Out of Pocket Costs - Gap Fees
FEES UPDATED AS AT 1 MAY 2023
Gap Fees and Rebate Schedule
Chirnside Park Medical Clinic had transitioned to a private billing practice for most consultations from September 2021 (adjusted 1 July 2022). All appointments will incur an out-of-pocket cost. Please note the following and the fees schedule table below:
- Health Care cardholders, Pension cardholders, DHS Commonwealth Seniors Health Care cardholders, Children under 12’s will bulk billed on weekdays 8am-6pm only.
- A reduced fee is offered to patients under the age of 12 years on weekends and public holidays
- Phone/telehealth consultations are the same as a face-to-face appointment and also incur an out-of-pocket fee. This includes simple requests like a script or referral. No phone consults will be bulk billed.
- Veterans Affairs (DVA) Gold cardholders are bulk billed on all occasions.
- Full payment is required on the day of consultation by cash or debit/credit card (VISA or Mastercard only)
- For your convenience, we can claim your Medicare rebate on the spot if you have registered your details with Medicare
- The item numbers below are for standard consultations, please note that different consultations (EG: mental health, care plans and procedures) will have separate item codes and fees
- Cancellation/no-show fees will be applied if you do not attend or fail to notify us of any changes to your appointment within 2 hours of your appointment time
-
We have absorbed as much of the increasing costs as possible but unfortunately, we are unable to continue bulk billing all our patients and maintain a high quality of care.
From November 2012 to date, the Australian Government had frozen Medicare rebates. This meant that for 10 years, the rebate amount for sessions did not grow whilst the costs of running a practice,including rent, utilities, medical consumables, PPE, staff costs etc continued to increase. In the past decade the Government has only increased the standard consultation fee by $4 over the last 9 years.
Consequently, the gap between Medicare rebates and cost of operating expenses will continue to widen. As a result, it is not possible for our practice to meet the running costs each year without having a gap (out-of-pocket) fee.
Weekdays 8am-6pm
| Item code | Concession cardholders, children UNDER 12 years | Non-concession cardholders |
|---|---|---|
|
Item 23 (short consultation) |
Bulk Billed |
Full fee: $82.85 Rebate: $42.85 Gap: $40.00 |
|
Item 36 (long consultation) |
Bulk Billed |
Full fee: $122.90 Rebate: $82.90 Gap: $40.00 |
|
Item 44 (extra-long consultation) |
Bulk Billed |
Full fee: $162.15 Rebate: $122.15 Gap: $40.00 |
Weekdays after 6pm, Saturdays and Sundays
| Item code | Children UNDER 12 years | All patients over 12-years-old |
|---|---|---|
|
Item 23 - Standard (6pm-8pm weekdays, 9am-1pm Saturday) |
Full fee: $69.85 Rebate: $42.85 Gap: $27.00 |
Full fee: $87.85 Rebate: $42.850 Gap: $45.00 |
|
Item 36 - Long (6pm-8pm weekdays, 9am-1pm Saturday) |
Full fee: $109.90 Rebate: $82.90 Gap: $27.00 |
Full fee: $127.90 Rebate: $82.90 Gap: $45.00 |
|
Item 5020 - Standard (8pm -9pm weekdays, 1pm-5pm Saturday, Sunday) |
Full fee: $82.80 Rebate: $55.80 Gap: $27.00 |
Full fee: $100.80 Rebate: $55.80 Gap: $45.00 |
|
Item 5040 - Long (8pm-9pm weekdays, 1pm-5pm Saturday, Sunday) |
Full fee: $122.70 Rebate: $95.70 Gap: $27.00 |
Full fee: $140.70 Rebate: $95.70 Gap: $45.00 |
Public Holidays
| Item code | Children UNDER 12 years | All patients over 12-years-old |
|---|---|---|
|
Item 5020 (standard consultation) |
Full fee: $98.800 Rebate: $55.80 Gap: $43.00 |
Full fee: $106.80 Rebate: $55.80 Gap: $51.00 |
|
Item 5040 (long consultation) |
Full fee: $138.70 Rebate: $95.70 Gap: $43.00 |
Full fee: $146.70 Rebate: $95.70 Gap: $51.00 |
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