In recent months, the financial landscape of healthcare has shifted, particularly for patients visiting medical clinics that do not fully bulk-bill. A survey conducted between November and mid-December 2025, which the federal government has contested, highlights a noticeable rise in out-of-pocket expenses for individuals not benefiting from bulk billing.

For those attending the nearly 60 percent of clinics that aren’t entirely bulk-billing, the costs have risen significantly. Over the past year, the average out-of-pocket expense for a standard consultation has increased from $43.38 to $49.23, as reported by the survey.

Interestingly, the proportion of clinics offering full bulk billing has seen a substantial rise, now exceeding 40 percent nationwide. In certain regions like New South Wales and the Northern Territory, this figure climbs above the 50 percent mark, according to data from the Cleanbill report.

However, it’s important to note that Cleanbill’s findings excluded clinics that either did not respond or were unwilling to disclose their pricing and availability details. These clinics were included in the database, but their costs were not analyzed due to the lack of verifiable information.

Breaking down the data regionally, New South Wales, Victoria, Queensland, and South Australia hover around the national average out-of-pocket cost of $49.23. Meanwhile, Western Australia stands out as the most affordable area, with an average cost of $46.63 per consultation.

Australia’s smallest and least populous jurisdictions are the most expensive for an adult patient without concessions, according to the report.

Tasmania has the highest average out-of-pocket cost for a standard consultation at $60.76 in 2026, followed by the ACT and Northern Territory.

NSW, Victoria, Queensland and South Australia all sit narrowly above or below the nationwide average out-of-pocket cost of $49.23, while Western Australia was the cheapest area at $46.63.

Tasmania has the highest average out-of-pocket cost for a standard consultation at $60.76, followed by the ACT and Northern Territory. Source: SBS News

Meanwhile, the number of bulk-billing clinics rose by 19.5 per cent across the country, the report found.

Government figures show that since 1 November, more than 3,200 practices are now fully bulk-billed. Almost 1,200 of these were previously mixed billing practices.

“Close to 7,500 General Practices are now registered with MyMedicare. This has increased significantly since 1 November 2025,” Butler said.

“By 2030, the number of fully bulk-billed practices will be boosted to around 4,800 nationally.”

The Royal Australian College of GPs (RACGP) said the availability of bulk billing indicated by both the Cleanbill report and federal government data was “good news”, but added it was not surprising out-of-pocket costs were on the rise.

“Medicare data show that most GP visits continue to be delivered without cost. However, the RACGP’s Health of the Nation report highlights that consultation complexity and average length are both rising,” said RACGP president Dr Michael Wright.

“At the same time, Medicare rebates haven’t kept pace with the cost of care for many patients. So, it is not surprising to see that out-of-pocket costs are increasing where new incentives don’t cover the cost of providing high-quality care.”

Wright said improved access to GP services in rural areas was positive but warned affordability remained a barrier for patients needing longer consultations, particularly for complex or mental health conditions.

He said Medicare funding for extended appointments needed to be improved to ensure patients were not disadvantaged.

What is the bulk billing scheme?

The government has expanded the bulk billing scheme to all Australians and is offering a 12.5 per cent incentive payment on Medicare rebates for clinics that bulk-bill all eligible patients, split between the GP and the practice, to boost accessibility and encourage fully bulk-billed services.

It means the Medicare payment for a standard GP consultation at a bulk-billed, city practice will be almost two-thirds higher — from $42.85 to $69.56.

For a regional or rural practice, it will be almost doubled, from $42.85 to up to $84.86, depending on location.

At the time of the policy announcement last year, Australian Medical Association president Danielle McMullen said there would be a shift in the rates of no out-of-pocket consultations in parts of the country.

However, some areas would see no difference.

“I do hope this will make a difference in rural and regional communities and in our areas of socio-economic disadvantage, where GPs have been really trying as hard as they can to keep those costs down,” McMullen said at the time.

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