Last week we outlined the headline changes to bulk-billing incentives from 1 November 2025 in our piece Bulk Billing From 1 November 2025: Need to Know and introduced the new practice-level settings. This follow-up takes a practical look at how GPs and practices can think about earnings under the new arrangements. Rather than diving into detailed rules or hard numbers, we focus on simple planning steps: operational readiness (as highlighted in the RACGP’s practical overview), the everyday drivers of GP income (see the GPRA GP earnings calculator), and light scenario thinking to sense-check what “good” could look like.
Key Summary
- Earnings outcomes vary by service mix, throughput, location and practice arrangements.
- New settings may make more consistent bulk billing operationally viable for some practices.
- Opt-in approaches typically require whole-of-practice planning and clear team alignment.
- A simple, high-level “scenario check” helps GPs and owners set expectations without complex modelling.
- Consider the timing of any incentive payments when planning cash flow.
BBPIP in Practice: What to Plan For
Participation decisions are best made with an operational lens. In most cases, practices will want to confirm internal registration steps, align all clinicians on a consistent bulk-billing approach for eligible services, and ensure the decision is clearly communicated to patients and community directories (see the RACGP’s practical notes on participation and visibility). Team-wide alignment matters—particularly for rosters, locum coverage and onboarding for new starters—so that day-to-day workflows remain smooth.
It is also helpful to plan around the rhythm of payments. Practice-level incentives usually reconcile on a periodic basis rather than instantly, so a quarter-by-quarter view of cash flow can keep expectations grounded (again, see the RACGP practical overview). None of this replaces professional advice, but a short internal checklist will reduce surprises when the new settings begin.
Are we operationally ready to opt in?
- Internal registrations and policy decisions are documented.
- A whole-of-practice approach is agreed and reflected in rosters and onboarding.
- Patient communications and directory listings are up to date.
- Quarterly cash-flow timing is understood and planned for.
Earnings Drivers: How GPs Actually Make Their Income
Day-to-day earnings are shaped by a handful of familiar levers. Throughput and session structure influence the number of consults completed; the billing mix—such as the balance between bulk-billed and privately billed visits, consult levels, and appropriate procedural work—affects billings; location adds its own context; and practice arrangements, including the share of billings retained and leave settings, complete the picture. The new bulk-billing settings may encourage a more consistent approach for eligible services, but the rest of these levers still matter. For a helpful way of thinking about these inputs, see the GPRA GP earnings calculator page.
Two GPs with similar hours can see different outcomes because patient cohorts, appointment lengths, procedural activity and practice models vary. A quick self-assessment against these levers can help you understand where your own opportunities for improvement are most likely to sit (again, the GPRA page offers a useful framework to reflect on).
One-page earnings levers worksheet (fill in for yourself)
- Throughput & sessions: patients per hour; sessions per week.
- Billing mix: bulk vs private; consult levels; scope of procedural work.
- Location context: metro, regional or rural; local demand patterns.
- Practice arrangements: share of billings; registrar/supervision settings; leave.
Scenario Thinking: Stress-Testing What “Good” Could Look Like
Light scenario planning helps translate policy settings into something practical. Start from your current baseline—hours, billing mix, location—and test small, realistic adjustments. For example, minor changes to appointment flow, a more consistent bulk-billing policy for eligible services, or a balanced increase in prevention and continuity activities. The aim is not to chase volume, but to find a sustainable mix that suits your practice and patients. You can use the prompts on the GPRA earnings calculator page as a neutral way to think through scenarios.
Sense-check outcomes periodically and adjust rather than committing to an all-or-nothing approach on day one. Involve reception and clinical teams early: the best scenarios are the ones your workflow can comfortably deliver. For operational considerations that commonly come up when practices participate in new programs, see the RACGP’s practical overview.
Try three scenarios
- Baseline: your current hours, mix and location.
- Modest change: small appointment-flow tweaks or a clearer policy for eligible services.
- Ambitious change: targeted service-mix adjustments with supporting patient communications.
Conclusion
The November settings may improve the viability of bulk billing for many, but earnings remain scenario-dependent. A short operational checklist, a clear view of your personal earnings levers, and some modest scenario thinking are often enough to make confident, low-risk decisions for the months ahead.
Disclaimer: This blog is a general overview and should not be construed as professional legal, financial or medical advice.
FAQs
- Do practices need to overhaul appointment lengths?
Not necessarily. Many clinics start by reviewing flow and patient needs, then make small adjustments and measure the impact.
- Will every GP earn more under the new settings?
Outcomes vary. Service mix, throughput, location and practice arrangements all influence earnings. Scenario checks help set expectations.
- How can registrars and locums fit a practice-wide approach?
With clear onboarding and consistent policies. Team alignment reduces friction and keeps workflows predictable.
- What should be reviewed each quarter?
Throughput, billing mix, patient access and team feedback, alongside any incentive reconciliations and cash-flow planning.
