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There’s a concrete financial reason why bulk billing rates jumped sharply from late 2025 — and it’s worth understanding if you want to know whether your own GP is likely to start bulk billing you.
The $20.65 Incentive — How It Changed the Economics
Before 1 November 2025, bulk billing incentives were structured to reward GPs for bulk billing specific patient groups: children under 16, concession card holders, DVA patients. For everyone else, there was no bonus — which meant many GPs made business decisions to charge gap fees to working-age adults without concession cards.
The November 2025 change added a $20.65 per-consultation incentive for bulk billing any Medicare patient. That’s on top of the standard MBS fee. Suddenly, bulk billing a working-age adult became meaningfully more profitable than it was the day before.
Here’s the thing: For a GP seeing 30 patients a day, bulk billing all of them at the new incentive rate generates an extra $619.50 per day compared to receiving no incentive. That adds up to over $150,000 a year for a full-time practice. The financial case became very different very quickly.
BBPIP: The 12.5% Bonus for Going All-In
The per-consultation incentive is one layer. The Bulk Billing Practice Incentive Payment (BBPIP) adds another.
Under BBPIP, clinics that commit to bulk billing 100% of their patients receive a 12.5% boost on all their Medicare payments. Not just on bulk-billed consultations — on everything. Payments started in Q1 2026 for registered clinics.
Here’s why that’s significant:
- A practice earning $1.5 million per year in Medicare payments would receive an additional $187,500 under BBPIP
- In exchange, they commit to bulk billing every patient — not just concession holders
- For high-volume practices, the BBPIP revenue often exceeds the gap fee revenue they’d lose
- This is why the number of fully bulk-billing clinics nearly doubled in late 2025
- Clinics register through MyMedicare — it’s a formal commitment, not an informal gesture
The Data Behind the Shift
The numbers confirm the incentives are working:
- 81.4% of GP consultations bulk billed (November 2025–January 2026)
- 77.1% — the figure just 12 months earlier
- Fully bulk-billing clinics nearly doubled in late 2025
- 15 million more Australians now eligible for incentivised bulk billing
In practice: The 4.3 percentage point jump in three months reflects genuine structural change. Clinics that were on the fence converted quickly once the BBPIP economics became clear. That’s exactly what the policy was designed to do.
Why Some GPs Still Don’t Bulk Bill
Despite the incentives, some GPs continue to charge gap fees. The most common reasons:
- High-cost practice locations (CBD, expensive commercial real estate)
- Specialist GP practices where consultation lengths are longer and volume is lower
- Patient demographics willing to pay gaps — demand supports the pricing model
- Haven’t yet run the BBPIP numbers for their specific practice volume
- Concerns about the all-or-nothing nature of BBPIP (must bulk bill 100% of patients to qualify)
If your GP still charges gaps, it’s not necessarily that they can’t bulk bill — sometimes they’ve made a business decision that the model doesn’t work for their specific practice. You can ask about it directly, or simply find a clinic that does.
Frequently Asked Questions
What is the $20.65 incentive exactly?
It’s an additional payment from Medicare to GPs for each consultation where they bulk bill any Medicare patient. It’s on top of the standard MBS fee and applies to all Medicare cardholders since 1 November 2025.
What is BBPIP and how does it differ from the $20.65?
They’re two separate incentives. The $20.65 is per-consultation. BBPIP is a 12.5% boost on all Medicare payments for clinics that bulk bill 100% of patients. A clinic can access both.
Can I find out if my clinic is enrolled in BBPIP?
The most reliable way is to ring and ask. You can also check via MyMedicare in myGov or use healthdirect.gov.au. BBPIP participation isn’t always publicly visible in real time.
Will these incentives keep going, or could they be removed?
They’re part of the government’s $7.9 billion Medicare commitment and embedded in Medicare legislation. A future government could change them, but there’s no current indication of that.
If my GP doesn’t bulk bill, what are my options?
Ask if they can bulk bill for your specific visit. Check if you qualify for a concession card. Search healthdirect.gov.au for a fully bulk-billing clinic in your area. With bulk billing rates at record highs, alternatives are easier to find than they’ve been in years.
