Bulk Billing Incentive(BBI)

Why this matters for your practice

The bulk billing incentive is a per-service MBS item you claim alongside the attendance item, and picking the wrong one is the kind of error the Department of Health, Disability and Ageing looks for in its regular post-payment audits of BBI claiming. There are 20 incentive items across three categories, and which one applies depends on your practice's Modified Monash area, the type of service, and in some cases whether the patient is registered with your practice in MyMedicare. On top of that, three different things get called "the bulk billing incentive" in everyday conversation: the incentive items themselves, the practice-level BBPIP loading that started on 1 November 2025, and bulk billing as a billing practice. This page separates them.

What is a bulk billing incentive?

Bulk billing incentives (BBIs) are additional payments made to medical practitioners when they bulk bill unreferred services. That is the definition in explanatory note MN.1.1, published 1 January 2026.

An unreferred service is defined in the Health Insurance (General Medical Services Table) Regulations 2021 as a "medical service provided by, or on behalf of, a medical practitioner to a patient who has not been referred to the practitioner for the service." Admitted hospital patients are not eligible for BBIs. All other patients eligible for Medicare are eligible when the relevant services are bulk billed.

All medical practitioners who bulk bill a relevant medical service can claim BBIs. Which BBI applies depends on three things:

• the geographic location of the practice, by Modified Monash area, checked on the Health Workforce Locator
• the specific MBS item provided
• in some cases, whether the patient is registered at the practice providing the service through MyMedicare

There are 20 BBI items, broken into three categories. Each category includes a BBI item number for use in each Modified Monash area. The relevant Modified Monash area is the area where the medical practitioner's practice is located, which is the location associated with the Medicare provider number used by the practitioner when providing the service. The practice location is used regardless of where the service is provided, whether that is out of consulting rooms or in a residential aged care facility, and for telehealth, regardless of the patient's location. The exception is the after-hours BBIs 10992 and 75872, where both the practice location and the patient location are considered. BBIs are specified in the Health Insurance (General Medical Services Table) Regulations 2021.

Which bulk billing incentive item do you claim?

Work out the category first, then read off the item number for your practice's Modified Monash area.

Category 1. This covers any unreferred services not covered by Category 2 or 3. It includes, but is not limited to, Level A general attendances and their equivalents; Level C, D and E telehealth (phone and video) attendances where the patient is not registered with the practice through MyMedicare; chronic condition management and health assessment items; Better Access mental health and eating disorder items; antenatal attendances; and minor procedures. If the service is not a Level B attendance or a MyMedicare-registered telehealth consultation, it sits here.

Category 2. This covers any Level B general attendances, whether face to face, phone or video, and Level C, D and E face to face consultations. It also includes the equivalent items used in residential aged care facilities, out of consulting rooms, and after hours.

Category 3. This category applies only to patients registered with the practice through MyMedicare, and only to Level C, D and E video attendances and Level C and D phone attendances. If the patient is not registered with your practice in MyMedicare, a Level C telehealth attendance falls back to Category 1.

What do the bulk billing incentive items pay?

The schedule fees below are as at the 1 July 2026 schedule fee update. The item descriptions were updated on 1 November 2025, and on that date the tripled bulk billing incentive was extended to every Medicare-eligible patient, rather than only children under 16 and concession card holders as before.

• Item 10990 (MM1, Category 1): fee $8.80, benefit 85% = $7.50. See item 10990 on MBS Online.
• Item 10991 (MM2, Category 1): fee $13.35, benefit 85% = $11.35.
• Item 10992 (MM1 practice, after-hours service in MM2 to 7, Category 1): fee $13.35, benefit 85% = $11.35.
• Item 75870 (MM1, Category 2): fee $26.35, benefit 85% = $22.40. See item 75870 on MBS Online.
• Item 75871 (MM2, Category 2): fee $40.10, benefit 85% = $34.10.
• Item 75872 (MM1 practice, after-hours service in MM2 to 7, Category 2): fee $40.10, benefit 85% = $34.10.

This is not a complete fee list. The fees for the remaining items (75855 to 75858, 75873 to 75876 and 75880 to 75885) are not set out here; check the current item on the Medicare Benefits Schedule before billing.

Bulk billing incentive, BBPIP or bulk billing? The three-way split

Bulk billing is the practice. The practice bills Medicare directly and accepts the Medicare benefit as full payment, so the patient pays no gap. The patient must assign their Medicare benefit to the provider. This is the underlying arrangement that makes the other two payments possible. See bulk billing.

The bulk billing incentive is the per-service MBS item. It is claimed at the time of billing, in conjunction with the eligible attendance item, and it is the subject of the rest of this page.

The BBPIP is a quarterly practice-level loading. The Bulk Billing Practice Incentive Program started on 1 November 2025 and pays participating practices a 12.5% loading on the Medicare benefit for eligible bulk-billed services, on top of the existing bulk billing incentive. The loading is split 50/50 between the practice and the individual GP who provided the service, and it is paid on the PIP quarterly cycle. To participate, a practice must be registered for MyMedicare and must add BBPIP as a program in the Organisation Register. See the BBPIP and our BBPIP compliance guide.

A single bulk-billed consult can attract both the incentive item and the BBPIP loading. They are separate payments with separate claiming paths.

