Medicare and Telehealth: Everything Eligible Australians Can Access

Medicare-rebated telehealth is now a permanent part of Australian primary care. Eligible patients with a valid Medicare card can access phone or video consultations with GPs, Nurse Practitioners, psychologists, and other allied health clinicians. Most GP telehealth items require a 12-month established relationship — meaning one in-person visit with that clinic in the preceding year — but patients in Modified Monash Model (MMM) categories 6 and 7 are exempt. Mental health, after-hours, and specialist items follow their own rules. At Abby, appointments are bulk billed for eligible patients with a valid Medicare card.

How telehealth became a permanent part of Medicare

Telehealth did not arrive with the pandemic. It arrived in Australia in 1928, with the Royal Flying Doctor Service's pedal radio, and it has been part of how Australians access care ever since. What changed in 2020 was Medicare. In March of that year, the Federal Government introduced temporary telehealth items that, for the first time, allowed a GP to bulk bill a phone or video consultation for any patient, regardless of location. In 2022, those items were made permanent — a recognition that telehealth had become a normal, expected part of how Australians access their doctor.

The current framework, administered by Services Australia and detailed on MBS Online, covers a wide range of clinical interactions: standard GP consultations, long consultations, mental health treatment, chronic disease management, specialist referrals, and Nurse Practitioner services. Each has its own item number, time threshold, and set of eligibility conditions. If you want the longer view of how the framework evolved, see a brief history of Australian telehealth.

Who is eligible for Medicare telehealth in 2026

Eligibility for Medicare telehealth rests on three conditions. First, the patient must hold a valid Medicare card. Second, the consultation must be delivered by a clinician with Medicare provider status — which means an AHPRA-registered GP, Nurse Practitioner, specialist, or allied health professional approved for the relevant item. Third, the specific Medicare item being claimed must match the nature and duration of the consultation and the patient's circumstances.

Most Australians with a Medicare card are eligible. Visitors on reciprocal healthcare agreements have different arrangements and should check their eligibility directly with Services Australia. Children can be seen via telehealth with appropriate guardian involvement; this is governed by standard consent rules rather than by Medicare eligibility. Patients on Department of Veterans' Affairs arrangements have their own telehealth provisions that closely mirror the Medicare structure.

A valid Medicare card does not, on its own, guarantee that every telehealth item will be rebated for every patient. The 12-month rule — covered below — is the most common reason a patient who would otherwise be eligible is routed to a different consultation type.

The 12-month established-relationship rule

When telehealth was made permanent in 2022, the Government introduced a condition known as the 12-month rule. Under this rule, for most standard GP telehealth items to attract a Medicare rebate, the patient must have had at least one in-person consultation with that same GP, or with another GP at the same clinic, in the preceding 12 months. The policy intent was to preserve continuity — to ensure that Medicare-rebated telehealth sat within an ongoing clinical relationship rather than in an episodic, disposable one.

In practice, the rule creates real friction for patients who most need telehealth: those without transport, those in rural and remote communities, those with caring responsibilities, and those whose local clinic has closed. The Government recognised this and built exemptions into the framework.

For a detailed walkthrough of how the rule works, what counts as an in-person visit, and the practical implications for your appointment, see the 12-month face-to-face rule explained.

MMM6 and MMM7 exemptions: rural and remote access

The Modified Monash Model (MMM) classifies every location in Australia on a scale from 1 (metropolitan) to 7 (very remote). Patients who live in MMM6 (remote) or MMM7 (very remote) locations are exempt from the 12-month rule. For these patients, a GP telehealth consultation can be bulk billed for eligible patients with a valid Medicare card without requiring a prior in-person visit.

This exemption exists because the 12-month rule, applied uniformly, would disproportionately harm patients in communities where the nearest GP might be hundreds of kilometres away. A patient in a very remote settlement should not need to travel a day to attend an in-person appointment simply to qualify for a rebated telephone consultation three months later.

Other exemptions apply to specific clinical circumstances: patients under the age of 12 months, patients who are homeless, patients receiving care in aged-care facilities under particular arrangements, and patients receiving mental health care under Better Access provisions. If your circumstances mean the 12-month rule doesn't apply to you, the clinical booking flow will identify that and route your consultation to the correct item. For broader context on how telehealth serves rural and remote Australians, see telehealth for rural and remote Australians.

