Gastroenterologists consultation fees revealed


By Geir O'Rourke

19 Sep 2023

Gastroenterologists are bulk-billing at least a third of all patients they see in private settings and also charging lower out-of-pocket costs than many other specialists, new figures show.

The data come from the federal government’s troubled Medical Costs Finder website, which is now accepting fee information from individual doctors after a $17 million relaunch last December.

The Department of Health says gastroenterologists can input their fees for around a dozen services, including initial and follow-up appointments and a variety of procedures, such as colonoscopies, gastroscopies, endoscopies and related procedures.

So far, only three gastroenterologists have taken up the offer, and the site was displaying the individual details of just half a dozen doctors around the country when the limbic checked last week.

But the site is now displaying updated aggregate Medicare data, revealing 33% of initial gastroenterologist and hepatologist appointments were bulk-billed in 2021-22.

Of the 67% of initial consults to which a gap fee was applied, patients were charged $250 on average, coming out as $115 after the Medicare rebate.

By contrast, 26% of initial rheumatology appointments claimed under MBS item 110 were bulk-billed, leaving the rest with an average out-of-pocket cost of $155.

Oncologists were the specialists most likely to bulk-bill, with 75% of their initial consults having no out-of-pocket costs.

The site also shows there were wide variations in the fees charged across the specialty, with the top 10% most expensive initial consults having out-of-pocket costs at least $185 versus $45 for the bottom decile.

There was also significant regional variance when it came to gastroenterologist fees.

Initial attendances (MBS item 110)

% with no out-of-pocket costs 23% 26% 29% 19% 32% 50% 13%
Typical specialists’ fees $285 $260 $200 $250 $250 $235 $290
Patients typically paid $150 $125 $65 $115 $115 $100 $155

Gastroenterologists’ subsequent consultations showed similar patterns, with 37% bulk-billed and the rest having a $62 median out-of-pocket cost (after $68 Medicare rebate)

Bulk-billing rates for these consultations ranged from 42% in Victoria to just 26% in Western Australia.

Gastroenterologists in Tasmania charged the highest fees at $165 on average, according to the figures.

Subsequent attendances (MBS item 116)

% with no out-of-pocket costs 35% 42% 26% 35% 39% 36%
Typical specialists’ fees $140 $127 $138 $105 $165 $140
Patients typically paid $72 $57 $70 $37 $97 $72

The updated site also includes detailed fee information for about 100 procedural items covered by Medicare, including the typical private hospital fees and those covering specialists, anaesthetists and assistant surgeons.

For example, the site shows that for gastroscopy (MBS items 30478 and 30473), 16% of privately insured patients had an out-of-pocket cost.

For this procedure, Medicare paid $420 on average, insurers typically paid $370 and patients typically paid $140, it says.

In addition, it says the hospital fees for this procedure were typically $530, covered mostly by health funds depending on a patient’s level of insurance.

Privately insured patients typically paid $150 out of their own pockets for colonoscopy and endoscopy  of bile ducts and pancreas (ERCP) & related procedures, it says.

At a webinar earlier this year, officials stressed they were still hoping to expand participation of individual specialists in the site, arguing recruitment was expected to build with additional exposure.

They also argued there was significant interest from the public, claiming the database was already receiving about 6,000 hits per month.

MBS item 110 (rebate $135): initial consult

Specialty Bulk-billing rate Average out of pocket cost Highest 10% of fees were at least* Bottom 10% of fees were under*
Gastroenterology 33% $115 $185 $45
Cardiology 42% $110 $186 $45
Endocrinology 32% $125 $215 $65
Neurology 34% $195 $270 $90
Rheumatology 26% $155 $255 $75
Oncology 75% $145 $255 $55
Haematology 52% $115 $185 $60
Respiratory 32% $125 $205 $55

*after Medicare rebate

MBS item 116 (rebate $68): follow-up consult

Specialty Bulk-billing rate Average out of pocket cost Highest 10% of fees were at least* Bottom 10% of fees were under*
Gastroenterology 37% $62 $107 $27
Cardiology 41% $70 $117 $32
Endocrinology 32% $82 $142 $42
Neurology 33% $102 $162 $52
Rheumatology 32% $82 $112 $47
Oncology 68% $67 $102 $35
Haematology 63% $57 $87 $27
Respiratory 34% $70 $112 $32

*after Medicare rebate

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