Two things changed together on 1 November 2025, and they get confused. The first applies to every practice that bulk bills anyone. The second is a program a practice chooses to join, and it only makes sense for some. Both need modelling before a doctor pays conversation, not after.
Change one: bulk billing incentives for all Medicare-eligible patients
Before 1 November 2025 the bulk billing incentive items could only be claimed for concession card holders and children under sixteen. From that date a GP can claim the incentive when they bulk bill any Medicare-eligible patient for an eligible service. For a mixed-billing practice this changes the arithmetic of who to bulk bill, appointment by appointment.
Change two: the Bulk Billing Practice Incentive Program
A practice that bulk bills all eligible services for all eligible patients, and is registered in MyMedicare, can receive an additional 12.5 per cent incentive payment for every dollar of MBS benefit earned from eligible services. It is paid on top of the MBS benefits and the bulk billing incentives, calculated quarterly and paid in arrears, with payments starting in the first quarter of 2026. The payment is split equally between the practice and the providers, and the split arrangements had to be settled before the program began. Patients do not need to be MyMedicare-registered. Participation is voluntary and a practice can opt in or out at any time. Accreditation requirements are waived for practices not yet accredited that join by 31 December 2026.
The program is all or nothing at the practice level. A practice cannot bulk bill some patients under the program and privately bill others. That is the decision to model.
What to model before opting in
- Current billing mix. Bulk-billed versus private revenue by doctor, item and patient group, out of Best Practice or Cubiko.
- The fully bulk-billed scenario. MBS benefit plus incentive items plus 12.5 per cent, against current private fee income. For some practices the program is a clear gain; for practices with a strong private fee base it is a clear loss; many are close, and the answer changes with the mix of long consultations, care plans and health assessments.
- Doctor pays. The split is fixed and the practice’s share of the 12.5 per cent needs to be in the contract. Doctors on percentage service fees will ask how it flows through.
- Volume and access. Full bulk billing usually lifts demand. Can the book, the nurse and reception absorb it without wait times blowing out?
- MyMedicare registration and accreditation. Both need to be in place; note the accreditation waiver deadline for practices joining by 31 December 2026.
1 July 2026 indexation
Separately, MBS fees for most general medical services, diagnostic imaging and several pathology groups were indexed by 2.6 per cent on 1 July 2026, along with a set of item additions and amendments. We keep the running list on our MBS & Medicare updates page.
We model this for clients as part of a clinic audit and build the billing workflow that follows through practice manager training.
- Services Australia — New Bulk Billing Practice Incentive Program starts 1 November 2025
- AMA — Changes to bulk billing incentives in general practice
- MBS Online — July 2026 news (indexation and item changes)
General information, not financial advice. Model your own practice’s numbers with your accountant before changing billing policy.
Quick answers
Do we have to bulk bill every patient to get the 12.5 per cent?
Yes. To receive the Bulk Billing Practice Incentive Program payment the practice must bulk bill all eligible services for all eligible patients, and it must be registered in MyMedicare. Patients themselves do not need to be registered. Practices can opt in or out at any time.
Can a mixed-billing practice still claim bulk billing incentives?
Yes. From 1 November 2025 the bulk billing incentive items can be claimed whenever a GP bulk bills any Medicare-eligible patient for an eligible service — not only concession card holders and children under 16. The practice-level 12.5 per cent program is the separate, all-or-nothing part.
How is the 12.5 per cent paid?
Calculated quarterly on the MBS benefit earned from eligible services and paid in arrears, with the first payments from the first quarter of 2026. The split between the practice and the GP had to be determined before the program started, and the incentive is split equally between practices and providers.
Fifteen years in medical practice operations. MBA, Melbourne Business School. Two medical centres built and sold; ten-plus centres overseen today. About Jamal →