Brief summary — can you be charged a gap for telehealth in Australia?

• Yes. Health providers (GPs, specialists, allied health, private psychiatrists, etc.) can charge a patient gap for telehealth consultations the same way they do for face-to-face consultations. You only avoid a gap if the provider bulk-bills you (charges you $0) or accepts another arrangement that covers the fee. (servicesaustralia.gov.au)

Key points and practical details

1. Medicare rebates for telehealth

   • Telehealth MBS items generally carry the same Medicare benefit as their equivalent face-to-face items. That means a provider can claim the same MBS rebate for a telehealth attendance as for an in‑person attendance. Medicare does not automatically prevent providers from charging an out‑of‑pocket/gap amount. (servicesaustralia.gov.au)

2. Bulk‑billing and gaps

   • If a practitioner bulk‑bills a telehealth consult they accept the Medicare benefit as full payment and you pay nothing. If they do not bulk‑bill, you may be charged a gap (patient out‑of‑pocket amount) on top of the Medicare rebate. Bulk‑billing availability has declined in many areas, so gaps are increasingly common. (theguardian.com)

3. Recent MBS/telehealth changes you should know (implemented 2024–2025)

   • From 1 March 2025 the MBS consolidated some telehealth rules and now prefers video services as the appropriate substitute for face‑to‑face where clinically suitable; phone-only services remain available where clinically appropriate. MBS item numbers for telehealth exist for video and phone services. (servicesaustralia.gov.au)
   • Some allied‑health MBS items (chronic disease allied health items) require the allied health professional to attend in person for at least 20 minutes — these cannot be claimed if provided by telehealth. Check the specific item rules if you’re relying on Medicare-subsidised allied health. (Examples: physiotherapy, podiatry, psychology chronic disease items). (servicesaustralia.gov.au)

4. Private health insurance and telehealth

   • Private health insurers are not generally allowed to cover out‑of‑hospital services that are also funded by Medicare (e.g., standard GP and specialist outpatient visits). Some funds have offered digital GP services to members (often as a private retail product), but this area is restricted and evolving — don’t assume your private hospital policy will pay a telehealth gap. Always check your fund’s terms. (uts.edu.au)

5. Medicare Safety Net and gaps

   • Out‑of‑pocket costs for eligible out‑of‑hospital services (including many telehealth services) count towards the Medicare Safety Net thresholds. Once thresholds are reached, additional financial assistance can apply — this can reduce the effective gap for high users of out‑of‑hospital services. (Safety Net thresholds and amounts change periodically.) (racgp.org.au)

What to do before a telehealth consult (practical checklist)

• Ask the clinic how they bill telehealth: will they bulk‑bill, charge the full fee and you claim the rebate, or apply some other co‑payment?
• Ask for the total out‑of‑pocket cost (gap) you’ll pay, and whether the provider will accept the Medicare online rebate in‑clinic (bulk‑billing) or you’ll need to claim back.
• If you have private health cover, ask your insurer if the telehealth service is covered under your policy (rare for Medicare-substitutable out‑of‑hospital services).
• For allied health: confirm whether the service is eligible for an MBS rebate if you’re relying on a chronic disease plan and whether the provider must see you in person. (servicesaustralia.gov.au)

If you want, I can:

• Look up the exact MBS item numbers and current Medicare rebate amounts for a specific telehealth service (GP, specialist, psychologist, etc.) and which ones require video vs phone vs face‑to‑face. (This requires checking Services Australia/MBS online for the latest rates.)

Sources

• Services Australia — Telehealth billing codes and rules; MBS item rules. (servicesaustralia.gov.au)
• RACGP / professional updates on MBS changes and Safety Net info. (racgp.org.au)
• Recent reporting on bulk‑billing and out‑of‑pocket trends in Australia. (theguardian.com)

Would you like me to fetch the current Medicare rebate amounts or the MBS item numbers for a particular telehealth service (GP, psychologist, specialist, allied health)?