Short summary

• Medicare (MBS) permanently funds many out-of-hospital telehealth items (video preferred; phone allowed where clinically appropriate) for GPs, specialists, psychiatrists and eligible allied‑health — but there are rules about eligibility, existing patient relationships, item numbers and geographic/exemption criteria. (servicesaustralia.gov.au)
• Private health insurers do not generally pay for services that Medicare covers (so most out‑of‑hospital GP and specialist consults remain a Medicare/private out‑of‑pocket matter). However insurers commonly:
  • include telehealth for “extras” allied‑health services (psychology, physio, dietetics, speech therapy, exercise physiology, podiatry, some counselling) where your extras cover includes those benefits; and
  • offer their own telehealth/virtual‑GP or mental‑health programs (partnerships or in‑house services), sometimes with reduced fees or a small number of free online GP consults for members. (Medibank.com.au)

What Medicare covers (key points)

• MBS telehealth items are permanent and available nationally for many service types (GP, specialists, consultant psychiatrists, nurse practitioners and eligible allied‑health). Video is the preferred modality; telephone items exist where clinically appropriate. There are dedicated MBS item numbers for telehealth (video and phone versions). (servicesaustralia.gov.au)
• There are rules about who can use telehealth items (for example many GP telehealth items are limited to patients with an existing relationship, with exemptions for some groups such as very young children, certain mental‑health or remote patients, Aboriginal Community Controlled Health Services, people experiencing homelessness, quarantine/isolation etc.). Check the exact item descriptions for conditions and billing rules. (servicesaustralia.gov.au)

What private health insurance typically covers

• Extras cover: Many funds will pay benefits for one‑to‑one telehealth appointments with recognised allied‑health providers (psychologists, physios, dietitians, speech pathologists, occupational therapists, exercise physiologists, podiatrists, lactation consultants etc.), subject to your level of cover, waiting periods and annual limits. Telehealth group classes are often not covered. (Medibank.com.au)
• Insurer GP/specialist telehealth offers: Some insurers have launched member telehealth programs (examples include Bupa’s Blua offering free GP telehealth consults for eligible members, NIB’s hub.health partnership and Medibank’s virtual psychology/telehealth programs). These are delivered by the insurer or a partner and have their own rules (who’s eligible, how many free consults, whether Medicare rebates apply). Note: because of the distinction between Medicare‑funded out‑of‑hospital services and private insurance, the way these offers are structured can vary and are sometimes provided as a limited member service rather than a conventional “policy benefit.” (media.Bupa.com.au)

Examples (recent real‑world examples — check current T&Cs)

• Bupa: announced a program giving eligible members up to three zero‑out‑of‑pocket telehealth GP consults per person per year via Blua. (media.Bupa.com.au)
• NIB: offers GP telehealth via a partner (hub.health) and lets members claim telehealth extras (allied health) where their extras cover includes those services. Australian resident members generally can’t claim GP telehealth through private cover, but overseas student/worker policies may differ. (NIB.com.au)
• Medibank: runs telehealth/virtual psychology clinics and offers telehealth claimability for eligible extras benefits; Medibank has other digital mental‑health supports as part of member services. (Medibank.com.au)
• HCF: has partnerships (e.g. GP2U, psych services) and member telehealth pathways—different funds partner with digital providers to give members easier access to online GPs/mental‑health care. (HCF.com.au)

Important practical steps for you

1. If you want an MBS rebate: ask your GP/clinician whether the telehealth consult qualifies for an MBS telehealth item (and whether video or phone item will be used). You can also check Services Australia / MBS Online for the specific item numbers and rules. (servicesaustralia.gov.au)
2. Check your private health fund’s policy/Extras brochure or member portal for:
   • which allied‑health telehealth services are eligible under your extras, limits/annual caps, waiting periods and whether telehealth claims are allowed; and
   • whether the fund provides any member telehealth GP or mental‑health programs (and the eligibility and booking process). Examples are shown on insurer sites (Bupa, NIB, Medibank, HCF). (Medibank.com.au)
3. If cost or eligibility is unclear, call your insurer’s member support and check with the clinician/practice before booking (to confirm Medicare eligibility, rebate and whether the insurer will accept a claim).
4. If you need the exact, current MBS telehealth item rules or the most recent changes, consult Services Australia / MBS Online (those pages list item numbers, billing rules and any March 2025 changes). (servicesaustralia.gov.au)

Would you like me to:

• look up the telehealth/Extras telehealth rules for a specific insurer and policy (name of insurer and the cover you have), or
• find the exact MBS telehealth item numbers for a particular service (GP, psychologist, specialist)?