Who is eligible for bulk billed telehealth under Medicare?

You are eligible if you are registered in MyMedicare with the practice you are having the telehealth consultation with, if that doctor or practice has seen you face-to-face in the last 12 months, or if your situation meets one of Medicare’s exemptions.

A Medicare card on its own is not enough.

That is also why one telehealth service can tell you your consultation is bulk billed while another says there is a fee. They are not applying different rules. They are checking whether you meet them, and the answer depends on your own history rather than on which service you call.

This page explains all three ways, lists the exemptions, and shows you what to check before you book.

The three ways to qualify

You are eligible for a Medicare rebate on a GP telehealth consultation if any one of these is true.

• You are registered in MyMedicare with the practice you are having the telehealth consultation with.
• That doctor, or that practice, has seen you face-to-face in the last 12 months, and the appointment was billed to Medicare.
• You, or the kind of consultation you need, meets one of Medicare’s exemptions.

The Department of Health, Disability and Ageing puts it this way: a doctor must only perform a telehealth service if "the patient is registered in MyMedicare and the telehealth service is from the patient’s registered practice; or the provider qualifies as the patient’s eligible telehealth practitioner, or an exemption applies."

Medicare’s name for the second way is the eligible telehealth practitioner requirement, which means a doctor who is allowed to treat you by telehealth because of an existing connection between you and their practice. It used to be called the established clinical relationship requirement, and you will still see both names used.

What counts as having seen the doctor before?

An appointment in person that was billed to Medicare. The wording is specific about the billing: the doctor "has provided a face-to-face service (that was billed to Medicare) to the patient in the last 12 months".

It does not have to have happened in a clinic building. What matters is that the practice provided you with a face-to-face service and billed Medicare for it, so a home visit counts. If a Perth Home GP doctor has visited you at home in the last 12 months and billed Medicare, that is the connection Medicare is asking about.

Two things do not count. An appointment you paid for privately, with no Medicare claim, does not start the 12 months. Neither does an earlier phone or video appointment: "a patient’s participation in a previous video or phone consultation does not constitute a face-to-face service for the purposes of ongoing telehealth eligibility."

Does it have to be the same doctor who saw you?

No, and this is the part most people get wrong.

The appointment can have been with someone else at the same practice. It can also have been with the after hours service that covers your practice, as long as your practice and that service have a formal arrangement in place.

Medicare’s name for that kind of after hours service is an approved medical deputising service. In plain terms, it is a service your regular practice has appointed to look after its patients when the practice is closed. Because your own practice saw you face-to-face, the after hours doctor can treat you by telehealth and claim Medicare, even though you have never met them.

Night Doctor is the approved medical deputising service that covers Perth Home GP patients after hours. If a Perth Home GP doctor has seen you face-to-face in the last 12 months, you are eligible for a Medicare rebate on a Night Doctor telehealth consultation, and Night Doctor bulk bills eligible patients for consultations of up to 15 minutes.

If you are not our patient and you want to know who covers your own practice after hours, look at your practice’s website. The after hours contact is usually shown on the contact page.

What is MyMedicare, and how does it change my telehealth eligibility?

MyMedicare is "a voluntary patient registration model that aims to formalise the relationship between patients and their preferred primary care teams". In everyday terms, it records which practice you think of as your regular GP. If you are not registered and would like to be, ask your regular practice about it.

Registering changes telehealth eligibility in a way most people do not expect. The wording is explicit: "patients who are registered by MyMedicare will be able to access these services from their MyMedicare practice even if they have not attended that practice in the previous 12 months." So your eligibility with that practice does not lapse on the anniversary of your last appointment.

Registration also unlocks the longer phone consultations, of 20 minutes and 40 minutes, which are only available to registered patients.

At Perth Home GP we raise MyMedicare with our regular patients as part of getting to know them, and we help them register.

Who is exempt from the 12 month rule?

Some patients, and some kinds of consultation, are exempt. Where an exemption applies, none of the three ways above has to be met.

An exemption is always a fact about you, or about the consultation. It is never a fact about the service. A telehealth service cannot make itself exempt.

These are the exemptions that can apply to a GP telehealth consultation.

Patient exemptions

Consultation exemptions

What about the natural disaster exemption?

It is a real exemption, and it is narrower than it sounds. It applies if you live in a local government area that a State or Territory Government has declared a natural disaster area, and it has to apply on the day of your consultation.

Medicare’s telehealth guidance says "patients in areas declared a natural disaster can access telehealth services from any medical practitioners in general practice", and it defines the areas: "eligible regions are State or Territory Local Government Areas identified as a natural disaster at the time of the service."

Two things have to line up, and both are about you rather than about the service you are calling.

1. Your local government area. Not your state, not your postcode, and not somewhere else in Australia. A declaration covers named local government areas, so two people in the same city can get different answers.
2. The day of your consultation. A declaration that has ended does not carry forward. Medicare’s test is the position "at the time of the service".

You can check your own area yourself, in about a minute. DisasterAssist is the Australian Government site where these declarations are published, and it lets you search by local government area. Its own description is that it is updated "as each State and Territory makes these declarations".