What the regulator or assessor expects

Only one BBI can be claimed in conjunction with each medical service, that is, each MBS item provided. BBIs can only be claimed when the patient is bulk billed for the medical service, and they must be claimed in conjunction with an eligible MBS item. BBIs cannot be claimed in conjunction with diagnostic imaging or pathology services; a separate set of incentives is available for those services.

The practice-location rule is based on the Medicare provider number used when the service is provided, not on where the patient happens to be. Medicare benefits are patient benefits, and it is a legal requirement that the patient assigns their benefit to the medical practitioner when a service is bulk billed. The Department of Health, Disability and Ageing undertakes regular post payment auditing to ensure that BBIs are claimed appropriately, and practitioners should keep relevant and contemporaneous records. See assignment of benefit and the assignment of benefit modernisation.

What is being proposed for bulk billing incentives?

The MBS Review Advisory Committee's Time-Tiered Primary Care Working Group published a draft final report in September 2026. Its recommendations are subject to public consultation and further consideration by MRAC and Government. Consultation opened on 3 September 2026 and closes at 11.59PM on 15 October 2026. None of this is settled law, and no commencement date exists for any of it.

Recommendation 6 proposes that bulk-billing incentives be based on a percentage of the MBS fee for the service that is bulk-billed, to avoid furthering the disproportionate remuneration of shorter consultations when compared to longer consultations. The working group considered that rural loadings for bulk-billing incentives are appropriate and should be retained under this approach.

Recommendation 7 proposes that bulk-billing incentives be available for nurse practitioner services when the consultation is provided to a patient who is registered through MyMedicare with the practice that provides the service. The working group noted that currently bulk-billing incentives are only available for services provided by a medical practitioner.

Recommendation 21 proposes that when providing after-hours care, medical practitioners can use the same bulk-billing incentives that are applicable when using standard attendance items. This would replace the need for after-hours bulk-billing incentive MBS items 10992 and 75872, which can only be claimed with a limited number of after-hours items, and those items could cease. You can read or contribute to the MRAC time-tiered items consultation while it is open.

Common mistakes

Claiming the Category 1 item for a Level B attendance. A Level B general attendance belongs in Category 2, so an MM1 practice should claim 75870, not 10990. The difference is $26.35 against $8.80 at the current schedule fees.

Using the patient's location instead of the practice location. The relevant Modified Monash area is the one attached to the Medicare provider number used for the service, regardless of where the service is provided or, for telehealth, where the patient is. The only exception is the after-hours items 10992 and 75872, where both locations matter.

Claiming a Category 3 item for a patient who is not MyMedicare registered at your practice. Items 75880 to 75885 require the patient to be registered with the practice through MyMedicare. Without that registration, the service falls back to Category 1 or Category 2 as appropriate.

Claiming more than one BBI against a single service. Only one BBI can be claimed in conjunction with each MBS item provided. Stacking a Category 2 item and a Category 1 item against the same attendance is not permitted.

Confusing the incentive item with the BBPIP loading. The incentive is a per-service MBS item claimed at the time of billing. The BBPIP is a quarterly 12.5% practice-level loading paid through the PIP cycle. They are separate programs with separate eligibility and separate claiming paths.

Assuming the incentive survives a service that was not actually bulk billed. BBIs can only be claimed when the patient is bulk billed. If the patient paid a gap, there is no incentive to claim.

Frequently asked questions

What is the bulk billing incentive?

It is an additional payment made to a medical practitioner when they bulk bill an unreferred service, claimed as a separate MBS item alongside the attendance item. There are 20 incentive items across three categories, and which one applies depends on your practice's Modified Monash area, the type of service, and in some cases whether the patient is registered with your practice in MyMedicare.

What is the difference between item 10990 and item 75870?

Item 10990 is the Category 1 incentive for an MM1 metropolitan practice, covering services not in Category 2 or 3, such as Level A attendances. Item 75870 is the Category 2 incentive for an MM1 practice, covering Level B, C, D and E face to face attendances and Level B phone and video attendances. It pays more: $26.35 against $8.80 at the 1 July 2026 schedule fees.

How much is the bulk billing incentive worth?

It depends on the item and your practice location. At the 1 July 2026 schedule fees, the metropolitan Category 1 item 10990 pays $8.80 (85% benefit $7.50), while the MM2 Category 2 item 75871 pays $40.10 (85% benefit $34.10).

Can I claim two bulk billing incentives for one patient visit?

No. Only one BBI can be claimed in conjunction with each medical service, that is, each MBS item provided. A single item cannot carry two incentives, and the incentive can only be claimed where the patient was bulk billed for that service.

Is the bulk billing incentive the same as the BBPIP?

No. The incentive is a per-service MBS item claimed at the time of billing. The BBPIP is a separate quarterly loading, paid since 1 November 2025, of 12.5% on the Medicare benefit for eligible bulk-billed services at participating practices. A bulk-billed consult can attract both payments.

Are items 10992 and 75872 being removed?

Not yet, and nothing is settled. The MRAC Time-Tiered Primary Care Working Group's draft final report, published September 2026, recommends in Recommendation 21 that these after-hours incentive items cease once standard incentives can be used for after-hours care. The recommendation is subject to consultation, which closes at 11.59PM on 15 October 2026, and to further consideration by MRAC and Government. No commencement date exists.

Last reviewed 6 September 2026