Telehealth Costs: Bulk Billing vs Private

Telehealth in Australia is not a single pricing model. When you search for an online doctor, you will encounter services that are bulk billed (you pay nothing), services with Medicare rebates (you pay the gap between the fee and the rebate), and private services (a flat fee with no Medicare involvement). These are fundamentally different arrangements, and understanding them prevents unexpected costs.

Bulk billing means the healthcare provider accepts the Medicare benefit as full payment for the service. You pay nothing out of pocket. The provider bills Medicare directly.

For a telehealth consultation to be bulk billed, three conditions must be met:

• You must hold a valid Medicare card
• The consulting doctor must be registered to bill Medicare
• The consultation must qualify under a Medicare Benefits Schedule (MBS) item for telehealth

The MBS includes specific telehealth consultation items for video and phone consultations with GPs, nurse practitioners, and various specialists. These items were made permanent after 2022, following their introduction during the COVID-19 pandemic. According to the Australian Institute of Health and Welfare (AIHW), telehealth accounted for approximately 37% of all GP services in 2021-22, reflecting how significantly the payment infrastructure expanded.

Bulk billing rates for general GP services in Australia sit at approximately 80-85% of standard consultations nationally, according to AIHW annual data, though rates have declined modestly in recent years as practices adjust to cost pressures. Telehealth-specific bulk billing rates are lower than in-person rates at dedicated telehealth-only platforms, because most of those platforms operate on private billing models.

Who Is Most Likely to Receive Bulk-Billed Telehealth

Bulk-billed telehealth is most accessible in these circumstances:

• Your existing GP practice offers telehealth appointments and bulk bills you as an established patient
• You use a bulk-billing GP service that has expanded to include telehealth alongside in-person consultations
• You hold a concession card and the practice has a policy of bulk billing concession patients
• You are in a regional or remote area where practices bulk bill to maintain access under incentive programs

Bulk billing is generally not available through dedicated on-demand telehealth platforms - particularly asynchronous services where you submit a form and a doctor reviews it later rather than conducting a real-time video appointment.

Private telehealth services set their own fees. You pay a fixed amount for a specific service, regardless of Medicare card status.

Typical private telehealth pricing in Australia (2026):

These fees cover the clinical review, any document or script issued, and the platform infrastructure. They are set by the provider and are not subject to Medicare pricing rules.

A private telehealth service can attract a Medicare rebate if the consultation involves a Medicare-registered practitioner and meets the MBS requirements for a telehealth item. Not all private telehealth consultations qualify.

For a Medicare rebate to apply:

• The service must be conducted by a registered MBS-eligible practitioner
• The consultation must occur via video or telephone (specific item requirements vary)
• Some MBS items require an existing clinical relationship with the provider
• The service must generate a receipt showing the applicable MBS item number

Asynchronous services - where you complete a structured intake form and a doctor reviews it without a real-time call - do not generally attract Medicare rebates. They do not meet the definition of a telehealth "attendance" under the MBS because there is no simultaneous two-way communication between patient and doctor. This includes most dedicated medical certificate and prescription request platforms.

Services offering real-time video consultations with Australian-registered GPs will generally be able to offer Medicare-rebatable consultations.

The Medicare Safety Net reduces your out-of-pocket costs if you incur high Medicare expenses in a calendar year. Once cumulative out-of-pocket costs exceed the annual threshold, further eligible services are rebated at a higher rate.

The Safety Net applies to any service that attracts a valid Medicare rebate, including eligible telehealth consultations. Services where you pay a private fee but do not receive a Medicare rebate do not count toward the Safety Net threshold.

As of 1 January 2026 per Services Australia, the Extended Medicare Safety Net thresholds are:

• Concessional or Family Tax Benefit Part A patients: $861.20
• All other patients: $2,699.10

After reaching the threshold, the rebate increases to 80% of out-of-pocket costs for the remainder of the calendar year.

Regardless of whether your consultation was bulk billed or privately charged, your PBS medication cost at the pharmacy is identical. The pharmaceutical subsidy is attached to your Medicare eligibility and the medication's PBS listing - not the billing model of the consultation that generated the prescription.

Under the Pharmaceutical Benefits Scheme, the co-payments current from 1 January 2026 are:

A prescription from an asynchronous telehealth service, a bulk-billing GP clinic, or a hospital outpatient department all dispense at the same PBS price at the pharmacy.

Comparing bulk-billed and private telehealth on price alone omits the full cost of accessing healthcare. Total cost includes:

• Travel time and transport cost (petrol, parking, rideshare)
• Time off work to attend an in-person appointment
• Waiting room time at a clinic (often 30-90 minutes at walk-in services)
• Care arrangements for dependents while attending in person

Before choosing

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Patients should confirm fee, rebate, service eligibility, and urgent-care exclusions before booking.

A private telehealth consultation at $30 that takes 20 minutes total may cost less in practical terms than a bulk-billed in-person appointment that requires taking half a day off work and $20 in transport. For people in full-time employment, the productivity value of a fast asynchronous service often exceeds the consultation fee.

If you do not hold a Medicare card - international students, visitors on temporary visas, working holiday visa holders - private telehealth services charge the same fee as for Medicare card holders, because it is a flat private fee unrelated to Medicare status.

The PBS prescription subsidy does not apply without Medicare eligibility. Medications dispensed privately cost the full unsubsidised price, which can be substantially higher than the PBS co-payment. International students on Overseas Student Health Cover (OSHC) should check their specific policy documents, as some policies cover GP consultation fees including telehealth.

Bulk-billed telehealth is the lowest out-of-pocket cost option where it is available. The constraint is access: you typically need an existing relationship with a GP practice that offers telehealth bulk billing, or you need to find a dedicated bulk-billing telehealth service.

Private telehealth with Medicare rebates offers flexibility: you pay a gap payment, but a portion is recovered. These services are generally available without a pre-existing patient relationship.

Private-only telehealth - including asynchronous services for certificates, prescriptions, and on-demand consultations - offers speed and convenience at a known, flat fee. The cost is predictable and often comparable to or lower than a private in-person GP gap payment. The tradeoff is that these services do not count toward the Medicare Safety Net.

The right choice depends on urgency, access, and your individual circumstances. For a non-urgent condition where you have a bulk-billing GP, book with them. For same-day needs - a certificate, a prescription running out, advice at 11pm - an asynchronous private service is usually faster and more accessible.

• PBS: fees, patient contributions and Safety Net thresholds
• Services Australia: PBS Safety Net thresholds
• Services Australia: Medicare Safety Net thresholds
• MBS Online: item 23 Level B GP attendance
• Healthdirect: medicines information
• Medical Board of Australia: telehealth consultations with patients
• AHPRA: Register of practitioners
• TGA: advertising a health service