The proportion of GPs who bulk billed all their patients more than doubled over a year – from 12% in 2025 to 26% in 2026, according to the RACGP’s latest report.
More Australians are being bulk billed, but the RACGP says Medicare still penalises longer, more complex consults.
The findings form part of the RACGP’s annual Health of the Nation report, published today, which included a survey of 2766 practising GPs – roughly 7% of the GP workforce.
Bulk Billing rises but remains below pre-covid levels
Almost two-thirds of Australians (63%) were bulk billed for all their general practice care, up from 56% in 2024 and 2025, following the government’s introduction of the Bulk Billing Practice Incentive Program (BBPIP) in November last year.
“The additional investment in general practice really is getting results,” RACGP president Dr Michael Wright told The Medical Republic.
However, this remained below the pre-covid bulk billing level of 70% in 2019.
Over the same period, the proportion of GPs who bulk billed most of their patients fell by 7%, as did the proportion who bulk billed only a minority of their patients.
In comparison, Medicare administrative data, which measured the proportion of services bulk billed rather than patients, found 81% of GP consultations were bulk billed in 2025-26.
What patients pay
The cost of a Level B consultation, lasting between six and 20 minutes, fell 3.8% from $82.06 in 2025 to approximately $78.91 in 2026.
Among GPs who did not bulk bill, however, average Level B fees rose by $3.39 to $90.45, bringing the gap fee to just over $46.
Fees varied by rurality, with the highest average in regional centres at $85.17, meaning patients paid $41 on average. These figures included GPs who bulk bill.
Dr Wright attributed this to greater availability of GPs and urgent care centres in metropolitan areas, while general practice in rural communities often operated as the “whole health system”, often with insufficient MBS rebates.
“Out-of-pocket costs are necessary in some areas to keep practices viable, because no one benefits if a practice shuts down. Regional and rural communities absolutely rely on general practice as the lifeblood of a health system,” he told TMR.
According to the report, 7.7% of Australians delayed GP care due to cost in 2024-25 – a 1.1% decrease from 2023-24. The decline was seen across nearly all age groups, except those aged 55 to 64.
People aged 25 to 34 remained the most likely to delay care due to cost in 2024-25 (12%).
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The case for longer consultations
The college continued to call for higher Medicare rebates for longer consultations to reflect the “real costs” of care for complex and chronic conditions.
“Medicare funding for patients to access longer GP consultations is not proportionally equivalent to shorter consultations,” the report read.
The RACGP calculated that a GP who spends 15 minutes with a patient attracts a rebate of $3.00 per minute, whereas a 55-minute consultation attracts only $2.33 per minute.
Most GPs (78%) disagreed or strongly disagreed that current MBS items adequately supported preventive healthcare in their practice, and 80% said competing acute or complex issues often limited their ability to address preventive health during consultations.
According to the report, it would cost the government only $87.10 to support a patient’s longer consultation of 20 to 29 minutes for appropriate preventive care, early diagnosis and treatment that could reduce avoidable hospital admissions.
The Australian Institute of Health and Welfare estimated potentially preventable hospitalisations cost the economy $7.7 billion in 2023-24.
Government spending on general practice reached $13.4 billion in 2024-25, up almost 6% from $12.7 billion in 2023-24, not including the November 2025 changes, such as the BBPIP.
Per person, this equated to roughly $489 in 2024-25 – the highest since 2021-22 but below the 2020-21 peak of $512. Hospital spending per person was more than eight times that of general practice in 2023-24 ($3836).
Dr Wright pointed to other countries, including Switzerland and the Netherlands, which spend roughly 10% of the health budget on primary healthcare.
“By our measures, Australia is only at approximately 5.5%, and it’s dropping over the past 20 years because hospital expenditure continues to rise,” he told TMR.
“We’ve seen some increased investment, which is great, but we really need to continue increasing it to 10% of the health budget, which we know will continue to allow more people to see a GP in the community, provide more comprehensive GP care, and take the pressure off hospitals and emergency departments, which we know are far more expensive.”
“We are also recommending the Government establish an independent primary care pricing authority to ensure Medicare funding reflects the true cost of delivering care,” Dr Wright said.
An independent body would provide GPs with more certainty that they would continue to receive funding, he said.
Longer, more complex consults
Time spent with patients rose approximately 12% over four years, from 17.7 minutes in 2022 to 19.8 minutes in 2026.
While AIHW data found almost nine in 10 patients (89%) reported their GP always or often spent enough time with them, the RACGP’s consultation duration figures still fell within a standard short appointment.
Level B consultations increased by 800,000 between 2025 and 2025, reaching 28.3 million, while Level C consultations rose by 700,000 to 6.3 million.
Level A consultations saw the smallest increase – just 100,000 more appointments, bringing the total to 2.6 million in 2026.
GPs said the main reasons they spent more time with patients were patient presentation complexity (49%) and care complexity (48%), followed by mental health demands (41%) and increased patient expectations (38%).
“I address multiple issues in a consultation, because it is very difficult to only address one issue and ignore the other interrelated issue,” one GP said.
This was felt more markedly among female GPs, who spent an average of more than 21 minutes with their patients, compared with just under 18 minutes for male GPs – 3.7 minutes more per patient consultation in 2026.
The most common reasons reported for patient presentation to female GPs were psychological (71%) – 13% higher than for male GPs – women’s health-related (55%), and endocrine and metabolic conditions (37%).
Psychological reasons also dominated presentations to male GPs (58%), followed by musculoskeletal (48%) and respiratory (40%).
“For too long, health issues affecting women have had less research funding than those that affected men, and so we’ve had fewer clear guidelines [and] research, and less support for GPs providing that care,” Dr Wright said.
“If [the government] supports GPs with proper funding, up-to-date guidelines, but also proper training to upskill if needed, additional investment really gets results and lets people access care with an expert GP in the community.”
Female GPs also reported higher burnout – almost two-thirds (65%) had experienced it in the past 12 months, compared with just over half (53%) of male GPs.
While burnout had fallen sharply since the previous year, female GPs reported lower satisfaction than their male counterparts and were less likely to recommend the GP profession to younger colleagues.
Overall, roughly half of GPs (51%) said being able to spend the time they needed with patients was a challenge, and 78% agreed the GP role was more professionally demanding in 2026 than 10 years ago.
MyMedicare uptake
Most practice owners (81%) reported their practice was registered with MyMedicare.
Registration was reportedly higher in rural areas, with 92% of outer-regional practices registered, compared with 77% in major cities.
However, patient enrolment remained low at most practices, with only 23% of practice owners reporting more than half of their patients were enrolled.
“The value proposition for signing up has been less clear. So hopefully that changes with additional funding to support a broader range of services,” Dr Wright said.
Survey responses comprised 2766 practising GPs, 239 non-practising GPs, and 504 GPs in training.
The Report also drew on data from the AIHW, ABS, DoHDA, Productivity Commission, and Medical Deans Australia and New Zealand.
Read the full report here.
