If you’re a General Practitioner, practice manager, or running Medical Centres, the latest Cleanbill Blue Report (January 2026) has landed with a headline trend that feels like a “bulk billing comeback” — but with a big asterisk. Cleanbill’s latest data suggests many more clinics now fully bulk bill standard consults for adult patients, yet the average out-of-pocket cost at clinics that don’t has also jumped.
The RACGP has highlighted this shift in a recent recap for GPs and practice owners, while noting the ongoing tension between access, consultation complexity, and long-term sustainability. RACGP coverage.
Key Summary – at a glance
- “Full bulk billing” clinics rose sharply: Cleanbill reports 40.2% of available clinics are fully bulk billing standard weekday consults for adult patients (up from 20.7% in 2025). (Cleanbill)
- Over 1,000 clinics switched billing approach: RACGP reports Cleanbill found 1,007 clinics moved from mixed/private billing to full bulk billing over the past year. (RACGP/Cleanbill)
- Out-of-pocket costs still climbed: Average out-of-pocket cost at clinics that are not fully bulk billing is now $49.23 (up from $43.38). (Cleanbill)
- Big state/territory differences: NSW sits at 51.9% fully bulk billing, Victoria 43.6%, while the ACT is 11.5% and WA 19.8%. (Cleanbill)
- Highest average gap fees: Tasmania’s average out-of-pocket cost is $60.76, and the ACT is $57.96. (Cleanbill)
What the Cleanbill Blue Report Is Actually Measuring
Before comparing numbers, it’s worth being clear about what the metric is. Cleanbill’s Blue Report focuses on what a clinic would quote if you called as an adult patient without concessions, seeking the price and availability of a standard consultation (MBS Item 23) during regular weekday business hours.
Quick definitions (Cleanbill):
Total clinics = in-scope GP clinics in their database (Item 23, general public, business hours).
Available clinics = clinics taking new patients (among clinics that provided a quote).
Bulk billing clinics = clinics stating they are fully bulk billing, divided by available clinics.
Average out-of-pocket cost = average gap for a standard consult at clinics not listed as fully bulk billing.
That means Cleanbill’s “bulk billing clinics” rate is different from the national Medicare “bulk billing rate” you’ll sometimes see in dashboards, because it’s a clinic-availability-and-pricing snapshot for a specific patient group and a specific appointment type. For General Practitioners and Medical Centres, it’s a useful lens for “what a new adult patient is likely to hear when they call around”.
2026 Update: Bulk Billing is Up, Gap Fees
National headline: a sharp lift in fully bulk billing clinics
Cleanbill’s historical comparison shows nationwide “bulk billing clinics” rising from 20.7% (2025) to 40.2% (2026). In other words, more clinics appear to have moved to fully bulk billing standard consults for adult patients — a notable shift for GPs, Medical Centres, and patients alike.
But the “cost squeeze” is real for patients who aren’t bulk billed
Over the same period, Cleanbill reports the average out-of-pocket cost for a standard consultation at clinics that aren’t fully bulk billing increased from $43.38 to $49.23 (a +13.5% jump).
How to read this: It’s possible for both things to be true at once — more clinics fully bulk bill, while the clinics that don’t increase fees (often due to rising operating costs, consultation complexity, and the need for sustainable practice models).
2025 → 2026 comparison (national + state/territory)
| Jurisdiction | Bulk billing clinics (2025 → 2026) | Change | Avg out-of-pocket (2025 → 2026) | Change |
|---|---|---|---|---|
| Nationwide | 20.7% → 40.2% | +19.5 pp | $43.38 → $49.23 | +13.5% |
| New South Wales | 34.5% → 51.9% | +17.4 pp | $44.05 → $50.51 | +14.7% |
| Victoria | 19.1% → 43.6% | +24.5 pp | $42.01 → $48.18 | +14.7% |
| Queensland | 13.9% → 32.7% | +18.8 pp | $43.33 → $48.58 | +12.1% |
| Western Australia | 6.2% → 19.8% | +13.6 pp | $42.66 → $46.63 | +9.3% |
| South Australia | 7.4% → 29.6% | +22.2 pp | $41.61 → $48.59 | +16.8% |
| Tasmania | 0.0% → 33.0% | +33.0 pp | $54.26 → $60.76 | +12.0% |
| Australian Capital Territory | 3.3% → 11.5% | +8.2 pp | $51.84 → $57.96 | +11.8% |
| Northern Territory | 9.5% → 57.1% | +47.6 pp | $43.86 → $55.04 | +25.5% |
For clinic teams, this is the key operational message: bulk billing access appears to be improving for adult patients in many areas, but out-of-pocket costs are still rising in the parts of the market that remain mixed billing.
