Healthcare directory Cleanbill's annual survey of nearly 7000 GP clinics found Australia's bulk-billing rate had plummeted to 20.7 per cent at the start of 2025, down from 35.7 per cent two years earlier.
Nationally, the average out-of-pocket cost for patients increased four per cent year-on-year, with the average charge $43.38 in 2025.
Remarkably, the study found no Tasmanian clinics that would bulk bill a new adult patient without concessions, with that state also having the largest average out-of-pocket cost at $54.26.
Over Cleanbill's three annual surveys, every state has seen an annual decrease to its bulk-billing rate combined with an increase to the average out-of-pocket cost.
Cleanbill founder James Gillespie said the data made it easy to see why Australians with health complaints were increasingly opting out of seeing a doctor.
Patients are now paying an average of $43.38 out of their own pockets at the GP, up four per cent. (Tracey Nearmy/AAP PHOTOS)
The Australian Bureau of Statistics' patient experiences survey released in November found about 1.5 million people did not attend a GP with a health complaint due to cost.
"The data is absolutely concerning, but it's not particularly surprising … anyone who's gone to see a GP in recent years knows how few bulk-billing clinics remain and how high out-of-pocket costs can be," Mr Gillespie told AAP.
"As bulk-billing rates continue to slide and out-of-pocket costs continue to increase, it's unsurprising that more Australians than ever before are delaying or avoiding seeing a GP because of concerns surrounding cost."
Health Minister Mark Butler disputed Cleanbill's figures, which are considerably lower than the government's official bulk-billing rate of 77.2 per cent in November.
Government figures show the ratio of all individual GP visits that were bulk-billed, compared with Cleanbill's study of clinics that would bulk-bill a new adult patient without concessions.
"Official data shows our record investment to strengthen Medicare has stopped the free-fall in bulk billing that was created under the Liberal and Nationals government," Mr Butler said.
"Every state and territory now has more bulk billing, with the largest rise in some states which have historically struggled with lower rates of bulk billing (but) we know there's more to do to keep strengthening Medicare after a decade of cuts and neglect."
The federal government tripled bulk-billing incentives in 2023 for pensioners, concession card holders and children, meaning GPs received a $21 bonus in cities and almost $40 in regional areas.
Given that lifted rates, Royal Australian College of General Practitioners president Michael Wright said an increase in Medicare funding should be front-of-mind heading to this year's federal election.
"Medicare has been underfunded for decades … today's patient rebates don't come close to the cost of care, so people are paying more out-of-pocket, it's harder for GPs to bulk bill," he told AAP.
"When people can't see their GP or delay care due to costs, their health gets worse and they are more likely to end up in hospitals … that's bad for their health, and costs taxpayers more."
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