A major analysis of Australia's primary healthcare system has revealed a significant rebound in the number of general practitioner clinics offering free bulk-billed appointments, following the introduction of enhanced federal government incentives late last year.
Incentives Drive Dramatic Shift in Clinic Billing
According to a national survey conducted by the online health directory Cleanbill, the proportion of clinics that fully bulk bill all eligible patients has nearly doubled. The data shows an increase from 20.7% in the previous year to 40.2% by the end of 2025. This shift is directly attributed to a policy change implemented by the Albanese government in November, which introduced an additional 12.5% payment on Medicare benefits for practices that commit to bulk billing all eligible patients for all eligible services.
Previously, most financial incentives were reserved specifically for children under 16 and Commonwealth concession card holders. The expanded incentive, applying to all patients, prompted a notable change in practice behaviour. Cleanbill's survey, which involved calling 6,877 clinics between 1 November and mid-December 2025, found that 1,007 clinics had switched from private or mixed billing to full bulk billing since the start of the year.
Regional Disparities and Rising Costs for Some
Despite the overall positive trend, the analysis uncovered stark geographical differences in access to bulk-billing services. For instance, in the Australian Capital Territory, while 96% of clinics were taking new patients, only about 12 out of 101 surveyed reported fully bulk billing. Similarly, in Western Australia, 19.8% of contacted clinics offered full bulk billing.
Conversely, New South Wales and Victoria showed stronger uptake, with 51.9% and 43.6% of contacted clinics respectively committing to the model. The report also highlighted a concerning counter-trend: for patients who are not bulk billed, out-of-pocket costs have risen by 13.5% over the year. The average total cost for a standard consultation now exceeds $100 in the ACT and Tasmania, leaving patients with gap fees averaging $58 and $61.
Government and Expert Responses
Federal Health Minister Mark Butler questioned the precision of Cleanbill's dataset, stating that specific figures "cannot be relied upon and should not be reported as accurate." He pointed out that clinics which did not answer survey questions were excluded. Minister Butler cited official government data indicating that since November, more than 3,200 practices are now fully bulk billing, including almost 1,200 that were previously mixed billing.
However, health policy experts warn that the incentive change, while boosting numbers, fails to tackle deeper structural issues. Peter Breadon, Health Program Director at the Grattan Institute, stated the rebound was expected but criticised the policy for not prioritising patients with the greatest need. "We've taken away one of the only mainstream parts of the GP funding system that explicitly prioritised disadvantaged patients," Breadon said, referring to the previous focus on concession card holders and children.
Breadon argued that funding should follow clinical and social need, targeting "GP deserts" and better supporting clinics serving low-income communities. He advocated for a more fundamental shift towards funding models that provide clinics with flexible budgets, increased for treating sicker and poorer patients, suggesting the recent changes might be a step backwards in aligning resources with need.
The government has also pointed to other measures aimed at improving healthcare access, including the rollout of additional Medicare Urgent Care Clinics and the establishment of the 1800Medicare advice line.
