Bulk billing

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Bulk billing is a payment option under the Medicare system of universal health insurance in Australia. It can cover a prescribed range of health services as listed in the Medicare Benefits Schedule, at the discretion of the health service provider.[1] The health service provider - usually a doctor - is paid 85% of the scheduled fee for outpatient services; and 75% of the scheduled fee for inpatient services, by billing the government via the patient's Medicare card. The service provider receives a fixed proportion of the scheduled fee but avoids the costs and risks of billing and debt collection. It could be described as a form of factoring.

Bulk billing rebates may be collected and paid directly to the service provider, or the service provider may collect the equivalent fee from the patient; leaving the patient to claim the rebate online, over the telephone, by mail, or at a Medicare office. Increasingly, service providers offer electronic lodgement at the practice using EFTPOS.[2]

Under Medicare, it is not permissible to charge the patient a co-payment with bulk billing (although this was previously permissible): a service provider who bulk bills for a service may not charge the patient further for that service.

Service providers may choose whether or not to use bulk billing. Many general practitioner services are bulk-billed, but less so in rural, regional, and remote areas of Australia where there is a greater shortage of doctors and health care services. The key purpose of bulk billing is to provide an economic constraint on medical fees and charges.

2014 co-payment proposal[edit]

In the 2014 Australian federal budget, the Abbott Government proposed to impose a $7 co-payment for all bulk billed GP and medical test visits. The proposal was to reduce the medicare rebate payable to service providers by $5 (which applies to all consultations, and not just bulk billed ones) with the additional $2 paid by patients also going to providers. The proposal was widely criticised.[3] In March 2015 the Health Minister Sussan Ley announced that "we are not pursuing it at all" with Prime Minister Abbott declaring the co-payment was "dead, buried and cremated".[4][5]


  1. ^ "Medicare Bulk Billing"
  2. ^ "Billing and claiming options"
  3. ^ The Age, 19 June 2014: Medical copayment deserves to fail in the senate
  4. ^ Sydney Morning Herald, 3 March 2015: Abbott government scraps GP co-payment
  5. ^ "Bulk Billing Doctors". Thursday, 23 May 2019