There are a handful of exemptions to the ban on billing the MBS for telehealth consults where the patient and clinician have never met face-to-face.
The vast majority of online-only telehealth clinics operate completely outside of the MBS system – but there are a growing few which publicly advertise as having bulk billed appointments available.
Here’s how it is possible.
Since the latter half of the pandemic, doctors have been subject to the “existing relationship” telehealth rule, whereby the patient is only eligible for a Medicare rebate if they have consulted with that doctor face-to-face sometime in the previous 12 months. Later, this was extended to include patients who were registered with that practice in MyMedicare.
As of November 2025, the same rules applied to telehealth consults conducted by a nurse practitioner.
Exemptions exist where patients are homeless, under the age of 12 months, are isolating because of a state- or territory-issued public health order or are living in a local government area which has been declared a natural disaster.
There are also exemptions where the practitioner works at an Aboriginal Medical Service or urgent care clinic, as well as when the service is urgent and after hours.
Certain types of consultations are also exempt, including those related to blood borne viruses, sexual or reproductive health, focussed psychological strategies, eating disorder planning and treatment, and chronic condition management.
On its website landing page, telehealth-only service My Weight Loss Clinic advises that “Bulk Billing and Medicare Rebates are available to eligible patients” and encourages patients to discuss this with their clinician.
Nurse practitioner and clinic founder Chris O’Donnell told The Medical Republic that the clinic billed patients privately “99% of the time”, but that patients contacting the service for a reproductive health assessment could be bulk billed or receive a Medicare rebate.
“Weight loss and reproductive health are inextricably linked,” Mr O’Donnell said.
“… I’m a big fan of Medicare, and if you if you look at any of my ministerial appointments, I take that very seriously … so we are very strict with our clinicians on when they shouldn’t use it, and that is most of the time, at the moment.”
Related
Telehealth startup Abby also bills itself as Medicare-friendly; its home page invites patients to check their “bulk billing eligibility” by creating an account, noting that “strict eligibility applies”.
Abby Health also runs a physical clinic in Broken Hill.
Clinic founder Charlie Veitch told TMR that the “majority” of what Abby does is bulk billing.
“We believe in access,” he said.
“We bulk bill wherever is possible, and what we’ve built to facilitate that is, in that online questionnaire when patients first sign up, we establish their clinical need.
“We understand what they’re here for, and if that’s appropriate to be treated in a virtual setting. We prefer the words virtual care because a lot of what we do is video, and it does come with a patient’s medical history, which is vastly different from just a phone call.
“In that assessment, we also try and figure out what is, if any, of their eligibility for bulk billing.
“There are a number of reasons outside the 12-month rule where that’s possible. Some of it is based on clinical need. So, for example, if it is sexual health, or infants under the age of 12 months, or other things such as homelessness, domestic violence, or natural disasters.
“The rates at which we provide bulk billing versus private [billing] really vary depending on who we’re seeing, the demographic, the patient cohort, where they live in Australia, and what they are here to see us for.”
According to Mr Veitch, Abby has “ongoing relationships” with 68,000 patients. Around 85% of incoming patients indicated in their sign-up forms that they were booking with the telehealth clinic “because they don’t have any other option”.
