April 2025
With the upcoming changes to Medicare Benefits Schedule (MBS) rebates for GP consults set to take effect in November, there has been significant discussion around the government’s proposed increases. While the announcement suggests a boost to rebates, it is essential for general practitioners to understand the fine print—particularly the conditions under which these increases apply.
The Reality Behind the Rebate Increase
The government has publicised an increase in GP consultation rebates, which on the surface appears to be a positive step toward supporting primary care. However, an important caveat often overlooked is that the full advertised increase will only be available to providers who bulk bill (BB) 100% of their patients.
For many practices, this presents a challenge. While bulk billing remains a vital component of accessible healthcare, the rising costs of running a practice—including staffing, rent, and medical supplies—make it increasingly difficult for clinics to sustain a 100% bulk-billed model.
Breaking Down the Changes
Here’s what GPs need to consider:
1. Tiered Incentives for Bulk Billing
The proposed increases are structured around bulk billing incentives, which means that only practices that exclusively bulk bill all patients will benefit from the full rebate adjustment.
2. Impact on Mixed Billing Practices
Clinics that operate under a mixed billing model—where some patients are privately billed—may not see the full financial benefit of the rebate increase. This could create disparities among practices based on their billing structures.
3. Financial Viability for Clinics
With the cost of delivering high-quality patient care continuing to rise, the new rebate model may not sufficiently offset operational expenses for practices that cannot commit to full bulk billing.
What This Means for GPs
It is crucial for GPs to be aware of how these changes will affect their practice revenue and patient billing policies. While the increase in rebates may sound beneficial, understanding the conditions tied to these incentives will help providers make informed decisions about their billing approach.
Next Steps for Practices
• Review Current Billing Structures: Evaluate whether a shift in bulk billing practices aligns with the financial sustainability of your clinic.
• Educate Patients: Transparency with patients about potential out-of-pocket costs will be key in managing expectations.
• Advocate for Viable Funding Models: Engaging in discussions with medical associations and policymakers can help push for more sustainable funding solutions for general practice. The RACGP continues to advocate for improvements in funding and support for longer, more complex consultations.
Final Thoughts
While any increase in Medicare rebates is a step in the right direction, it is essential that GPs are fully informed about the conditions surrounding these changes. Ensuring that providers understand the breakdown of these incentives will help them navigate the evolving financial landscape of general practice effectively.
Author
Melissa Jacob
