On 1 November 2025 the bulk billing incentive was opened to every Medicare eligible patient, and the Bulk Billing Practice Incentive Program began. By June 2026, 3,819 practices had registered for the program, and the national bulk billing rate for GP consultations reached 84.1 per cent for April to June, 4.9 points higher than a year earlier. Many owners are still deciding, and some who joined early are asking whether the numbers have worked out.
A year in, the decision still has two parts. The first is what universal bulk billing does to the practice. The second is what it does to each doctor who works there. The two answers can point in different directions, because the program payment and the private fees it replaces are shared in different proportions.
How the program pays
A practice that bulk bills every eligible service for every Medicare eligible patient, and is registered with MyMedicare, receives an extra 12.5 per cent of the MBS benefit on those services. The payment is split evenly between the GP and the practice, and it is paid within the month after each quarter ends. The first round, for November and December 2025, paid $61.4 million to 2,949 practices in January 2026.
Every bulk billed consultation also attracts the bulk billing incentive, which is paid to the GP as an MBS benefit and sits outside the 12.5 per cent calculation. For a standard consultation, item 23, the MBS benefit is $45.05 from 1 July 2026. The incentive depends on the practice’s Modified Monash category: $22.40 in a metropolitan practice (item 75870, Modified Monash 1), rising to $43.15 in the most remote category (item 75876, Modified Monash 7).
The list of eligible services covers the most common GP services, such as time based consultations, health assessments, mental health treatment items and chronic condition management items. No procedures are on it at present, and a practice in the program can still charge a fee for services that are not on the list.
One practice, two answers
Take a six doctor practice in a metropolitan suburb that sees about 30,000 standard consultations a year. Seven in ten are already bulk billed and the rest pay a $100 fee. Doctors keep 65 per cent of their billings and pay the practice a 35 per cent service fee.
Modelled on the figures that apply from 1 July 2026, switching to universal bulk billing lowers the practice’s revenue by $18,064 a year, or 2.2 per cent. The doctors’ income falls by $105,949 between them, 7.0 per cent, about $17,658 each. The practice’s share of the program payment is about $21,117 a quarter, paid in arrears.
The doctors fall further because of how each stream is shared. The private fees given up were shared 65 to 35 in the doctors’ favour, while the program payment is shared evenly. Each dollar of private fees lost costs a doctor 65 cents and the practice 35 cents, and each dollar of program payment returns 50 cents to each.
To stand still, the practice needs 2.3 per cent more consultations. Each doctor needs 7.6 per cent more, about 1.8 extra patients a day for a doctor seeing 24.
The same model points the other way for a practice already bulk billing 85 per cent of consultations at an $85 fee: practice revenue rises 7.7 per cent and doctor income 2.4 per cent. Two practices in the same suburb can reach opposite answers, and both can be right.
Illustrative example, modelled on standard consultations using public Medicare figures from 1 July 2026 and typical settings for a practice of this size. Not a client engagement. A full review uses your own item mix, fees, service fee and capacity.
What to check on your own figures
The example uses standard consultations and typical settings. Your answer depends on figures only your practice holds, and these are the ones that move it most.
Your item mix
Longer consultations, health assessments and chronic condition management items each carry their own MBS benefit and their own gap between your private fee and the rebate. Work through the eligible services list item by item, because the services that are not on it, procedures included, keep their fees.
Your private fees
The program has to make up the gap between each private fee and the MBS benefit plus the incentive. The higher your fees, the wider that gap.
The service fee
Check what your service fee agreements say about program payments. If the fee applies to the doctors’ half of the payment, the practice gains and the doctors lose a further slice. Agree it in writing before you switch.
Each doctor’s capacity
The extra consultations have to come from somewhere. A doctor who is already fully booked cannot add two patients a day without longer waits for patients.
Your patient mix
A practice that already bulk bills concession card holders and children starts closer to breaking even. Patients who pay today may change how often they book once their consultations are bulk billed, which moves your volume and your waiting list.
Your Modified Monash category
The incentive rises with remoteness, so the same switch can work in a regional practice and fail in a metropolitan one. From 1 November 2026 Medicare moves to the 2023 Modified Monash categories, so confirm your practice’s category, and the incentive item that goes with it, before you model the change.
MyMedicare registration
The program pays only practices registered with MyMedicare. A practice that registers in order to join does not need accreditation, and its patients do not need to enrol.
Cash timing
Private fees arrive on the day. Program payments arrive quarterly in arrears, so the first months after a switch carry the lost fees before the first payment lands. Plan the cash for that gap.
Payroll tax
How state revenue offices treat payments between a practice and its contracted doctors differs by state and has changed several times in recent years. Talk to your tax adviser about your own arrangements before you change your billing model.
Deciding with your doctors
The model sets a clear test. Switch only if the doctors can add the consultations they need without lengthening waits, and agree it with them first, because their income moves about three times as far as the practice’s in percentage terms.
Our page on fractional CFO support for GP and medical centres shows how we model this decision for a practice, and our Healthcare Hub covers how practice economics differ across GP, dental and allied health. Every article we have written for general practice is in the blog library’s general practice view.
If you would like the model run on your own item mix, fees and service fee before you decide, book a complimentary 45 minute discovery call.
Sources: MBS Online, items 23, 75870 and 75876, fees from 1 July 2026; Department of Health, Disability and Ageing, Bulk Billing Practice Incentive Program page, program guidelines of 3 March 2026, questions and answers of 7 April 2026, the eligible services list and the National GP Bulk Billing Snapshot for April to June 2026 (August 2026); MBS Online, November 2026 news; Services Australia, BBPIP payments. All checked 16 October 2026.