Respiratory and sleep physicians are among the specialists least likely to bulk-bill an initial appointment but are also charging fees on the lower end of the spectrum, patients are being told.
The figures come from the federal government’s Medical Costs Finder website, which is currently recruiting specialists ahead of a $17 million relaunch later this year.
After the redesign, it will list specific fee details and gap fee arrangements from individual practitioners across about 100 medical services, the Department of Health and Aged Care says.
While individual specialist fees remain unavailable for the time being, a beta version has been launched already and the site now shows aggregate fees across MBS items broken down by specialty and location.
Based on historic data, it shows that for initial consultations claimed under MBS item 110, respiratory and sleep physicians bulk-billed some 40% of patients, leaving the rest with an out-of-pocket cost of $115 on average.
By contrast, 29% of rheumatology appointments claimed under the item were bulk-billed, although those that weren’t had a higher out-of-pocket cost of $148 on average, the website says.
It also showed significant regional variation when it came to specialist fee setting.
Initial attendances (MBS item 110)
| NSW | VIC | QLD | SA | WA | TAS | NT | ACT | |
| % Bulk-billed | 49% | 50% | 43% | 43% | 25% | 55% | 45% | 31% |
| Typical doctors’ fees | $250 | $237 | $260 | $210 | $257 | $232 | $265 | $278 |
| Patients typically pay | $118 | $103 | $128 | $78 | $125 | $100 | $133 | $146 |
The same was true of subsequent consultations billed under MBS item 116, which had bulk-billing rates of 60% in Tasmania and the NT, compared but 27% in in Western Australia.
But the highest out of pocket costs were levied by specialists in the ACT at $150 on average, according to the website.
Subsequent attendances (MBS item 116)
| NSW | VIC | QLD | SA | WA | TAS | NT | ACT | |
| % bulk-billed | 58% | 49% | 44% | 57% | 27% | 60% | 60% | 44% |
| Typical doctors’ fees | $140 | $130 | $140 | $120 | $135 | $125 | $130 | $150 |
| Patients typically pay | $74 | $64 | $74 | $54 | $69 | $59 | $64 | $84 |
The department has not said how many doctors have signed up to the new site so far, but if the testing goes as planned their fees will be made public by the end of July.
It has also stressed participation will remain strictly voluntary and individual doctor’s information will not be used for compliance purposes.
“The department will not be checking the data against Medicare claims data,” it said in an FAQ earlier this year.
“The portal will run a data assurance check against typical data to ensure that any errors (significant variance from other data) are identified by the system.”
“Where a discrepancy is detected, the user will be notified so they can check their entry for potential errors.”
| Specialty | % of bulk-billed initial consults (MBS item 110) | Average out-pocket cost initial consults (MBS item 110) | % of bulk-billed subsequent consults (MBS item 116) | Average out-of-pocket cost subsequent consults (MBS item 116) |
| Geriatric medicine | 79% | $78 | 69% | $59 |
| Infectious diseases | 81% | $80 | 73% | $54 |
| Nephrology | 60% | $88 | 65% | $59 |
| Rehabilitation medicine | 85% | $88 | 87% | $59 |
| Cardiology | 50% | $93 | 47% | $61 |
| Gastroenterology and hepatology | 40% | $98 | 48% | $54 |
| Respiratory and sleep medicine | 40% | $115 | 43% | $64 |
| Endocrinology | 47% | $118 | 47% | $74 |
| Haematology | 64% | $118 | 69% | $54 |
| Medical oncology | 77% | $118 | 71% | $64 |
| Paediatric medicine | 38% | $148 | 41% | $92 |
| Rheumatology | 29% | $148 | 26% | $74 |
| Neurology | 46% | $168 | 41% | $94 |
| Immunology and allergy | 26% | $168 | 57% | $79 |