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Practical details of new bulk billing program revealed


Anastasia Tsirtsakis


1/04/2025 3:44:03 PM

New DoHAC factsheets explain how the controversial incentives program will work, how GPs’ earnings could change, and accreditation exemptions.

Patients sitting in a practice waiting room.
Practices who choose to take part in the program and bulk bill 100% of their patients will receive an extra 12.5% loading payment on Medicare rebates.

This article was updated on Thursday 3 April at 10.50am to clarify that all GPs at a practice participating in the incentive program must bulk bill every patient for every eligible service to receive the 12.5% loading payment.

The Federal Government has set its sights on increasing the number of bulk billing practices across the country through a new Bulk Billing Practice Incentive Program.
 
Included in the 2025–26 Federal Budget, if re-elected, the Government has pledged to invest $7.9 billion to expand the triple bulk billing incentive to all Medicare-eligible people, while practices that bulk bill every patient will be eligible to receive an extra 12.5% loading payment on Medicare rebates.
 
The Coalition has promised to match this investment if elected on 3 May.
 
This loading payment will apply to time-tiered consultation items, health assessments, mental health treatment items and chronic disease management items.
 
Slated to commence on 1 November 2025, to be eligible to receive the new loading payment, practices will need to:

A feature of the new program is that unaccredited practices and sole providers who are not yet registered through MyMedicare and wish to sign up for the new incentive program, will receive an accreditation exemption. This will be in place until 31 December 2026. 
 
RACGP President Dr Michael Wright said it remains unclear as to why this decision has been made.
 
‘Since the start of the Practice Incentives Program, accreditation has been the standard for accessing this,’ he told newsGP.
 
‘While we would welcome funding going into every general practice, it hasn’t been explained why we’ve changed the rules for this incentive.’
 
A spokesperson from the Department of Health and Aged Care (DoHAC) told newsGP the program’s accreditation requirements are about ensuring patients ‘are not unfairly disadvantaged in accessing bulk-billed services if their practices cannot achieve accreditation’.
 
‘This approach may support Aboriginal and Community Controlled Organisations, and rural and remote practices,’ the spokesperson said.
 
The DoHAC said the new incentive will support GPs and practices to provide ‘high quality bulk-billed care’, by growing their teams, upgrading their facilities and expanding their services.
 
‘The combined investment means around 4800 practices will be in a better financial position if they adopt full bulk billing – meaning they will receive more in Medicare payments than they currently receive in patient fees,’ it said.
 
Commenting on the new incentives, Dr Wright said the new Practice Incentives loading payment will prove to be ‘a bonus’ for practices who already bulk bill all patients. But for practices with other billing models, it will be a different story.
 
‘It will be a difficult decision for many practices because setting a hurdle of 100% is going to be a big ask, particularly when you have multiple doctors working under multiple consultation and billing styles in a practice,’ Dr Wright said.
 
‘I’m also concerned about the impact on practices who already may have high levels of bulk billing, but won’t be able to meet that 100% threshold.

The Government has confirmed participation in the program will be voluntary and that practices can ‘choose to opt-in or opt-out at any time’.
 
For practices who do wish to take part, the 12.5% loading payment will be paid on every $1 of MBS benefit paid from eligible services.
 
The payment will be split between the practice and the GP, and will be made quarterly in arrears, commencing in the first quarter of 2026.
 
The DoHAC said further details about the payment split will be determined ‘in consultation with the sector’ prior to the program’s launch in November, with further information expected to be released later this year.
 
Also, part of the program is an expansion to the eligibility criteria for bulk billing incentives. This will allow GPs to claim incentives when they bulk bill any Medicare-eligible patient.
 
Currently, this is only possible for patients who are aged under 16, pensioners and other Commonwealth concession cardholders.
 
Dr Wright said while the additional funding to support general practice is ‘welcome’, he highlighted that the focus on bulk billing incentives rather than increasing Medicare rebates is ‘worrying’.
 
‘Once again I am concerned that it won’t provide much support to a lot of patients, their practices or GPs,’ he said.
 
However, the DoHAC has taken a different line, and says the move ‘not only benefits participants financially but supports accessible healthcare for all Australians’.
 
Practices who decide not to join the new incentive program have been reassured that they will still be able to claim bulk billing incentive items for any patient they bulk bill.
 
