When he made this announcement in March, just 70 of the 11,000 eligible specialists had voluntarily displayed their fee information on the website.
 
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bulk billing Mark Butler non-GP specialists