For the first time since 2023, every electorate in Australia has at least one universal bulk billing clinic.
Out-of-pocket costs have risen in 147 of 150 electorates since the November 2025 Medicare reforms, even as the number of universal bulk billers increased across almost all of the country, according to Cleanbill’s 2026 electorate breakdown report.
The Cleanbill report, published 21 June, is the first independent, electorate-level analysis of GP accessibility since the reforms took effect.
For the first time since 2023, every electorate in Australia had at least one universal bulk billing clinic.
In 143 out of 150 electorates, there was an increase in the proportion of universal bulk billing clinics compared to mixed or private billing clinics. Thirteen electorates saw increases above 45%.
But at the same time, there was a 340% increase in the number of clinics charging more than $50 out-of-pocket.
“While reflective of the economic realities currently faced by individual GP clinics, it does mean that patients not accessing universal bulk billed care are, on average, paying more to see a GP than at this time last year,” a Cleanbill spokesperson said.
Ten electorates had an average out-of-pocket consultation cost exceeding $100, with six in either Tasmania or the ACT.
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In just two of these 10 electorates did universal bulk-billing clinics account for more than half of all clinics.
Despite the overall increase in universal bulk billing, 49 electorates – almost one third – still had a lower proportion of universal bulk billing clinics than in 2023.
All 18 electorates where the proportion of universal bulk billing was 70% or higher were in New South Wales or Victoria.
Cleanbill measured clinics that offered bulk billed standard consultations (MBS Item 23) for non-concession adults during regular business hours, based on self-reported clinic data.
“Our figures should be interpreted as the front-door commercial reality for an everyday Australian adult seeking to access primary care around them,” the Cleanbill spokesperson told The Medical Republic.
Medicare’s quarterly statistics for the March quarter 2025-26 measured claims for all GP non-referred attendances.
The datasets are not directly comparable, but together provide a broader picture of access.
Medicare’s data broadly reinforced Cleanbill’s geographic findings – the ACT had the lowest universal bulk billing rate nationally at 54.1% across 528,985 services, with all four ACT statistical areas ranking in the bottom 10 universal bulk billing rates in the country.
Tasmania recorded the second-highest average out-of-pocket cost of $71.01, up from $61.18 the previous year.
The Northern Territory recorded the highest universal bulk billing rate at almost 90%, followed by NSW at 85.6%, and Victoria at 83.7%.
But where bulk billing broke down in the NT, costs were extreme – Bourke-Cobar-Coonamble had the highest average out-of-pocket cost nationally at $87.48, though, with a bulk billing rate of 95.7%, few patients paid out of pocket.
Darwin City averaged $83.22, followed by Katherine at $81.72 and NSW’s Northern Suburbs at $81.20.
Only six of the 334 statistical area Level 3 (SA3) – 1.8% – had an average out-of-pocket cost under $50, with four in SA and two in NSW.
Read the full Cleanbill report here.
