One rogue private biller could make a whole practice ineligible for the new payment.
GP clinics will be forced to have tough conversations about whether to commit to the new universal bulk-billing practice incentive payments, doctor leaders say.
Speaking at the RACGP’s practice owners’ conference on Saturday, health department officials confirmed more details related to the incoming program – including that GPs will still be allowed to privately bill some procedural items while participating.
The new bulk-billing PIP – aka the BB PIP – will kick off in November alongside the expanded bulk-billing incentives.
MBS policy and review assistant secretary Louise Riley clarified that the new payment program, despite sharing a name, will be run entirely separately to the Practice Incentive Payments program most GPs are familiar with.
Practices will only be able to access the new program by registering with MyMedicare, but they will not be required to register all patients.
She also confirmed that, as a condition of participating in the program and receiving the 12.5% PIP on MBS billings, practices will be required to advertise that they were part of the program.
Crucially, all GPs at a participating practice will have to agree to bulk bill 100% of GP non-referred attendances.
Director of MBS affordability Jacob Grooby said it would be a discussion for individual practices.
“There are clinics in which [switching to universal bulk billing to get the new PIP] makes sense, that have providers [for whom] it won’t make sense,” Mr Grooby told delegates.
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“In those cases, I think it’s up to the practice owners to negotiate with the GP’s contract there, to adjust just contract terms for them, or to decide that it’s not worth it.”
Chris Smeed, who founded GP software startup Cubiko, acknowledged during a later session that this would be a “brutal” conversation for some practices.
“I’ve spoken to practices … that have a team of six people, seven people or 20 people that have always loved having a variety of different billing models within their practice to surface their cohort,” Mr Smeed told delegates.
“And suddenly, now you’re looking at a practice of seven, with four strong mixed billers and three strong bulk billers – the bulk billers won’t want to miss out on that 12.5%.
“That’s a meaningful amount; if you bill $350,000 a year, 12.5% is a lot of money.
“[It’s about] … understanding who’s in your practice and what sort of practice they want to work in and be part of, because as the conversations get tougher and tougher … if you don’t know where each member of your practice is at, you run a real risk of losing them.”
Former RACGP vice president Dr Bruce Willett went further.
“This is a series of discussions where everyone works out what everyone else in the practice is wanting and thinking … and gradually getting into alignment,” he said.
“I think there’s a big risk that this will tear practices apart and have people at one another’s throat within the practice.”
There are, however, some exceptions to the universal bulk-billing rule – the chief being that it only applies to GP non-referred attendance items.
That means GPs who do procedural work, for instance, will be allowed to continue privately billing for those items without jeopardising the entire practice’s universal bulk billing status.
Each physical location will also be counted as a separate practice under the scheme, meaning that companies which own multiple clinics will not be forced into an all-or-nothing bulk billing scenario.
The 2025 RACGP Practice Owners Conference was held at the Melbourne Convention and Exhibition Centre on 24 and 25 May.
This article was corrected on 4 June; it previously stated that the Department nickname for the PIP was the ‘Big Big PIP’. This was a mishearing of the phrase ‘BB PIP’. Big Big PIP does, however, have a ring to it, no?
