Why did bulk-billing rates go up so sharply this year?

The November 2025 Medicare changes introduced substantially higher rebates for GP practices that bulk-bill all their patients — not just concession card holders. Previously, the incentive applied mainly to pensioners and children. Expanding it to all patients made bulk-billing financially viable for more practices, and the result is visible in the data: over 3,800 practices now registered as bulk-billing practices nationally, up significantly since the policy took effect.

If I've been paying a gap fee, should I check if my GP now bulk-bills?

Yes. More than 1,000 practices in NSW and Victoria registered as bulk-billing practices between November 2025 and mid-2026 alone. If you were paying a gap fee before November 2025 and have not checked since, it is worth calling ahead of your next appointment. Ask whether the practice bulk-bills all patients — not just concession card holders — before you book.

GP bulk-billing reaches 84%: what changed and who's still missing out

What just happened

The latest quarterly Medicare data is out, and the GP bulk-billing rate has reached 84.1% of non-referred attendances for the April–June 2026 quarter — up from 79.2% a year prior.

That 4.9 percentage point rise is not routine drift. It is a direct consequence of the November 2025 Medicare changes, which restructured incentives to make it financially viable for GP practices to bulk-bill all their patients rather than only concession card holders. The result: more than 3,800 practices are now registered as bulk-billing practices nationally. In NSW alone, the number rose from 1,031 to 1,473 practices since November. In Victoria, from 635 to 1,044.

RACGP President Dr Michael Wright described the result as “access to affordable general practice care at its highest ever” — before immediately qualifying that further rebate increases are still needed. Minister Mark Butler called it “literally millions of free visits” and pointed to the government’s target of 90% bulk-billing by 2030.

For a patient who has been paying a gap fee: this is the prompt to check. Not all practices updated their policy at the same time, and some who registered as bulk-billing practices did so months after November 2025. If you haven’t asked since then, it is worth asking now before your next appointment.

Both-and

The improvement is genuine and significant

The headline figure is real, and the mechanism is clear. A policy change incentivised different behaviour, and the behaviour changed. That is how health policy is supposed to work.

The group that benefited most from the policy change is adults aged 16–64 — previously the least likely to be bulk-billed because the old incentive structure concentrated on concession card holders and children. That cohort gained 8.2 percentage points, the largest movement in any demographic group. If you are in the working-age bracket and were paying a gap fee, the odds that your situation has changed are now meaningfully higher.

The geographic picture is also improving. The Northern Territory gained 13 percentage points to reach 90.8%. NSW, Victoria, and most other states are above 80%. The infrastructure — practices that have committed to bulk-billing all patients — is more widely distributed than it was 12 months ago.

The headline obscures real access gaps

The ACT at 59.3% is a striking outlier. Nearly two in five GP visits in the ACT involve a gap fee, even after a national policy change that was supposed to improve access. The ACT has a cost structure — higher rents, higher staff costs, high practitioner wages to compete with adjacent Canberra salary markets — that the November rebate rise may not fully offset. A 2.4 percentage point improvement in the ACT suggests the policy is working there too, but much more slowly.

Outer-suburban, regional, and rural communities face a related but distinct problem. The average gap fee nationally is around $60 for non-bulk-billed visits. In areas where bulk-billing rates remain below average, those fees accumulate across a family over a year into a meaningful disincentive to seek care. Delayed GP presentation does not stay cheap — it tends to surface later, at higher complexity, often in a hospital emergency department.

Dr Ramya Raman, a GP writing in the Medical Republic this week, argues that the headline bulk-billing figure treats a symptom rather than the underlying structural problem. Her thesis: Australia’s hospital spend is in part a bill for the consequences of chronic underfunding of general practice — delayed presentations, missed diagnoses, preventable admissions. Total national health expenditure reached $270.5 billion in 2023-24, with $113.8 billion going to hospitals. GP non-referred attendances cost approximately $9.7 billion in 2024-25, with 83.8% of Australians having at least one subsidised GP visit. The GP system is not cheap — but it is substantially cheaper than the hospital end it is meant to prevent.

Her argument is persuasive as structural analysis. The counterfactual — how many hospital presentations were avoided by the 167.7 million GP services last financial year — is genuinely hard to model. But the direction of the argument aligns with evidence on primary prevention: prevention-focused, continuity-based general practice reduces downstream morbidity in ways that episodic, throughput-driven appointments do not.

What the RACGP’s qualified welcome tells us

The RACGP endorsed the result but did not stop there. Dr Wright’s call for further rebate increases is not routine lobbying — it reflects a real tension in the policy design. The November 2025 change makes bulk-billing financially viable for many practices, but it does not eliminate the economic case for gap fees in high-cost locations or for longer, more complex consultations. A 20-minute Level B item and a 45-minute chronic disease review attract different MBS rebates. For GPs doing complex work, a blanket bulk-billing commitment has a real cost.

The government’s 90%-by-2030 target implies further policy movement. What form that takes — additional MBS item increases, practice incentive redesign, workforce investment in underserved areas — will determine whether the access improvement is durable or concentrated at the lower end of complexity.

My two cents

If you have been paying a gap fee at your GP and have not asked since November 2025: call ahead of your next appointment and ask whether the practice bulk-bills all patients. The answer may have changed, and the conversation takes 30 seconds.

If you are still paying a gap fee and your practice has not changed: this is also worth knowing. The $60 average gap nationally means some patients are paying significantly more. If cost has become a barrier to attending regularly, a conversation with your GP about whether there are alternatives — bulk-billing practices in your area, chronic disease management plans that may shift some of the cost structure — is worth having openly.

The structural argument that better-funded, longer general practice consultations reduce downstream hospital cost is persuasive but remains a policy-level fight, not something you can act on directly this week. What you can act on is whether your own access situation has changed.

Verdict: yes — the improvement is real and if you haven’t checked your practice’s bulk-billing status since late 2025, now is a good time.

Sources cited

Bulk-billing rate rises to 84.1%. RACGP newsGP, 10 August 2026. https://www1.racgp.org.au/newsgp
‘Literally millions of free visits’: Mark Butler lauds latest GP bulk-billing rate. AusDoc, 11 August 2026. https://www.ausdoc.com.au/news/literally-millions-of-free-visits-to-the-doctor-mark-butler-lauds-84-gp-bulk-billing-rate/
Australia is paying hospital prices for failures in general practice. Medical Republic, 11 August 2026. https://www.medicalrepublic.com.au/australia-is-paying-hospital-prices-for-failures-in-primary-care/128089