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Practical details of new bulk billing program revealed
New DoHAC factsheets explain how the controversial incentives program will work, how GPs’ earnings could change, and accreditation exemptions.
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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