A general practice bulk bills and claims the incentives

The Commonwealth pays 12.5 per cent extra — but only at 100 per cent bulk billing. The states give payroll tax relief at 80 per cent, or proportionally, or not at all, depending on the border. One lever, two governments, six settings.

healthA general practice deciding whether to bulk bill all services, and establishing its position under both Commonwealth incentives and state payroll tax draft compare across jurisdictions

315 days elapsed
longest dependent chain

6 discrete steps
across 3 bodies

0% waiting on availability
scheduling or queue, not assessment

120 days saved by concurrency
vs. 435 if run end-to-end

Where the time goes

Critical-path days only. Steps that run alongside others are real work but do not lengthen the process, so counting them here would overstate the prize.

statutory		180d	A legislated period that must elapse regardless of readiness.
applicant		135d	Waiting on the applicant to supply or fix something.

The process, step by step

Applies when: A general practice considers participating in the Bulk Billing Practice Incentive Program.

#	Step	Who	Why it waits	Clock	Typical	Basis
1	Register the practice for MyMedicare registration Practice registration, and patient registration, underpin the incentive arrangements.	Department of Health, Disability and Ageing	applicant	—	45 estimate	—
2	Register for the Bulk Billing Practice Incentive Program registration after Register the practice for MyMedicare 240d slack	Services Australia	applicant	—	30 published	—
3	Bulk bill 100 per cent of eligible services assessment The eligibility condition for the additional incentive. after Register for the Bulk Billing Practice Incentive Program 150d slack	Services Australia	statutory	—	90 published	—
4	Incentive paid quarterly in arrears fee Payments commence in the first quarter of 2026 and are made quarterly in arrears, split 50/50 between practice and provider. after Bulk bill 100 per cent of eligible services 60d slack	Services Australia	statutory	—	90 published	—
5	Establish the practice's payroll tax position assessment Whether payments to contractor GPs fall within the payroll tax base, and whether a bulk-billing concession applies. after Register the practice for MyMedicare 150d slack	State revenue office	assessment	—	120 reported	—
6	Reconcile incentive income against forgone private fees assessment Whether 12.5 per cent plus the expanded patient incentive exceeds the private billing given up. after Incentive paid quarterly in arrears, Establish the practice's payroll tax position	—	applicant	—	60 estimate	—

on the critical path scheduling/queue = delay not caused by the assessment itself

Proposed changes

Six state payroll tax rules and one Commonwealth incentive, all keyed to bulk billing, none aligned merge ~120d
Every jurisdiction built a payroll tax concession keyed to bulk billing, and set it differently — 80 per cent of wages, 80 per cent of services, proportionally, outright, or by threshold. The Commonwealth requires 100 per cent. Nobody chose this; it is what happens when two tiers pick the same lever.
A 12.5 per cent incentive that switches off at 99 per cent bulk billing threshold
The Bulk Billing Practice Incentive Program pays an additional 12.5 per cent on every dollar of MBS benefit — but only to practices that bulk bill 100 per cent of eligible services. The marginal privately billed consultation costs the practice 12.5 per cent of everything.

Sources

Services Australia, Bulk Billing Practice Incentive Program: from 1 November 2025, an additional 12.5 per cent on every dollar of MBS benefit for eligible services, requiring the practice to bulk bill 100 per cent of eligible services; payments split 50/50 between practice and provider, quarterly in arrears from the first quarter of 2026
From 1 November 2025 all Medicare-eligible patients are eligible for bulk billing incentives, expanding beyond children, pensioners and concession card holders
RevenueSA Revenue Ruling PTASA004; Revenue NSW Bulk Billing Support Initiative from 4 September 2024; Victorian exemption from 1 July 2025; ACT exemption from 1 July 2025

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