In the lead up to the 2025 Federal Election and in the most recent Federal Budget, the Government announced a $7.9 billion investment to expand the eligibility for bulk billing incentives to all Australians and establish the Bulk Billing Practice Incentive Program (BBPIP).
The BBPIP has raised much discussion amongst the profession in the last six months, with the Government only recently confirming some of the final details.
What is BBPIP?
The intent of the Bulk Billing Practice Incentive Program is to support general practices to bulk bill all their patients, a practice known commonly as universal bulk billing. From 1 November 2025, practices that have registered for the program will receive an additional 12.5% incentive payment on the Medicare Benefits Schedule (MBS) benefits paid for eligible services, provided that all GPs in their practice bulk bill all patients. The 12.5% payment will be split evenly between the GP and the practice. The practice must advertise that it is a bulk billing clinic in addition to registering for the program. Payment will be made to the bank accounts nominated by the practice and the GP.
What to consider before switching to 100% bulk billing?
There are many factors to consider whether universal bulk billing is financially suitable for your practice including:
- Current bulk billing practices (high vs low)
- Patient profile
- Billing behaviour of individual GPs
- Personal earnings of individual GPs
Case Study – Doctor’s perspective
Dr Tip is a GP at Highside Medical Centre and is required to pay a service fee of 35% to the practice. Dr Tip sees 32 patients in an 8-hour day and bills a standard consultation (Item 23) for each of these patients. Dr Tip bulk bills 26 of these patients (81.25%), and charges a gap of $61.10 to 6 patients, which, along with the MBS rebate of $43.90, brings their total private fee to $105. Let’s compare Dr Tip’s take-home pay per day under her current billing practices and if her practice were to bulk bill 100% of its patients.
| Scenario |
Billing |
Total billings |
Less: service fee (35%) | BBPIP | Dr Tip’s take home pay | ||
| Gap | MBS | BBI | |||||
| Current Billing Method (from 1 Nov) | 366.60 | 1,404.80 | 568.10 | 2,339.50 | (818.83) | – | 1,520.68 |
| Universal Bulk Billing (from 1 Nov) | – | 1,404.80 | 699.20 | 2,104.00 | (736.40) | 87.80 | 1,455.40 |
Case study – Practice’s perspective
The Practice Manager of Highside Medical Centre and the accountant have analysed the practice costs and determined that the cost for each consulting room is $90 per hour. These costs include rent, overheads, wages for the administration and nursing staff and other operational expenses. Using Dr Tip’s daily billing from Case Study 1, let’s see the impact of universal bulk billing on the practice’s bottom line:
| Scenario | Service fee received by practice | Less: costs per 8 hour day | BBPIP | Practice profit/(loss) per 8 hour day |
| Current billing method (from 1 Nov) | 818.83 | (720.00) | – | 98.82 |
| Universal bulk billing (from 1 Nov) | 736.40 | (720.00) | 87.80 | 104.20 |
On the face of it, the practice is financially better off under universal bulk billing; however this example does not consider:
- Whether the MBS rebate will be increased in line with rising costs of the practice.
- Most GPs will bill a number of different items in their consulting day, not just Item 23 as in the examples above.
Any practice aiming for 100% bulk billing should consider potential changes to the MBS. For instance, from 1 November, mental health consultation (Item 2713) and review of treatment plan (Item 2712) will be removed, requiring GPs to use time-based general attendance items (23, 36, 44, 123).
Before you decide
Ask yourself:
- Have we met the full eligibility test – registration, advertising, and 100% bulk billing?
To qualify for the 12.5% combined BBPIP, practices must register for the program, promote themselves as a 100% bulk billing practice, and ensure every patient is bulk billed. - Do we understand exactly what the 12.5% applies to?
The incentive is calculated only on the Medicare Benefits Schedule (MBS) benefits component – it excludes the Bulk Billing Incentive. - Are we comfortable with how the payment is distributed?
The 12.5% payment is shared equally between the GP and the practice, meaning both share in the reward (and any resulting financial adjustments). - Have we considered how universal bulk billing could affect our practice model?
Practices should weigh a range of factors – from the impact on individual GP earnings and behaviour to future changes in the MBS that could alter financial outcomes over time.
If you’d like support in determining whether to become a universal bulk billing practice or assistance with the best billing model suited to your practice, contact your local William Buck Health Team Advisor.
