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New bulk billing rules have come into effect for GPs

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Changes to Medicare aimed at giving GPs more incentive to bulk bill patients came into effect on November 1.
GP bulk billing

Changes to Medicare aimed at giving GPs more incentive to bulk bill patients came into effect on November 1.

It means bonus payments will triple for GPs who don’t charge out-of-pocket fees to older patients, low-income patients, and children.

The Treasurer announced the changes in the May Federal Budget. It comes amid a sharp fall in bulk billing rates.

What is bulk billing?

The Government subsidises GP visits through Medicare.

The current subsidy for a basic consultation under 20 minutes is $41.40 – meaning a GP can charge a patient any amount, and the patient will then be reimbursed $41.40 through Medicare.

This means the patient pays for the ‘gap’ (any amount above $41.40). Alternatively, the GP can bulk bill.

How does bulk billing work?

Instead of charging the patient, a GP can accept the $41.40 subsidy as the full price for a consultation, and receive payment directly from Medicare instead. This is bulk billing.

On average, patients who aren’t bulk billed pay $42 above the subsidy level.

The incentive

The bulk billing ‘incentive’ is a payment given to GPs who bulk bill certain patients.

These patients include children under 16, people over 65, welfare recipients and those with low incomes.

Patients who live in regional, rural, or remote areas are less likely to have a bulk billing option.

The changes

Since last Wednesday, the bulk billing incentive will triple for all face-to-face ‘general attendance’ consultations longer than 6 minutes, and for telephone and video consults longer than 20 minutes.

For example, a GP can now claim $20.65 (up from $6.60) for patients in urban areas. The incentive in the most remote areas has risen from $12.70 to $39.65.

Note: ‘General attendance’ excludes special categories such as chronic disease management, minor procedures and mental health items covered by the Better Access program.

What they mean for you

Patients don’t receive any direct financial benefit from bulk billing. Medicare pays GPs the incentive after a patient a bulk-billed treatment.

However, eligible patients may benefit from the incentive if it encourages more GPs to bulk bill, as the Government hopes it will.

Falling rates

The change comes after a sharp decline in bulk billing rates in the 2022-23 financial year.

Government data shows 80% of GP services were bulk billed in 2022-23, down from nearly 90% the year before.

Some experts dispute these figures, suggesting the true rate is much lower. Bulk billing rates vary significantly by area.

GP concerns

The Royal Australian College of GPs (RACGP) and the Australian Medical Association welcomed the incentive.

However, GPs warn cost pressures will continue to force them to charge patients more.

The RACGP is campaigning against Victorian and ACT Government decisions to change how GP clinics are treated for payroll tax purposes, which they say will heighten cost pressures. Federal Health Minister Mark Butler has expressed concern about these changes.

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