About bulk billing
Bulk billing is when a medical practitioner bills Medicare directly for their patient’s medical or allied health service.
In a bulk billing arrangement, both of the following apply:
- the medical practitioner accepts the Medicare benefit as full payment for the service
- the patient assigns their right to a Medicare benefit to the medical practitioner, so Medicare pays the benefit to the medical practitioner.
Bulk billing incentive payments
Bulk billing incentive payments are available under the MBS to medical practitioners that bulk bill:
- children under 16 years of age
- patients with a Commonwealth concession card.
Medicare pays the bulk billing incentive as well as the patient benefit.
The value of MBS bulk billing incentives are scaled and increase for patients who live in regional, rural and remote communities, as determined using the Modified Monash Model location classification. Bulk billed items are scaled approximately as follows:
- Modified Monash 2 locations – 150% of value of bulk billed items in metro locations (Modified Monash 1)
- Modified Monash 3-4 locations – 160%
- Modified Monash 5 locations – 170%
- Modified Monash 6 locations – 180%
- Modified Monash 7 locations – 190%
1 November 2023 changes
On 1 November 2023, MBS bulk billing items with higher incentive payments commenced. These payments are triple the amount of existing standard bulk billing incentive payments. Doctors can use these when bulk billing the following types of consultations:
- All face-to-face general attendance consultations that are
- longer than 6 minutes (that is Levels B, C, D and E)
- in any location (in and out of consulting rooms, residential aged care facilities)
- at any time (business and after-hours items)
- MBS Level B video and telephone general attendance consultations
- Video and telephone consultations that are
- longer than 20 minutes (Levels C, D and E (video only)) and
- the patient is registered with the practice through MyMedicare.
The standard bulk billing incentive payments will continue to be available for doctors to co-claim when bulk billing with:
- MBS Level A (and equivalent) general attendance consultations
- Level C, D and E video and telephone general attendance consultations where the patient is not enrolled in MyMedicare
- all other relevant MBS unreferred services, for example
- chronic disease management items
- Better Access mental health items
- eating disorder items
- health assessments
- minor procedures.
Bulk billing incentive consultation reference tables and example scenarios are available at MBS Online.
Why it is important
Increasing MBS bulk billing incentive payments will support:
- doctors to continue to bulk bill Australians who feel cost of living pressures most acutely
- younger Australians and concessional patients to better access affordable general practice services.
More information
