At cmr, we talk to healthcare professionals across Australia every day, and lately, one topic keeps popping up: bulk billing.

For decades, bulk billing has been the heart of Medicare, ensuring Australians could see their GP without reaching for their wallets. But if you’ve noticed it’s getting harder to find a doctor who bulk bills, you’re not imagining things. It’s estimated that currently only 70% of consults are bulk billed, with the majority of these purely for children and pensioners. So, what’s driving this shift, and is there change on the horizon?

Why More Doctors Are Moving Away from Bulk Billing

Here’s what we’re hearing from our network:

1. The math just isn’t adding up.

Right now, the Medicare rebate for a Standard Item 23 Consult is $42.85. But running a practice (paying staff, rent, insurance, tech systems) often costs closer to $40-$60 per appointment. That gap? It’s coming out of the practice’s pocket.

2. City clinics are feeling the squeeze.

Urban practices face higher operating costs. For many, bulk billing simply isn’t sustainable unless they significantly cut corners, or staff.

3. One-size-fits-all rebates don’t reflect patient needs.

The current system offers the same rebate regardless of how complex the consultation is. That can lead to shorter appointments and limited time for patients with multiple or chronic conditions, something no clinician wants to compromise on.

4. The admin load for bulk billing is no joke.

Strict bulk billing compliance rules mean any small error could trigger an audit or financial penalty. It’s another layer of stress in an already busy day.

5. Many GPs feel undervalued

When rebates are fixed and far below the real cost of care, it sends a message. Many doctors feel their time and expertise aren’t being properly recognised or rewarded.

So, What’s Being Done About It?

Good news: change is on the way. From 1 November 2025, the Australian Government will roll out reforms aimed at making bulk billing more financially viable for clinics. Here’s a quick overview:

• Universal Incentives – Clinics will receive extra payments for bulk billing any patient, not just concession card holders or children.

• 12.5% Loading for Full Bulk Billing Clinics – Practices that commit to bulk billing everyone will receive a 12.5% top-up on top of the standard Medicare rebate.

• Support for Rural and Remote Practices – Clinics outside metro areas could receive up to 190% of the base incentive, acknowledging the unique challenges of delivering care in those regions.

The government’s goal? To generate 18 million extra bulk-billed visits per year and bring national bulk billing rates up to 90% by 2030. 

Will It Be Enough?

It’s a step in the right direction, and a much needed one. But it’s not a magic fix. Rising costs, rebate structures, and the administrative load still need long-term solutions.

At cmr, we’re hopeful. We know how hard our healthcare professionals work to deliver quality care, especially when the system feels stacked against them. These new incentives might just give doctors the breathing room they need to keep doing what they love: helping people.

Whether you’re a doctor wondering how these changes could impact your practice or a clinic leader navigating sustainability, our team is here to talk through the details. Because your experience matters, and together, we can build a healthcare system that supports everyone.