Telehealth appointments are covered by Medicare when your consultation meets Medicare Benefits Schedule rules. They are bulk billed only when the clinic or doctor accepts the Medicare benefit as full payment.
That means your telehealth appointment in Australia is not automatically free. Even when Medicare covers the appointment, you still pay an out-of-pocket cost if the clinic charges more than the Medicare rebate.
According to Services Australia, Medicare benefits are available for both video and phone telehealth services. These services are provided by GPs, medical practitioners, specialists, nurse practitioners, midwives, allied health professionals, and other eligible health providers.
What Does Bulk Billed Telehealth Mean?
Bulk-billed telehealth means your doctor bills Medicare directly and accepts the Medicare benefit as full payment for your appointment. You pay nothing out of pocket for that eligible service.
Bulk billing means Medicare covers the full cost of the service and pays the health professional directly. The Medicare benefit is the amount Medicare covers for a service, while the difference between the doctor’s fee and the Medicare benefit is called a gap payment or out-of-pocket cost.
| Term | What it means for you |
| Medicare-covered telehealth | Medicare pays a rebate when your appointment meets MBS rules. |
| Bulk billed telehealth | Your GP accepts the Medicare benefit as full payment, so you pay no gap. |
| Mixed billing telehealth | You pay the clinic fee and receive a Medicare rebate when eligible. |
| Private telehealth | You pay the full fee when no Medicare rebate applies. |
Are Telehealth Appointments Covered by Medicare in Australia?
Yes, eligible telehealth appointments are covered by Medicare in Australia. According to the Australian Department of Health, Disability and Ageing, telehealth services became an ongoing part of Medicare from 1 January 2022, and it includes diagnosis, treatment, and prevention.
Telehealth is used when your healthcare provider has determined that a physical examination is not required, and a phone or video consultation is sufficient. However, your consultation still needs to meet the same clinical standard as an in-person appointment. MBS telehealth items have the same clinical requirements as face-to-face consultation items.
So Medicare covers your telehealth appointment when it is:
- provided by an eligible healthcare professional
- clinically appropriate for phone or video
- billed under an eligible MBS telehealth item
- connected to a patient who meets Medicare telehealth eligibility rules
Who Is Eligible for a Medicare Rebate on GP Telehealth?
For GP telehealth, your Medicare rebate eligibility depends on your relationship with the GP or practice. The 12-month rule applies here: GPs use telehealth items for patients who either have an existing clinical relationship with the provider or have visited the practice for a face-to-face service in the last 12 months.
You also qualify through specific exemptions. Services Australia’s telehealth claim page states that exemptions include:
- Homelessness
- Children under 12 months
- Treatment at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service
- Natural disaster areas
- Urgent after-hours care in unsociable hours
- Sexual or reproductive health consultations
- MyMedicare registration with the practice
- COVID-19 isolation or quarantine under a public health order
- Mental health planning and treatment
- Eating disorder management
- Chronic condition management
- Commonwealth Urgent Care Clinic treatment
- Obstetric attendance
In practical terms, a Medicare rebate applies when you, your provider, your appointment type, and your clinical situation match the MBS telehealth rules.
Are all telehealth appointments bulk-billed?
No, not all telehealth appointments are bulk billed.
Before assuming your appointment is free, there are 3 separate questions to check:
- Is your appointment clinically suitable for telehealth?
- Are you eligible for a Medicare rebate?
- Does the clinic or GP bulk bill that appointment?
The answer needs to be yes to all 3 for a bulk-billed telehealth appointment.
Not all health professionals bulk bill. Some doctors only bulk-bill patients with a concession card or a health care card. When the doctor does not bulk bill, the patient pays for the service and claims the Medicare benefit back, where applicable.
This is why one patient has a no-gap telehealth consult, while another patient at the same clinic pays a private fee and receives a rebate.
What Happens at a Mixed Billing Clinic?
At a mixed-billing clinic, some appointments are bulk-billed, and others are privately billed with a Medicare rebate.
For instance, Smith Street Medical Centre is a mixed billing practice. The clinic bulk bills patients with a valid pension card and children under 12 years of age. Saturday and after-hours appointments are charged at the full fee with no discounts available.
Before booking at a mixed billing clinic, check:
- whether your telehealth appointment qualifies for Medicare
- whether your patient category qualifies for bulk billing
- whether a gap fee applies under the clinic’s current fee schedule
Are Telehealth Appointments Free?
Telehealth appointments are free to you only when they are bulk-billed. Telehealth is Medicare-covered only when MBS rules are met.
A Medicare rebate does not always cover the full clinic fee. When the clinic charges more than the Medicare benefit, you pay the difference, known as the gap fee or out-of-pocket cost.
