--- title: "Telehealth vs in-person GP in Australia: an honest verdict" description: "Australian Medicare telehealth still hinges on an established relationship for many items. Here is when video or phone wins — and when the consulting…" url: https://www.getarbol.com/en/blog/telehealth-vs-in-person-gp-au/ lang: en --- # Telehealth vs in-person GP in Australia: an honest verdict Australian Medicare telehealth still hinges on an established relationship for many items. Here is when video or phone wins — and when the consulting room must. [**Samuel Giraldo** Product Manager, Arbol](https://www.getarbol.com/en/blog/authors/samuel-giraldo/) May 8, 2026 10 min read Telehealth did not replace the Australian GP consulting room — and Australian Medicare never said it would. For many MBS telehealth items, the Department of Health’s continuing-telehealth factsheet still defines an **established relationship** as at least one face-to-face service with the practitioner in the **12 months** before the telehealth attendance. RACGP-reported Medicare statistics from the pandemic peak showed phone and video consults bulk-billed at **99%** and **97%**, lifting national bulk-billing rates even while average out-of-pocket costs rose. So the honest comparison is not “digital good, desk bad.” It is: **telehealth wins for continuity, triage and access when the relationship and clinical task fit; in-person wins when the body must be examined, procedures done, or the relationship has not been established.** Pretending otherwise burns trust with patients and with auditors. Key takeaways - MBS continuing-telehealth rules for GPs commonly require an established relationship: ≥1 face-to-face service in the preceding 12 months (with defined exceptions in the factsheet). - In 2019–20 Medicare stats reported by RACGP newsGP, >99% of phone and 97% of video GP consults were bulk-billed; removing telehealth dropped the bulk-billing rate to 86.4%. - Temporary COVID telehealth items were 8.8% of GP consultations that year — large enough to move headlines, not large enough to retire the consulting room. - Bulk billing incentives and telehealth mix interact; read them together with Australian Medicare (not US Medicare) vocabulary. - Verdict: default to telehealth for eligible continuity tasks; default to in-person for new relationships, examinations and procedures. ## The relationship rule is the real gate Services Australia publishes [telehealth billing codes for MBS items](https://www.servicesaustralia.gov.au/telehealth-billing-codes-for-mbs-items?context=20) for eligible GPs and other practitioners working in general practice. The clinical-system question underneath the code list is simpler: **may this patient be seen remotely under the rules that apply today?** The Department of Health’s continuing MBS telehealth factsheet for GPs and other medical practitioners states the established-relationship test in plain language: the medical practitioner performing the service has provided **at least one face-to-face service to the patient in the 12 months** preceding the telehealth service (with the factsheet’s listed exceptions). That single sentence decides more appointment-mode fights than any preference survey. Operationally it means: - A practice cannot honestly advertise “anyone, anywhere, by video” for rebateable GP telehealth without checking relationship status. - New patients, lapsed patients and visitors often need an in-person bridge before remote follow-up is billable under the standard rule. - Continuity clinics — chronic disease reviews, medication titration, results discussions — are exactly where telehealth earns its keep **after** that bridge exists. RACGP practice standards still treat after-hours access as a practice-owned obligation (Criterion GP1.3). Telehealth can be part of that design; it does not erase it. National nurse-triage helplines and practice-owned after-hours paths are different instruments — the same warning we make in Anglo after-hours comparisons. Vocabulary In this article, **Medicare** means **Australian Medicare** (MBS rebates and bulk billing). It is not US Medicare. Mixing the two is how international copy becomes wrong overnight. ## What telehealth moved in the numbers RACGP newsGP’s reporting on official Medicare statistics for **2019–20** is still the cleanest public unpacking of how telehealth distorted — and illuminated — bulk-billing headlines: - Bulk-billing rates under Medicare reached **87.5%**. - More than **99%** of phone and **97%** of video consults were bulk-billed by GPs. - Strip telehealth out and the bulk-billing rate falls to **86.4%** — only **0.2** points above the prior