November 1st, 2025, marks a significant day in Australian General Practice. With upcoming changes to mental health item numbers and new bulk billing incentives taking effect, staying on top of the latest updates is more vital than ever. Although these changes are designed to improve patient access to care, for busy GPs and practice teams, they introduce a further layer of complexity.
Navigating these changes is not just about compliance; it's about ensuring your practice is accurately paid for the work you perform. Incorrect billing due to a lack of knowledge can lead to lost revenue and unnecessary administrative headaches.
One of the most notable changes is the expansion of the Medicare bulk billing incentives eligibility to all Medicare-eligible patients. Previously, bulk billing incentives were limited to children under 16 and Commonwealth concession card holders. This expansion means that any patient holding a Medicare card can benefit from bulk billing incentives, making healthcare more accessible to a broader range of Australians.
The update to item descriptors for bulk billing incentive (BBI) items will eliminate references to specific age groups and concessional beneficiaries. This change ensures that every Medicare-eligible patient can take advantage of the tripled bulk billing incentives for general attendance items and standard bulk billing incentives for other services. This move is part of the Australian Government’s broader $7.9 billion investment aimed at improving healthcare accessibility and affordability¹.
The BBPIP aims to create a financial environment that encourages practices to adopt full bulk billing, therefore enhancing the overall healthcare experience for patients. To qualify for the BBPIP, practices must bulk bill all eligible services2 for every Medicare-eligible patient. The goal of this initiative is to deliver substantial gains in both operational efficiency and financial sustainability for General Practices nationwide.
There will also be significant updates to the Better Access initiative, which will reshape how GPs deliver and bill for mental health support in General Practice. Here’s what you need to know to prepare your clinic and patients:
These changes mean GPs will adopt new billing practices for MHTP reviews and consults, and support a stronger, ongoing patient-GP relationship for mental health care. Clinics will want to review their current workflows and communication with both patients and clinical teams to ensure a smooth transition and continued access to compliant, high-quality mental health care.
Deciding whether to transition your practice to fully bulk billing and participate in the BBPIP is a highly individual choice. The Department’s new Bulk Billing Incentives Calculator can help clarify whether this approach is financially advantageous for your clinic. It’s essential that the entire practitioner team is on board, so a comprehensive discussion and team meeting are crucial before making any final decisions.
Choosing fully bulk billing requires careful consideration; while the increased BBI and BBPIP can boost revenue, you’ll forgo gap fees. Calculating the impact on your specific practice is critical to getting the balance right.
In my conversations with practices, some are eager to make the switch, citing values around providing accessible care and simplifying billing processes, while others feel strongly about maintaining private billing due to the substantial revenue impact a change would bring. There’s no universal answer, only what best suits your team and your business sustainability.
If you’re undecided, remember that you can opt in at any stage after the changes commence on 1 November 2025.
Additionally, with the Better Access initiative updates, the way practices bill and see patients will shift. The higher, mental-health-specific rebate for reviewing a mental health treatment plan (2712, 92114, 92126, 277, 92120, 92132) will be discontinued; instead, GPs will bill the relevant time-based general attendance item (such as Item 23 for a 6-19 minute consult). As a result, rebates for mental health reviews will now be based on the general item used, potentially resulting in a lower rebate compared to utilising the previous item numbers.
One of the primary goals of these changes is to improve access to healthcare for all Medicare-eligible Australians. By expanding the eligibility for bulk billing incentives and introducing BBPIP, it's promised that patients will find it easier to access General Practice services without the financial burden of out-of-pocket expenses. This is particularly beneficial for low-income individuals and families who may have previously struggled to afford regular medical consultations.
If more practices adopt fully bulk billing, patients can expect greater availability of bulk-billed services, reducing the financial barriers to healthcare. This change will promote preventive care and early intervention, as patients are more likely to seek medical advice and treatment when cost is not a prohibitive factor. Ultimately, this leads to better health outcomes and a healthier population.
Even if practices choose not to participate in the BBPIP, private and mixed billing practices can still opt to bulk bill services at their discretion while receiving additional Medicare funding, making it possible to offer affordable, no out-of-pocket gap care to patients whenever needed. The expanded Bulk Billing Incentive offers an ongoing advantage to mixed billing practices by providing greater flexibility for practitioners to determine when to bulk bill and when to privately bill, maximising choice and supporting both financial sustainability and patient access.
To take advantage of the new BBPIP, General Practices will need to follow specific registration and compliance steps. Registration for BBPIP will open on 1 November 2025, and practices will need to register via Services Australia’s Organisation Register. It is essential for practices to bulk bill all BBPIP MBS-eligible services2 to qualify for the incentive payments.
Practices must also be MyMedicare registered to participate in BBPIP. For practices already accredited under the National General Practice Accreditation Scheme (NGPA), early registration for MyMedicare is recommended. However, practices not yet accredited should wait until 1 November 2025 to register, as they will be exempt from MyMedicare accreditation requirements during initial registration.
Additionally, participating practices must promote their status as fully bulk billing practices by registering with Healthdirect Australia’s National Health Services Directory (NHSD) and displaying Medicare Bulk Billing Practice signage on-site. These steps ensure that patients are aware of the availability of bulk-billed services at these practices. Sign up with the EOI form to stay in the know.
The Australian Medicare system is dynamic, with regular updates to item numbers and rules. This constant evolution creates a significant challenge for GPs who are already stretched thin.
Your focus is on providing the best possible care for your patients, and you shouldn't have to become an expert in Medicare compliance to ensure your practice remains financially healthy.
This is where MediBetter’s solutions can make all the difference. We’ve designed our tools to handle the complexity of compliance, so you can focus on your patients and your team can work with confidence.
With the sweeping bulk billing reforms coming in November, MediBetter’s tools, BOSS and MIA, are here to make sure your practice stays ahead. As new eligibility rules, item numbers, and workflows roll out, BOSS checks every consultation, ensuring you never miss an item. MIA gives you instant answers about compliance questions, new item descriptors, and helps you interpret the evolving criteria, all integrated right in your existing workflow, so you can focus your energy on patient care.
The result? Fewer headaches, a smoother transition, and no missed revenue opportunities, so you, your team, and your patients can all benefit from the new expanded incentives and a streamlined billing process. MediBetter ensures you remain compliant, get paid fairly, and reclaim valuable time as General Practice enters a new era.
With the new bulk billing incentives and changes to mental health items, it’s essential to ensure every consult is billed to its full potential. Our BOSS tool seamlessly integrates into your workflow, providing instant, accurate recommendations based on your consultation notes. It helps you:
The practice team is on the front line of your billing process. They need quick, reliable answers to ensure every claim is submitted correctly. MIA, our MBS-specialist chatbot, is the perfect resource. Instead of spending time on hold with Services Australia or searching through MBS online documentation, your team can simply ask MIA.
The November 1st changes present an opportunity to improve your practice's financial health. By equipping your GPs with BOSS to optimise consults and your practice team with MIA to confirm eligibility and compliance of MBS item numbers, you can confidently navigate the new landscape.
Don't let these updates become a source of stress. Start your 30-day free trial today and experience how MediBetter can transform your billing process, ensuring you're ready for whatever changes come next.