Specialist costs highlighted in Medicare report


By Michael Woodhead

16 Mar 2020

Less than one in three specialist attendances are bulk billed and patients now face an average of $84 in out of pocket costs to see a specialist, latest Medicare figures show.

The MBS Statistics for the 2018-19 financial year show that the bulk billing rate for specialist attendances was 31.5% – up only 0.4 percentage points from the 31.1% rate the previous year. The average patient contribution per service for specialists rose by 4.8% from $80 to $84.

For GPs, 86.2% of non-referred attendances were bulk billed in 2018-19 (up 0.2 percentage points) and the average out of pocket cost for a GP attendance was $38.50.

Specialist attendances accounted for 32 million of the 424 million Medicare services in 2018-19 ( 1.1% annual increase), and the costs were $2.58 billion (up 3.3% on the previous year).

There were 158.3 million GP attendances (up 2%), at a cost of $8 billion (a 2.8% rise on 2017-18).

At a state level, bulk billing rates were highest for specialists in NSW (35.9%) and SA (34.5%) and lowest for specialists in WA (22.0%) and Queensland (26.8%). Out of pocket costs were as high as $102.90 for specialist attendances in the ACT and $91.90 in NSW, compared to $64.75 in SA and $66.80 in Tasmania.

For other sectors, out of pocket costs were $106 for diagnostic imaging (79% bulk billing), $24 for pathology tests (89% bulk billing), $145 dollar for anaesthetics (11% bulk billing) and $59 for radiotherapy/nuclear medicine (74% bulk billing).

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