year. - Temporary telehealth items represented **8.8%** of GP consultations and **4.1%** of all Medicare services that year (**\~13.9 million** phone consults and **504,307** video). - Average out-of-pocket costs still rose to **$39.33**, even as more services were free at the point of care. Those figures are pandemic-era. They remain the best published evidence that **telehealth can move access metrics without proving that every clinical problem belongs on a screen**. Practices that treat bulk-billing rate as a proxy for “telehealth quality” are measuring the wrong thing. Medicare statistics 2019–20 (RACGP newsGP) Telehealth’s fingerprint on bulk billing 87.5% Bulk-billing rate (all services context in report) RACGP newsGP 99%+ Phone GP consults bulk-billed RACGP newsGP 8.8% GP consults that were temporary telehealth items RACGP newsGP Fuente: RACGP newsGP citing official Medicare statistics ## Side-by-side: when each mode fits Mode choice Telehealth GP vs in-person GP Telehealth (phone/video) Best for continuity Established relationship + task that does not need hands-on exam “Review the plan, adjust the script, book the next step.” Results discussion Medication review Triage & redirect Rural travel saved In-person consulting room Best for first contact & body New relationships, examinations, procedures, uncertain diagnosis “If you need to look, listen or touch, book the room.” New patient / lapsed Physical exam Procedures Complex undifferentiated care Clinical and billing fit Decision grid for Australian general practice Question Favour telehealth Favour in-person Relationship Face-to-face in last 12 months (standard rule) New, lapsed, or exception not met Clinical task History-dominant, follow-up, counselling Exam, procedure, red-flag undifferentiated Access barrier Distance, mobility, infection control Digital exclusion, need for in-room supports Billing risk Item + relationship documented Relationship missing → wrong mode Fuente: MBS telehealth factsheet; RACGP reporting; practice operations ## Bulk billing is adjacent — not identical Australian debates about [bulk billing incentives and GP access](https://www.getarbol.com/en/blog/bulk-billing-access-general-practice/) and telehealth mode choice share a vocabulary and a trap. Bulk billing answers **who pays at the point of care**. Telehealth answers **where the consult happens**. You can bulk-bill either mode; you can privately bill either mode (within rules). Collapsing them into one slogan — “bulk-billed telehealth for everyone” — hides both the relationship gate and the clinical fitness test. For practice operations, the useful dashboard is three columns: **mode mix** (phone / video / face-to-face), **relationship status** (eligible for telehealth items or not), and **billing model** (bulk bill vs gap). Practices that only track the first column will mis-staff rooms and mis-train reception scripts. After-hours coverage is the stress test. A message bank is not a plan; a telehealth shift without escalation rules is not a plan either. Pair this comparison with how your clinic covers evenings before you promise 24/7 video. Booking flow How a well-run practice chooses the mode 1 Reason for contact Symptom, results, admin, chronic review. 2 Relationship check Face-to-face in 12 months? Exception? 3 Clinical fitness Exam needed? Procedure? Safety netting. 4 Book & bill Correct MBS item; confirm channel; document. ## Reception scripts that prevent the wrong mode Most mode errors are booked at the front desk, not in the consulting room. A short script prevents the expensive ones: 1. **Ask the reason in one sentence.** “Medication review after bloods” and “new chest pain” should never share a booking template. 2. **Check the last face-to-face date** before offering video. If it is older than 12 months under the standard MBS relationship rule, offer an in-person bridge first — or confirm an exception applies. 3. **Name the clinician team**, not only the modality. Telehealth with a doctor who knows the file is continuity; telehealth with a rotating unknown number is a different product. 4. **Confirm the device and privacy setting.