But we’re still missing data on what that has meant for the way rural doctors are practising.
A new analysis of self-reported bulk-billing data appears to show that rural and regional GP practices are taking up the government’s bulk-billing PIP at a higher rate than their metro counterparts, but key questions remain unanswered.
Online healthcare directory Cleanbill, which gathers data predominantly by manually ringing clinics and asking if they bulk bill new, non-concession patients, today released a new geographic breakdown of a dataset it previously put out in January of this year.
The reconfigured report contains responses collected between November and mid-December 2025 – i.e. the weeks immediately following the introduction of the new BB PIP, for which practices must commit to universal bulk billing to qualify.
As confirmed by federal health minister Mark Butler on Friday, the total number of clinics registered on the program has grown by at least 450 since the end of December 2025.
Because the number of sign-ups has grown so significantly since Cleanbill’s original data collection, its new report only represents the immediate impact of the policy.
Broadly, the new data analysis shows a substantially higher uptick in universal bulk billing among clinics in more rural areas.
While the number of universal bulk billers in MM1 regions increased by around 17%, the number of universal bulk billers in MM5, 6 and 7 locations increased by 37%, 33% and 27%, respectively.
According to Cleanbill, 64% of GP clinics in very remote MM7 communities are now universal bulk billers, compared to just 39% of MM1 practices.
The RACGP has attributed the split to rural loading.
Although the BB PIP itself does not include rural loading or bulk-billing incentive items, the bulk-billing incentives are graded by rurality.
If a rural practice and a metropolitan practice bulk billed the same number of patients, both would receive the same payment under the BB PIP but the rural practice would earn more overall through higher bulk-billing incentive payments.
“Given that [the bulk-billing] incentives are highest in regional and remote areas, it’s not surprising that that’s had the biggest uptake,” RACGP president Dr Michael Wright told The Medical Republic.
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“And it really shows that if you fund general practice properly [and] if that funding matches the cost of care, then more practices are able to bulk bill more patients.”
ACRRM president Dr Rod Martin questioned how the data was interpreted.
“The question that still might need to be asked is, in those practices that have switched to bulk billing, are rural and remote doctors having to change the way they do their business,” he told TMR.
“It might be that they need to be seeing more patients per unit time, and that’s probably the piece of data that would be [most instructive to see].”
The keepers of that data are Services Australia and Medicare.
