Quick answer
From 1 November 2025, practices in the Bulk Billing Practice Incentive Program must bulk bill every eligible service for every Medicare-eligible patient. In return they receive an extra 12.5% incentive on MBS benefits from eligible services, paid quarterly and split evenly between the practice and the GP. Moving to full bulk billing replaces same-day gap fees with a quarterly payment, so practices need working capital to bridge the wait.
Key points
- BBPIP started on 1 November 2025 with a quarterly 12.5% incentive split between practice and GP
- Participating practices must bulk bill every eligible service for every Medicare-eligible patient
- Switching from mixed billing trades same-day gap fees for a quarterly payment
- Model the first two quarters carefully; that's when the cash gap is widest
- Program start
- 1 November 2025
- Incentive
- 12.5% on eligible MBS benefits
- Paid
- Quarterly
- Split
- Evenly, practice and GP
For decades, general practice cash flow followed a simple pattern. Patients paid on the day, or the practice bulk billed and received the Medicare benefit soon after. The Bulk Billing Practice Incentive Program adds a new element: a significant incentive paid quarterly. For many practices, joining is a sound decision. It also changes when money arrives, and that deserves planning.
How does the Bulk Billing Practice Incentive Program work?
The Department of Health, Disability and Ageing describes the key features:
- Participating practices must bulk bill every eligible service for every Medicare-eligible patient.
- In return, they receive an additional 12.5% incentive on MBS benefits paid from eligible services.
- The incentive is paid quarterly.
- It is split evenly between the GP and the practice.
The Health Minister’s release says practices and GPs registering for the program share in the 12.5% incentive from 1 November 2025.
Why does it change cash flow?
Consider what changes when a mixed-billing practice moves to full bulk billing:
| Before | After joining BBPIP |
|---|---|
| Private patients pay a gap fee on the day | No gap fee; the service is bulk billed |
| Gap income arrives daily | Part of the replacement income arrives quarterly |
| Revenue timing closely matches costs | Revenue lags costs by up to a quarter for the incentive portion |
The practice may be better off across the year. But in the first quarter, and every quarter after, there’s a stretch where wages, rent, software and payroll tax are paid before the incentive lands. The practice’s share also needs to be separated from the GP’s share when it’s received, which affects how contractor or employee arrangements are administered.
How big is the gap for your practice?
Work it out rather than guess:
- Estimate eligible MBS benefits per quarter once you’re fully bulk billing.
- Calculate the practice’s share of the 12.5% incentive (half of it, under the even split).
- Compare with the private gap fees you’ll no longer collect, month by month.
- Map the timing. Gap fees stopped from day one; the incentive arrives after the quarter.
- Find the lowest point in your bank balance across the first two quarters.
That low point is your working capital need. The claims gap calculator can help you estimate how much cash sits waiting on payments at any time.
Ways to bridge the gap
- Build a reserve before switching. If you can, time the move after a strong period.
- Talk to your GPs early about how their share of the incentive will flow and when, so there are no surprises.
- Review costs that can be deferred or smoothed across the quarter.
- Arrange a facility before you need it. A line of credit is easiest to set up while trading is strong.
Unsecured, cash-flow and line-of-credit options for trading practices typically run from $5,000 to $500,000, measured against your turnover and statements. For larger needs, such as funding the transition alongside a fit-out, property-secured loans from $20,000 to $5,000,000 are available. Check what your practice could access without a credit check.
What about payroll tax?
State payroll tax rules for medical centres have shifted alongside the push towards bulk billing. Victoria announced a payroll tax exemption for payments for bulk-billed GP consultations from 1 July 2025. In NSW, Revenue NSW’s CPN 036v2 describes a rebate for GP contractor wages from 4 September 2024 where at least 80% of GP services are bulk billed in metropolitan Sydney, or 70% in regional areas. Other states differ. Our payroll tax guide for medical centres explains more.
An illustrative example
Illustrative only. A five-GP suburban practice currently bulk bills children and concession patients and charges a gap to everyone else. After modelling, the owners expect joining BBPIP to improve income across a full year. Their forecast also shows the bank balance dipping sharply in the last month of each of the first two quarters, when gap fees have stopped and the incentive hasn’t yet arrived. They set up a line of credit before switching, and only draw on it in those weeks.
What else should GP owners plan for?
- Doctor agreements. How the GP’s share of the incentive is handled in service agreements.
- Patient communication. Explaining the change to patients who previously paid a gap.
- Growth. Full bulk billing may lift patient numbers, which may mean more staff or rooms. See medical practice finance.
Questions to settle with your GPs
Moving to full bulk billing changes things for the doctors as well as the practice. Before switching, agree:
- how each GP’s share of the incentive will be calculated and passed on
- whether service fee percentages will change
- how the change will be explained to patients who used to pay a gap
- what happens if a GP prefers to keep private billing
Clear answers avoid disputes later, and they’re the kind of thing a lender will want to see reflected in updated service agreements.
See what your practice could qualify for
You made the change to help patients. Let’s make sure it doesn’t squeeze the practice. The enquiry takes about 60 seconds and involves no credit check. Your details won’t be passed along to a line of lenders. A person who understands GP billing will look at your numbers and call you.
Please answer accurately, including the amount you need and what it’s for, so we can match you properly on the first call.
Frequently asked questions
What is the Bulk Billing Practice Incentive Program?
It's a program under which participating general practices bulk bill every eligible service for every Medicare-eligible patient. The Department of Health, Disability and Ageing says they receive an additional quarterly 12.5% incentive payment on MBS benefits from eligible services, split evenly between the GP and the practice.
When did it start?
The Health Minister's release says practices and GPs registering for the program share in the 12.5% incentive from 1 November 2025.
Why would full bulk billing create a cash-flow gap?
A practice that charged private gap fees received that money on the day. Under full bulk billing, part of that income is replaced by an incentive paid quarterly. Wages, rent and payroll tax still fall due weekly or monthly, so the practice waits longer for part of its revenue.
Can finance bridge the gap until the quarterly incentive arrives?
Yes. A line of credit or short-term unsecured facility, typically $5,000 to $500,000 for trading practices and sized on turnover and bank statements, can cover the timing gap. You draw when needed and repay when the quarterly payment lands.
Does bulk billing affect payroll tax for GP clinics?
In some states. Victoria announced a payroll tax exemption for bulk-billed GP consultations from 1 July 2025, and NSW has a rebate for GP contractor wages where bulk billing thresholds are met. Check your state's rules with your adviser.