How the Bulk Billing Incentives Significantly Increase GPs' Income

Since the expansion of the Medicare bulk billing incentive for all Australians, GPs that bulk bill are now benefiting from the tripling of the bulk billing incentive, an extra $20.65 for MM1 on every eligible consult. But, not every bulk billing GP will receive the 6.25% Medicare Bulk Billing Practice Incentive Program Payments they’re entitled to.

If you’re bulk billing eligible patients in a mixed billing clinic, you are missing out on income simply because of the way your practice bills.

How does the Bulk Billing Incentive work?

Understanding how Medicare bulk billing incentives work could make a significant difference to your overall earnings.

Medicare provides two bulk billing incentives:

1. The Bulk Billing Incentive (BBI) – The existing bulk billing incentive has now been expanded to include all Australians, no longer limited to children under 16 and concession card holders. That’s an additional $20.65 (MM1) on every eligible bulk billed consult.
2. The Bulk Billing Practice Incentive Program (BBPIP) – an additional 12.5% incentive payment on eligible bulk billed services for practices that 100% bulk bill eligible patients. The incentive payment is equally split between the doctor and the practice.

Here’s the part many GPs don’t realise: GPs working in mixed billing clinics typically only receive the per-service Bulk Billing Incentive ($20.65 for MM1), but not the additional Bulk Billing Practice Incentive Program benefit, which is an additional 6.25% loading on all eligible bulk billed services.

Why? Because BBPIP eligibility is determined at the practice level, not the individual GP level.

If a clinic does not bulk bill 100% of eligible patients for eligible items, the practice may fail to qualify for BBPIP. This means GPs miss out on the additional 6.25% loading that would otherwise be available.

What does this mean for your income?

If you are:

• Bulk billing eligible patients
• Working in a clinic that also privately bills
• Not practising in a 100% bulk billing environment

You could be leaving Medicare incentive income on the table. This can amount to a meaningful difference in your total earnings. For the typical bulk billing GP billing $500,000 per year, this can be $34,375 extra every year.*

How Cornerstone Health is Different

Cornerstone Health’s purpose has always been to increase access to quality, accessible healthcare for all Australians. Cornerstone Health operates 100% bulk billing medical clinics, ‘Our Medical’, across Melbourne, Sydney, Brisbane and the Gold Coast, open to 10pm, 365 days.

The government’s investment in bulk billing enables Our Medical centres to continue delivering free GP care to patients with a Medicare card while continuing to operate extended hours and providing all primary healthcare services in one location.

Our Medical centres operate as 100% bulk billing. This is a deliberate, structured model, and it makes a difference.

Because we bulk bill all eligible patients, GPs in the Cornerstone Health network qualify for both Medicare bulk billing incentives:

• The per-consult Bulk Billing Incentive, and
• The Bulk Billing Practice Incentive Program (BBPIP)

This means GPs practising within the Cornerstone Health network are supported to receive the full benefit of Medicare’s bulk billing framework, rather than just part of it.

Want to better understand how bulk billing incentives apply to you?

Medicare bulk billing incentives can be complex, and the way a practice bills can significantly affect what GPs ultimately receive. We have expertise in how Medicare bulk billing incentives operate at both a GP and practice level.

If you would like to find out more or want to better understand the bulk billing incentives, complete the form below so we can get in touch.