The clearest way to understand it is this:
| Billing situation | What you pay | What Medicare pays |
| Bulk billed telehealth | $0 | Medicare benefit paid to the provider |
| Mixed billing telehealth | Gap fee after rebate | Medicare rebate |
| Private telehealth without rebate | Full fee | $0 |
Are Telehealth Appointments Cheaper Than In-Person Appointments?
Telehealth is not automatically cheaper as a medical service, but it does save you time, travel, parking, and time away from work or family.
From a clinic perspective, it still involves GP assessment, clinical judgement, medical documentation, prescribing decisions, referral decisions, certificate decisions, and follow-up planning. That is why they bill telehealth under normal GP consultation categories.
The format is different, but the doctor’s clinical responsibility and service charge remain the same.
What Telehealth Services Are Commonly Covered?
Medicare-supported telehealth is used for many GP and healthcare services when your concern is suitable for phone or video. Common reasons for a telehealth appointment include:
- repeat prescriptions
- medical certificates
- referral requests
- test result reviews
- simple follow-ups
- mental health support
- chronic condition reviews
- contraception discussions
- sexual and reproductive health questions
- medication reviews
- general GP advice
When is Telehealth Not Useful?
Telehealth is not suitable when your GP needs a direct physical assessment. An in-person appointment is needed for hands-on examination, vital signs, procedures, some injuries, full-body skin checks, suspicious mole checks, ear examinations, abdominal examinations, pathology sample collection, and concerns that require physical interaction.
Physical examinations, pathology collection, and skin checks require in-person care, and full-body skin cancer checks or examinations of suspicious moles require close inspection and sometimes a dermatoscope.
Telehealth is also not for emergencies.
Important Note: Dial 000 for chest pain, breathing difficulty, severe injury, heavy bleeding, collapse, stroke symptoms, or immediate danger.
How to Check Before Booking a Bulk Billed Telehealth Appointment?
Before booking, check whether your telehealth appointment meets both Medicare eligibility and the clinic’s bulk billing policy. Then check these points:
- Do you have a valid Medicare card?
- Are you an existing patient of the practice?
- Have you had a face-to-face appointment at the practice in the last 12 months?
- Are you registered with MyMedicare at that practice?
- Does your appointment type qualify for a Medicare rebate?
- Does the clinic bulk bill your patient category?
- Is the appointment during standard hours, on Saturday, or after hours?
- Is your concern suitable for a phone or video call?
- Is there a gap fee?
These questions help you avoid confusion between a Medicare rebate, bulk billing, and a gap fee. A telehealth appointment can be Medicare-eligible without being fully bulk billed.
If you are unsure, confirm the billing before the appointment starts. Also, make sure your concern is suitable for phone or video, because anything needing a physical examination, procedure, or urgent assessment requires a different type of care.
Book a Telehealth Appointment
If you think a physical examination is not required in your case, you can openly discuss your concerns through a telehealth GP appointment. It suits many follow-ups, repeat scripts, medical certificates, referral requests, result discussions, and general concerns.
Smith Street Medical is a mixed-billing practice, so check the current fee schedule before booking to understand Medicare rebates, gap fees, bulk-billing eligibility, Saturday fees, and after-hours fees.
FAQs
Are telehealth appointments bulk-billed?
A telehealth appointment is bulk billed when you are eligible, the appointment meets Medicare rules, and the clinic or GP accepts the Medicare benefit as full payment.
Are all telehealth appointments bulk billed?
No, not all telehealth appointments are bulk-billed. Many telehealth appointments are privately billed or mixed billed, and the patient must pay a gap after the Medicare rebate.
Are telehealth appointments covered by Medicare?
Yes, Medicare benefits are available for eligible video and phone telehealth services in Australia. Medicare treats both in-person visits and telehealth the same.
Does Medicare cover phone appointments?
Yes. Medicare covers eligible phone telehealth appointments when MBS rules are met. Health professionals can offer telephone services where clinically appropriate, and these services are considered on the same level as in-person services.
Are telehealth appointments free?
Telehealth appointments are free to you only when they are bulk-billed. If the clinic does not bulk bill, you pay the clinic fee and receive a Medicare rebate when eligible.
Why do I have to pay if Medicare covers telehealth?
Even if Medicare covers telehealth, you may still have to pay because Medicare does not always cover the full clinic fee and instead applies a rebate. The difference between the clinic fee and the Medicare benefit is the gap payment, which you pay out of your own pocket.
Do new patients get Medicare rebates for telehealth?
To get Medicare rebates for telehealth, new patients must meet Medicare telehealth eligibility requirements. For GP telehealth, the usual rule requires an existing clinical relationship or a face-to-face visit at the practice in the last 12 months, unless an exemption applies.
Is bulk-billed telehealth lower quality?
No, bulk billing is a payment arrangement, not a quality measure. A telehealth GP consultation still requires clinical assessment, appropriate documentation, privacy compliance, medical decision-making, and follow-up where needed.
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