Rural generalists still can’t access advanced-skill MBS items, restricting them to standard consultations.
It’s been 12 months since rural health organisations handed the government a blueprint to provide rural GPs access to unique MBS items, but the Rural Doctors Association of Australia (RDAA) says progress has been slow.
CEO Peta Rutherford told The Medical Republic the Medicare Benefits Review Advisory Committee (MRAC) had established a working group to examine the proposal and met with the RDAA earlier this year, but there had been no further development.
“We want to keep seeing forward momentum on this work and not see it stall,” she said.
Ms Rutherford said while rural GPs could claim most procedural work using the existing MBS item numbers, there was no higher-benefit consultation item available when they practised in their area of advanced skill.
This gap affects 11 non-surgical advanced skill areas, including paediatrics, mental health, palliative care and adult internal medicine, she said.
Introducing RG-specific MBS item numbers was also the focus of January 2025 ACRRM’s pre-budget and election submission.
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ACRRM President Dr Rod Martin said in a March 2025 statement that the initiative would be a “game-changer” in delivering crucial healthcare services in underserved populations and aiding rural workforce recruitment and retention.
Dr Martin told TMR an RG might spend three days a week in general practice and one day seeing only paediatric patients, but without RG-specific item numbers, could not bill for that paediatric work at specialist-equivalent rates.
“I’m an RG obstetrician, and I can use the same item numbers that an obstetrician can use because I’m doing very similar things – we’re just trying to make sure that we extend that across all of the fields where it doesn’t exist at the moment,” he said.
ACRRM’s budget submission this year sought 10 RG-specific items and 13 additional mental health items for appropriately skilled RGs.
Unique MBS items for RGs were omitted from this year’s 2026 – 2027 Federal Budget and last year’s, despite a $265.2 million investment to expand the pipeline of future GPs and rural generalists – a pipeline increasingly under strain.
Dr Martin told TMR he hoped these MBS changes would take effect within the next 18 months.
RDAA president Professor Sarah Chalmers said the Australian Medical Council’s recognition of RG medicine as a specialty in September 2025 was a “landmark achievement”, but one Medicare has yet to match.
“Recognition alone is not enough… Medicare must also recognise the additional skills, expertise and services rural generalists provide,” she said.
While the government had invested heavily in training rural GPs, Professor Chalmers said they would not see a full return until RG-specific MBS item numbers are recognised, with every delay incurring a cost.
“Every time a patient has to leave their community to access care that could otherwise be provided locally, there is a cost; to the patient, their family, their employer and the healthcare system itself.
“Rural Generalists help keep care local. They improve access to services such as mental health care, paediatrics, palliative care and emergency medicine, while supporting multidisciplinary teams and helping other health professionals work to their full scope of practice,” she said.
The RDAA said it recognised Medicare reform would take time, but would continue pushing until rural generalism was fully embedded in the healthcare system.