What This Means for General Practitioners, Medical Centres, and Workforce Planning
1) Patient communication will matter more than ever
- Spell out billing rules clearly: If your Medical Centres bulk bill only certain cohorts, ensure your phone scripts, website, and online booking labels match reality (and stay updated).
- Reduce “surprise gap” friction: A short pre-appointment message about fees (and when bulk billing applies) can prevent front-desk blow-ups and protect patient experience.
2) Booking templates can protect both access and sustainability
Where clinics are balancing access with viability, the practical lever is often the appointment book: protecting adequate time for complex consults, and using clear pathways for short reviews or quick follow-ups. The RACGP has repeatedly highlighted growing consultation complexity as a core pressure point.
3) The workforce angle: why this data matters to recruitment
Bulk billing settings and out-of-pocket pressure influence demand patterns (and sometimes clinic culture). For GP recruitment, this can affect:
- GP retention: how consult length, admin load, and patient expectations interact with billing policy.
- Practice expansion: clinics changing billing models may need new GPs, practice nurses, or admin support to keep access stable.
- Candidate fit: some General Practitioners strongly prefer private/mixed billing models; others are motivated by universal access and bulk billing workflows.
Recommended reading (Gorilla Jobs):
If you want a practical explainer on the policy changes that shaped late-2025 clinic decisions, see: Bulk Billing From 1 November 2025: Need to Know and What Earnings Could Look Like.
For broader Medicare context, this YTD snapshot is also useful: Medicare Statistics 2025–26 YTD.
Conclusion
Cleanbill’s Blue Report points to a genuine shift for General Practitioners and Medical Centres: more clinics appear to be fully bulk billing standard consults for adult patients, but patients who aren’t bulk billed are facing higher out-of-pocket costs. In 2026, the clinics that win trust will be the ones that make billing rules clear, protect consult quality, and align staffing and appointment design to patient demand.
Disclaimer: This blog is a general overview and should not be construed as professional legal, financial or medical advice.
FAQs
- Does this mean Medicare bulk billing is “back” everywhere?
Not necessarily. Cleanbill’s metric is the share of “available clinics” that say they fully bulk bill a standard consult (MBS Item 23) for adult patients without concessions during weekday business hours. It’s a useful access signal, but it’s different from the national Medicare bulk-billing rate across all services.
- Why can bulk billing rise while out-of-pocket costs also rise?
Both can happen at once if some clinics switch to fully bulk billing, while clinics that remain mixed billing lift fees due to rising costs and consultation complexity. Cleanbill reports a national rise in fully bulk billing clinics alongside a higher average out-of-pocket cost at clinics that are not fully bulk billing.
- Which states and territories have the biggest differences?
Cleanbill reports large variation. In 2026, NSW and the NT sit high for fully bulk billing clinics, while WA and the ACT are much lower. Average out-of-pocket costs are highest in Tasmania and the ACT among the listed jurisdictions.
- What should Medical Centres monitor internally in 2026?
Track appointment demand, “new patient” availability, patient feedback on fees, DNA rates, and average consult length. If you adjust billing policy, update staff scripts and online booking labels quickly to reduce confusion and protect patient experience.
- How does this relate to GP recruitment and retention?
Billing policy and patient expectations can shape workload, consult time, and practice culture — which all affect recruitment and retention. Many General Practitioners weigh sustainability (time, complexity, admin) alongside the billing model when choosing a clinic.
Information Sources
- RACGP (newsGP) — “A complete reversal”: Surge in bulk-billing practices (12 Jan 2026)
- Cleanbill — 2026 Blue Report (media release page)
- ABC News — National bulk-billing rates are increasing, according to Cleanbill report (Jan 2026)
- Gorilla Jobs — Bulk Billing From 1 November 2025: Need to Know
- Gorilla Jobs — Bulk Billing From 1 November 2025: What Earnings Could Look Like
- Gorilla Jobs — Medicare Statistics 2025–26 YTD: What the Early Data Shows