How much will GP earnings increase?
The DoHAC has acknowledged that, at present, a bulk-billing GP earns less than their mixed billing or privately billing colleagues for providing the same number of services. However, it claims that the new investment from 1 November ‘fixes that’.
 
‘We can see that at metropolitan practices there is an approximately $45,000 gap in annual earnings between a GP with average rates of bulk billing and a GP that bulk bills every visit,’ it said.
 
‘The new investments will bridge that gap, so that fully bulk-billing GPs receive the same as mixed billing GPs for providing the same number of services.’ 
 
Figures provided by the DoHAC estimate that from 1 November, with the new incentives, GPs in metropolitan areas (MM1) who bulk bill every patient could earn $403,805 compared to a GP with average rates of bulk billing, who will earn $398,448.
 
Meanwhile, at a rural practice (MM3–4), GPs that bulk bill every visit will have the potential to earn over $20,000 more each year than those with average rates of bulk billing, earning $457,816 compared to $433,852.
 
Combining bulk billing reforms included in both the 2023–24 and 2025–26 Federal Budgets, in addition to annual Medicare indexation being applied, from 1 November metropolitan GPs who bulk bill every patient will have seen an increase of $123,754 to their annual earnings compared to $79,005 for those with average bulk billing rates.
 
While rural GPs who bulk bill every patient will have seen an annual increase of $155,204 compared to $97,284 for their colleagues who have average rates of bulk billing.
 
The calculations, presented by the DoHAC, are based on the GP Earnings Calculator provided by General Practice Registrars Australia, which is modelled on standards set by the RACGP.
 
The earnings are based on being a full-time GP delivering four services an hour and working for 3.8 hours per session for 10 sessions per week, with four weeks of annual leave a year. They also assume the GP is retaining 70% of billings, with 30% of billings being passed on to the practice to cover costs and profits.
 
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Dr Deon Gouws   2/04/2025 7:51:56 AM

More breadcrumbs for GP's. Do away with bulk billing all together. GP's must charge whatever is reasonable for the services provided. The patient can then claim some percentage (or all of it) back directly from the government. Remove the government as middleman between patient and GP. Until this system is changed, GP medicine will remain as undervalued as it is today.


Dr Irene Rosul   2/04/2025 8:15:41 AM

I would love to read the other Doctors comments on this :D


Dr Ayodele Ezekiel Ogunjobi   2/04/2025 8:52:12 AM

Amazing; how many patients GPs will have to attend to earn this much while BB?


Dr Christopher David Mitchell, AM   2/04/2025 1:46:43 PM

Agree with you Dr Tom Owen Morley.

One would hope someone at the department would understand the problem with this language after all these years

"have all GPs employed at the practice bulk bill every patient for every eligible service"

I can't see enough advantage for our practice to sign up, obviously for those patients I BB already eg palliative care frequent reviews it's a help


Dr Matt Harvey   2/04/2025 2:19:27 PM

No-one in politics understands general practice, GPs, or small business. Apparently peak representative bodies like RACGP, surprisingly, have the same problem. If we are tenants in a practice, we are not employees. We can't be directed to bill a particular way. If that were possible, we'd be staff providing services to a practice, not independent small business operators providing services to our clients (patients). This is just an extension of the stupidity of payroll tax exemptions. Being exempt doesn't stop you being in an employee/employer relationship, and this BB rubbish just reinforces that. Medicare as a whole and its rebates aren't fit for purpose. The fact PIPs exist demonstrates this. If you run a service business for doctors, but need government grants to keep your business afloat because you can't afford to charge the doctors more because they're not billing enough themselves to meet the costs of their service, then clearly something is amiss.


Dr Matthew James Harvey   2/04/2025 2:22:23 PM

Also: If you're a GP who does a lot of mental health and complex medicine where appointments are typically 45-60 minutes, you can't BB because you'd go broke. Incentives are a rubbish idea - they wouldn't be needed if rebates were adequate. Increase the base rebate for every timed item in a linear fashion. Don't disincentivise longer consultations and encourage low quality high turnover consultations.


Dr Peter James Strickland   2/04/2025 2:55:01 PM

Do NOT play this game with the Labor Govt if they get to govern again --it is straight-down the line of socialistic medicine with this so-called bulk-billing 'boost'. Just say 'NO' --simply say our GPs are independent of Govt controls, and the Medicare rebate is an insurance for patients, and not GPs, and it is up to the government as to the level of rebate ---i.e. for PATIENTS. GPs only rebate out of the goodness of their heart, and once the Govt tries to tell GPs what to do by setting 'conditions to receive the boost', then tell them to get 'nicked'!! Already the cost of these Urgent Medicare Clinics are costing them (Govt) around $260/consult --half that should be the item 23 rebate NOW for GPs who privately bulk-bill anyone!


