Almost twice as many Australian GP clinics bulk billing since Medicare incentive changes, analysis suggests | Bulk billing

Analysis by online health guide Cleanbill shows that family doctor bulk billing rates have rebounded following incentives introduced by the federal government in November.

The national analysis released Monday found that the proportion of clinics bulk billing nearly doubled to 40.2% by the end of 2025, from 20.7% the previous year.

The Albanian government implemented a 12.5% ​​surcharge on Medicare benefits for practices that bulk bill all eligible patients for all eligible services. Previously, most incentives were only available to children under 16 and Commonwealth concession card holders.

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Cleanbill searched 6,877 clinics between November 1 and mid-December 2025 and found that 1,007 clinics had switched from private or hybrid billing to full bulk billing since the beginning of 2025.

But there were differences depending on location.

In the ACT, 96% of GP practices said they were taking on new patients, which was a criterion for including them in the survey, but only 12 of 101 respondents reported they were fully bulk billing. In Western Australia, 95% of clinics reported taking new patients to Cleanbill, but approximately 130 of 657 clinics contacted (19.8%) said they billed entirely in bulk.

According to the report, 51.9% of 2,342 clinics contacted in NSW were billed in bulk, while 43.6% of 1,793 clinics contacted in Victoria were billed.

The data shows a 13.5% increase in out-of-pocket expenses for patients who were not bulk billed over the year.

The average total cost of a standard GP visit now exceeds $100 in the ACT and Tasmania, leaving patients on average $58 and $61 out of pocket respectively.

Federal Health Minister Mark Butler said “certain data contained in the Cleanbill analysis cannot be relied upon and should not be reported as accurate.”

“They failed to include in their clinic numbers, for example, clinics that did not answer their questions,” he said.

The Cleanbill report says clinics that cannot be reached or refuse to provide information are identified in the database but excluded from pricing and availability calculations if costs cannot be independently verified.

Butler said the government’s own data showed more than 3,200 practices were now fully subject to bulk billing since November.

“Almost 1,200 of these were previously hybrid billing practices,” he said.

Butler also noted other measures to expand access to care through additional Medicare urgent care clinics and the establishment of 1800Medicare, a free, 24/7 nationwide health advice line.

Grattan Institute health program director Peter Breadon said the rebound in bulk billing was not surprising given the new incentives, but the changes had failed to address deeper structural problems in general practice.

That means access to care still varies by location, he said, and the most vulnerable patients are often left without it.

“This isn’t really about the supply and distribution of care,” Breadon said. “We need a different way to fund general practice that targets GP leavers and better supports clinics that care for more disadvantaged and low-income patients.”

A key concern, he said, is that the expanded incentive applies to all patients rather than prioritizing those most in need.

“The incentive for bulk billing was linked to caring for concession card holders or children. This was one of the only mainstream parts of the GP funding system that clearly prioritized disadvantaged patients,” Breadon said.

“While countries like New Zealand were moving in the opposite direction, tying funding to disadvantage, complexity and rurality, we have dismantled that.”

Greater bulk billing incentives are being offered to rural Australia, but Breadon said the changes were a step backwards in aligning funding with needs.

Cleanbill’s data is based on what clinics say when called at a particular point, Breadon said, and over time, more comprehensive Medicare data from the health department will provide a more accurate picture.

But he said successive independent reviews had consistently recommended a more fundamental change in GP funding, including voluntary models that provide clinics with increasingly flexible patient budgets to see sicker and poorer patients.

“Funding should be based on need,” he said. “In fact, recent changes are moving us away from that.”