If you are told that a natural disaster exemption is the reason your consultation is bulk billed, it is reasonable to ask which local government area you are recorded as living in, and whether it is currently declared.

Our full guide to the natural disaster telehealth exemption explains who makes the declarations, how the timing works, what a doctor has to record when relying on it, and what to do if it does not apply to you.

What does Medicare mean by experiencing homelessness?

Medicare uses a broad definition. A person experiencing homelessness "does not have suitable accommodation alternatives", and is considered homeless if their current living arrangement:

• is in a dwelling that is inadequate; or
• has no tenure, or an initial tenure that is short and not extendable; or
• does not allow them to have control of, and access to, space for social relations.

Where this exemption applies, the doctor still has to record it, and why, in your notes.

What counts as an urgent consultation in unsociable hours?

This exemption is narrower than booking an appointment late at night. Four things have to be true.

1. The time of the consultation. It has to take place between 11pm and 7am.
2. Time of booking. The consultation has to be requested "during the same unbroken urgent after-hours period in which the medical service is provided". The after hours period runs from 6pm to 8am on a weekday, from 12 noon on a Saturday, and covers all of Sunday and public holidays. Unbroken means one continuous stretch of that time: a booking made at 8pm on a Tuesday for a consultation at 1am on Wednesday is in the same unbroken period, while a booking made at 3pm on Tuesday is not, because 3pm is in hours.
3. How urgent it is. The doctor has to decide that your condition "requires urgent medical assessment during the after-hours period to prevent deterioration or potential deterioration in their health" and that it "cannot be delayed until the next in-hours period".
4. Video, not phone. Medicare funds this kind of consultation as a video appointment only. There is no phone equivalent.

So a routine problem does not become urgent because it is booked after 11pm, and a phone call after 11pm is not covered by this exemption at all. A phone consultation late at night can still be bulk billed, but through one of the other ways on this page. Our after hours bulk billed telehealth page explains how that works in practice.

Is telehealth automatically bulk billed if I have a Medicare card?

No. Two things have to happen, in order.

First, you and the consultation have to meet Medicare’s requirements, which the questions above set out. Second, the doctor decides whether to accept the Medicare rebate as full payment. That second step is what bulk billing means.

A telehealth consultation can be the right thing for you clinically and still not qualify for a Medicare rebate. Where that happens you can usually still be seen by telehealth, with a fee to pay. See our fees on our telehealth page.

Can I get bulk billed telehealth as a new patient?

It depends on which kind of new you are.

• New to the practice, and nobody there has seen you. You will not meet the 12 month requirement, so you would need to be registered in MyMedicare with that practice, or meet one of the exemptions.
• New to the doctor, but the practice has seen you. You already meet the requirement, as long as the appointment was in person, in the last 12 months, and billed to Medicare. It does not matter that you have not met this particular doctor.
• New to the after hours service that covers your practice. Same answer, provided your practice saw you in person in the last 12 months and the two have a formal arrangement.

What nobody can do is qualify simply by holding a Medicare card.

How do I know whether I am eligible?

If you answer yes to any of these, your consultation can be bulk billed.

1. Has this doctor, or anyone at this practice, seen you in person in the last 12 months, and was that appointment billed to Medicare?
2. Are you registered in MyMedicare with this practice?
3. Has your own practice seen you in person in the last 12 months, and is this the after hours service that covers it?
4. Do you, or does the consultation you need, meet one of the exemptions above?

At Perth Home GP, if you are eligible, we bulk bill telehealth consultations of up to 15 minutes. See our fees on our telehealth page.

Billing policies differ between services, so check with whichever telehealth service you are booking with. Being eligible for a Medicare rebate and being bulk billed are not the same thing.

Why is Medicare paying attention to telehealth claiming?

Telehealth is the first of five compliance priorities the Department of Health, Disability and Ageing set for 2026, and the Department’s own starting point is supportive: "telehealth is vital for maintaining continuity of care and improving access to timely health services for Australians."

Its concern is with on demand telehealth platforms specifically, and it names four things: "opportunistic and/or inappropriate claiming of health program payments, as well as commercial incentives conflicting with clinical best practice, continuity of care and patient safety."

That does not make any particular service non compliant. It does mean services need to be able to demonstrate why each Medicare funded consultation was eligible.

How Perth Home GP approaches telehealth eligibility

We are an accredited mobile GP practice. We check Medicare eligibility against the rules on this page rather than treating a Medicare card as automatic eligibility.

Most of our telehealth patients are eligible for one of two reasons. A Perth Home GP home visit in the last 12 months, billed to Medicare, is a face-to-face appointment, and it makes you eligible for telehealth with us for the following 12 months. Registering with us in MyMedicare keeps that eligibility in place.

Night Doctor is the approved medical deputising service that covers our patients after hours, so a patient we have seen face-to-face in the last 12 months is eligible for a Medicare rebate there too.

We tell you what applies before you book. If you are eligible, we say so, and we bulk bill. If you are not, we say that too and tell you the fee, so nobody finds out afterwards. We would rather spend a minute on the phone than waste your time or leave you with a surprise.

Where you are not eligible, you can usually still be seen by telehealth, with a fee to pay. See our fees on our telehealth page.