News Review
31 OCTOBER 2025 ausdoc. com. au
The looming reforms to the GP consult time tiers
Paul Smith Editor
THE government’ s move to reengineer the Medicare time tiers for GP consults has the potential to become one of the most significant structural reforms to fee-for-service in decades.
With the MBS Review Advisory Committee expected to reveal a draft of the new time tiers next year, questions are being asked about whether the rebates will attach— whether much-needed change will again end up being done on the cheap.
We spoke to Dr Danielle McMullen, AMA president.
Australian Doctor: This is a long time coming— someone fixing the time tiers which have not been fit for purpose for many years now.
Dr Danielle McMullen: The need to modernise Medicare has been a peak policy for us over a number of years now, particularly so ahead of the last election.
The time tiers were built 40 years ago when patients were presenting with one or two simple problems. A 5-10-minute appointment was a pretty standard appointment. Whereas now, RACGP data would suggest that the average consultation time is closer to 18 or 19 minutes.
Even the [ Department of Health, Disability and Ageing ] recognises that consultations are [ running ] longer, and that’ s due to mental health presentations [ and ] more chronic and complex disease.
But it’ s even the so-called‘ simple’ stuff. I mean, if you go back 20 years, when we were treating asthma, we had Ventolin, whereas now we’ ve got a whole big chart on the wall of options to work through.
AD: So to be clear, the system is still incentivising six-minute medicine?
Dr McMullen: Yes, the shorter the consultation the better financially. Of course, there needs to be some efficiency dividend built into any system, but we would say that it’ s too extreme. It has been for many years.
Your sweet spot at the moment, if you’ re financially motivated, is a 6-10-minute consult, but many GPs will find it difficult to provide complex care in that time frame.
AD: This review, is it the brainchild of the advisory committee itself or something pushed by the government? You worry that governments tend to ignore things they never asked for?
Dr McMullen: The MBS Review Advisory Committee is conducting the review, but I believe it would have needed to act on a request from the government, but you need to confirm that.
We have been telling government for some time about the need for reform. And we are certainly celebrating that this review is happening.
AD: Is the review examining the structure of the time tiers— but with no remit to look at the actual
The time tiers were built 40 years ago when patients were presenting with one or two simple problems.
rebates attached? We saw that separation with the reform of chronic disease management items, in fact with the entire Medicare review process a decade ago.
Are we in the same situation with this?
Dr McMullen: They will have to— and the MBS Review Advisory Committee is the right place to have those conversations. They haven’ t yet said what their recommendations are going to look like, and we don’ t expect that detail to emerge