The expanded bulk-billing incentive program is a big change and it’s going to take some time for GPs to understand if and how the program can work for our practices and our patients.

In announcing the package, the Government provided the table below to assist GPs when considering how it might work for them. The Government has advised that official Medicare billing data shows the package’s combined investment indicates around 4,800 practices will be in a better financial position if they adopt full bulk billing. That advice suggests, on average, these practices will receive approximately $350,000 a year in additional Medicare payments, ranging from $90,000 for a small metro practice to $1.2 million for a large metro GP practice.

 

Common GP visits	Current Medicare rebate	New total Medicare payment at a Bulk Billing Practice*
		Cities & metro areas	Regional centre	Large & medium rural towns	Small rural town	Remote
Standard consultation 6 to <20 minutes (Level B)	$42.85	$69.56 (up 62%)	$80.71 (up 88%)	$82.71 (up 93%)	$84.86 (up 98%)	$86.91 (up 103%)
Long consultation 20 to <40 minutes (Level C)	$82.90	$114.61 (up 38%)	$125.76 (up 52%)	$127.76 (up 54%)	$129.91 (up 57%)	$131.96 (up 59%)
Longer consultation 40 to <60 minutes (Level D)	$122.15	$158.77 (up 30%)	$169.92 (up 39%)	$171.92 (up 41%)	$174.07 (up 43%)	$176.12 (up 44%)
Mental Health Plan 20 to <40 minutes	$81.70	$99.06 (up 21%)	$102.71 (up 26%)	$103.36 (up 27%)	$104.11 (up 27%)	$104.76 (up 28%)

* Totals include item Medicare rebate, Bulk Billing Incentive item rebate, and 12.5% Bulk Billing Practice Incentive Program payment.

The RACGP did not ask for funding to be allocated in this way. We have always said additional investment should be directed at increasing patient rebates, particularly for longer consultations, and we will continue to do so.

The RACGP is working to support all practices no matter how they how they choose to bill.

Practices that choose to participate in the Bulk Billing Practice Incentive Program receive an additional 12.5% payment on every $1 of Medicare Benefits Scheme benefit claimed for GP Non-Referred Attendances (GP NRA).

The Department of Health advises that to participate in the Program, a GP practice must:

• commit to bulk bill all GP NRA services
• advertise their participation in the program
• be registered with MyMedicare (accreditation requirements are waived for practices joining the program).

The Department further advises that participating practices are expected to advertise as fully bulk billing on Healthdirect’s National Health Services Directory and are supported with marketing materials to identify their participation in the program.

Yes. The RACGP has confirmed with the Government that the bulk-billing incentive items for all Australians are indexed as per the current arrangements.

This will occur on 1 July each year. In the 2023–24 Federal Budget, alongside tripling the bulk-billing incentive for concession card holders and under 16s, the Government provided an additional $1.5 billion into indexation and changed the indexation formula. 

The 12.5% Bulk Billing Practice Incentive Payment is a 12.5% payment on MBS benefits paid. The items that count towards the 12.5% are indexed as per the arrangements above, so the 12.5% will be applied to an indexed group of MBS benefits. This will see the dollar value of the 12.5% increase each year.
 

No. The Bulk Billing Practice Incentive Program is available to practices where all GPs bulk bill for all GP NRA services and meet the requirements outlined above.

The Bulk Billing Practice Incentive Program payment is split evenly (50/50) between practices and GPs. 

No. Practices can choose to opt-in and, if they choose to do so, opt-out later. 

The RACGP continues to support full autonomy for practices to set their own billing policies.

Yes. It is paid based on all MBS Benefit Scheme benefits claimed for GP NRAs. All eligible items are listed in here.

It is up to individual practices to make a decision about participating. The RACGP will always support billing autonomy for individual practices, especially in an environment where existing rebates do not come close to representing the true cost of delivering care.

The incentives will be paid on all eligible billings in the previous quarter with the first payments to commence in the first quarter of 2026.

Only GP Non-Referred Attendances are required to be bulk billed to be eligible for the Bulk Billing Practice Incentive Program. This means that procedures such as insertion of long-acting reversible contraceptive implants or skin lesion excisions do not need to be bulk billed. It also does not apply for care provided where there is no MBS item number, such as iron infusions. All eligible items are listed in here.

Yes. You can claim the bulk-billing incentive items for any patient you bulk bill.

The new Bulk Billing Practice Incentive Program raises the possibility of payroll tax exposure for practices in certain circumstances.
 
Whether a particular practice is ‘at risk’ depends heavily on its operating model, its legal relationships with GPs (contracts, service agreements), and how the incentive payments are structured and distributed.
 
If a practice owner exerts operational control (dictating billing method, setting mandatory bulk billing compliance, auditing GP service delivery) and ties incentive payments to compliance, a state-level revenue office might argue that the GPs are, in part, ‘subcontracted employees’ rather than independent practitioners.
 
As business models vary across the sector, and payroll tax is a state-based issue, it is important to seek independent legal and accounting advice tailored to your circumstances.

As of November 1, GPs are able to claim bulk-billing incentive items when bulk billing any Medicare-eligible patient. There are no changes to the items that the triple bulk-billing incentive applies to. Bulk-billing incentives, both the triple and the original single incentives, continue to apply to the same items that they apply to now.

Consultation items, health assessment and chronic disease management items are included in the practice incentive payment. All eligible items are listed in here.

The department has advised that to participate in the bulk-billing practice incentive payments, practices need to fully bulk-bill all eligible services. 
 
They need to advertise their participation and be registered with MyMedicare.