** A phone consult taken on a worksite loudspeaker is not equivalent to a video consult in a closed room — document constraints if care is still appropriate. Practices that already run structured phone triage — see Australian GP phone-triage operations notes in this corpus — can reuse the same acuity language for telehealth booking. The goal is not to maximise video percentage. The goal is to maximise **correct modality on first book**, which is what protects both rebate integrity and clinical safety. ## What your clinic can do this week Telehealth vs in-person — clinic checklist - Code relationship status in the appointment book Reception should see ‘telehealth eligible / needs face-to-face bridge’ before offering video. - Publish a mode policy patients can understand When we offer phone, when we require the room, how after-hours works. - Train for red-flag escalation Telehealth that cannot escalate to same-day in-person is a risk, not a service. - Separate bulk-billing policy from mode policy Two decisions, two scripts — see the bulk billing access note for the payment side. Australia’s market landing for practice phone and DNA recovery sits at [/en/australia/](https://www.getarbol.com/en/australia/). Use it when the comparison turns into an operations project. ## Verdict Verdict For Australian general practice, telehealth should be the default for eligible continuity tasks — and in-person should remain the default for new relationships, examinations and procedures. The MBS relationship rule and the RACGP-reported bulk-billing spike both point the same way: remote care amplifies an existing GP–patient bond; it does not invent one. Clinics that invert that order create billing risk and clinical risk at the same time. Choose telehealth when… The patient meets the established-relationship rule and the task is history-dominant follow-up, results, medication review or safe triage. Choose in-person when… You need a physical exam or procedure, the relationship is not established under MBS rules, or safety-netting requires the room. Choose a hybrid pathway when… Telehealth triages today and books a same-week face-to-face slot with the same clinician team — documented as one episode of care. Frequently asked questions Does Australian Medicare allow GP telehealth without a prior face-to-face visit? Many continuing MBS telehealth items require an established relationship — typically at least one face-to-face service in the preceding 12 months — with exceptions set out in the Department of Health factsheet. Always check the current item rules before booking. Did telehealth cause record bulk billing? RACGP newsGP reported that in 2019–20, removing highly bulk-billed phone and video consults cut the headline bulk-billing rate to 86.4%, showing telehealth drove much of the jump — not that every consult should be remote. Is bulk billing the same as telehealth? No. Bulk billing is about patient cost at the point of care under Australian Medicare; telehealth is about modality. Either mode can be bulk-billed or privately billed within the rules. Disclaimer This content is for informational and educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition. ## Keep reading Australia **Keep reading** Australia Regulation ### [Bulk billing incentives: what actually changed for GP access](https://www.getarbol.com/en/blog/bulk-billing-access-general-practice/) Australia rebuilt its bulk billing incentive in 2025. Two real, non-comparable figures now describe GP access, and mixed billing got a sharper trade-off. Norbelys Chirinos Jun 10, 2026 9 min read Read the article ### More to read Australia Practice operations ### [After-hours clinic coverage in Australia: own the first line](https://www.getarbol.com/en/blog/clinic-after-hours-coverage-au/) Healthdirect took 1.4 million calls in FY25, mostly after hours. RACGP still requires clinics to own access — how a first-line voice agent closes the gap. David Lara Feb 13, 2026 10 min read Australia Practice operations ### [GP phone triage in Australia: the after-hours gap clinics still own](https://www.getarbol.com/en/blog/gp-phone-triage-australia/) Healthdirect took 1.4 million helpline calls in FY25, mostly after hours. RACGP standards still require every clinic to own how patients reach care overnight. Norbelys Chirinos Jan 16, 2026 10 min read Australia Practice operations ### [Bulk billing and reminders: what patients tolerate](https://www.getarbol.com/en/blog/bulk-billing-reminder-ethics-au/) Australian Medicare bulk billing and clinic reminders collide when messages feel like marketing. What patients tolerate—and how consent shapes ethical prompts. David Lara May 31, 2026 12 min read ## Let’s look at your population in Arbol. A 30-minute video call with our team, using your cases: your contract, your patients and your channels. You leave with a first read of your population, your contract and your utilization rates. [Book a demo](https://cal.com/tomas-giraldo-pdfbl9/30-min-arbol-ai-demo) [Message us on WhatsApp](https://wa.me/573185230045?text=Hello%2C%20I%27d%20like%20to%20learn%20more%20about%20Arbol%20for%20my%20organization.) 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