Dr Jennifer May Smith   2/04/2025 3:26:42 PM

Please for the love of all that is good can we stop talking about patient fees, whether medicare or not, as "earnings". GPs do NOT earn $400 000 - the money charged by a single GP at a practice each year is $400 000, and this pays for everything - the doctor, the staff, the building, the dressings, the indemnity. No wonder people think we're lining our pockets!!! $400 000 a year MINUS the $200 000 we pay to run our practice and cover indemnity and essential registrations is an EARNING of $200 000, which assuming we work 40 hours a week in general practice pays us under $100/hour.


Dr James Vivian McConochie   2/04/2025 7:33:48 PM

in 1984 medicare started the rebate was higher than the recommended fee, naturally bulk billing followed. Has the rebate kept up with inflation and costs.
Does anyone honestly believe this increase will keep pace with future need?
medicare rebate is an insurance payment
the BB incentive is not.
Insurance payments are not subject to GST according to the insurance ACTS
BB incentives will be if any government in future changes the GST tax laws, and medical exemptions for GST
So also will all incentive payments.
Government is hesitant to tackle health costs.
They are even more hesitant to tackle tax reform.
But one day they will have to .
Be very wary of your future if you are a young doctor.
Australia does not have a free health system. It never has. It has a universal health insurance scheme. As the medical indemnity insurances were shaken up at the end of the 20th century so too does our universal health insurance need shaking up
BUT BB IS NOT THE WAY


Dr Joe Jin Lee   2/04/2025 8:23:09 PM

Just curious, looking at the PDF of "Every eligible service", it includes after-hours item numbers too. If that's the case, which clinic will be keen to be open during those times and especially over the weekend???


Dr Michael Charles Rice   3/04/2025 8:01:45 AM

I'd appreciate some RACGP analysis and explanation, here.

For a start, what does RACGP mean by "all GPs employed at the practice"
Apart from registrars GPs working from my practice are not "employed" and, rather, are likely to be tenants in a "serviced office" model. Please clarify if GPs classed as tenants or contractors are affected.

How does RACGP recommend a practice "advertise their participation in the program, as a fully bulk billing practice" when we are unlikely to be bulk-billing all other attendances, especially procedures and potentially items like 16500 etc, 4001, 16591, 30192 and so on? It will be important for patients to understand that a "fully bulk billing practice" may be charging fees and advantageous if RACGP were to recommend wording (including for the National Health Services Directory) that would be consistently used nationwide.

What will RACGP recommend for GPs providing iron infusions? Patients pay the lot with no rebate at all?


Dr Matthew James Harvey   3/04/2025 6:59:45 PM

Further to Dr Rice's excellent comments, can RACGP please explain:

To whom are patients to be registered with under My Medicare? Tenanted doctors operate their own practices and therefore patients should be registered with a doctor, not a practice.

Since tenanted doctors operate their own practices, does that mean all tenanted doctors have to undergo practice accreditation individually to be eligible to continue to claim Medicare rebates on behalf of patients for items only available under My Medicare?

Why is there ongoing argument over the recipient of the PIP? If a tenanted GP wants to UBB timed attendances, they're doing the work, so should get the PIP. The serviced office space they use need to adjust their fees to meet their own costs. (We all know under that arrangement those GP's will very likely end up insolvent so it's kind of a moot argument, but still worth making.)


Dr Sumati Margaret-Mary Pestana   4/04/2025 6:04:02 AM

Labour and liberal are in general the same same pointless disrespect GPs. If I may be so kind, try and have a chat to a Libertarian candidate. The founder of the Libertarians is my patient as is his wife and their children. The man has a PhD in economics currently lectures at a private institution in Saudi. And I can tell you that he is a deep thinker with compassion behind his decision to start a political party when he was at University. Sometimes you need a whole new party to get change happening. And that only needs to be the balance of power. And he is someone who listens very careful to what I tell him because I am his GP and he has always said that I could email him to initiate a purely political conversation. And I see a lot of his family because of chronic conditions his wife had even before they met.