What telehealth items cover: standard, long, and mental health

Standard GP telehealth items cover consultations up to a defined time threshold — typically the equivalent of an ordinary Level B consultation. Longer consultations, where the clinician spends a greater time on complex or multi-issue presentations, attract higher-value items that recognise the additional clinical work involved. Mental health treatment items, available to patients on a Mental Health Care Plan under the Better Access initiative, allow for extended mental-health-specific consultations with a GP and unlock subsidised psychology sessions.

Chronic disease management plans — including GP Management Plans and Team Care Arrangements — can be created, reviewed, and adjusted by telehealth where clinically appropriate. Specialist telehealth items exist for consultations with specialists, though most specialist referrals still begin with a GP consultation. Nurse Practitioner telehealth items, expanded in the 2024 MBS changes, provide rebated access to Nurse Practitioner-led care for a broader range of presentations than was previously covered.

At Abby, all of these items are billed directly to Medicare for eligible patients. No invoice is issued, no gap payment is charged, and no credit card is required at the point of booking for a standard Medicare-rebated consultation. Appointments are bulk billed for eligible patients with a valid Medicare card. If you want to see the detail of how this works in practice, see is Abby bulk billed.

GPs and Nurse Practitioners: different items, same care network

One of the most common misconceptions about Medicare telehealth is that Nurse Practitioner consultations are somehow lesser, or sit outside the Medicare framework, or are only available as a workaround where a GP is unavailable. None of this is accurate.

Nurse Practitioners are AHPRA-endorsed senior clinicians with prescribing authority and an independent Medicare provider number. They hold a clinical Master's degree with advanced practice training in a specialty area. The November 2024 Medicare changes significantly expanded the item numbers available for Nurse Practitioner services, brought rebate values closer to GP equivalents for comparable consultations, and broadened the services eligible for bulk billing. For the full policy detail, see Nurse Practitioner billing and the 2024 Medicare changes.

Where a Nurse Practitioner is the appropriate clinician for a presentation, their consultation is a senior clinical interaction — not a compromise. Where a Specialist GP is more appropriate, Abby's booking flow routes accordingly. Both clinician types are part of the same 300+ clinician care network (Abby Health internal data, Q1 2026), and both hold current AHPRA registration. For the distinctions in clinical role, see what a Nurse Practitioner is in Australia and what makes a Specialist GP in Australia.

Common misconceptions about telehealth and Medicare

A persistent misconception is that telehealth consultations are only available during business hours. They are not. Medicare after-hours items apply to telehealth as they do to in-person consultations, meaning that clinically appropriate consultations provided outside standard hours attract the relevant rebate. Abby operates seven days a week, 365 days a year.

Another misconception is that a phone consultation is worth less, clinically, than a video consultation. The MBS framework treats phone and video equivalently for most items at comparable time thresholds. What matters for clinical quality is whether the modality is appropriate for the presentation — and whether the clinician has enough information to make safe decisions. On that question, see when telehealth is right for you and what telehealth can't do — safety limits.

A third misconception is that a prescription issued via telehealth is somehow conditional, temporary, or second-tier. It is not. A prescription issued by an AHPRA-registered clinician after a clinically appropriate telehealth consultation is a full prescription, valid at any Australian pharmacy, with the same PBS subsidy arrangements as an in-person prescription. For more, see how to get a prescription online in Australia.

How Abby AI supports every Medicare telehealth consultation

Continuity is the clinical backbone of the Medicare telehealth framework — it is the reason the 12-month rule exists, and it is the reason patients benefit more, over time, from seeing the same clinician. At Abby, continuity is supported by Abby AI, our medical AI. Before every appointment, Abby AI prepares a consult-ready brief: it surfaces the patient's history, medications, relevant past consultations, pathology results, and any flagged follow-ups. This means your clinician begins the consultation already informed — regardless of whether you've seen them before.

Abby AI does not diagnose. It does not prescribe. It does not replace clinician judgment. It is a decision-support tool that makes sure the right information is in front of the right clinician at the right time. For the full explainer, see what Abby AI is — decision support explained. For how continuity is maintained when you see a different clinician, see how Abby remembers you — continuity of care.

71% of Abby patients rebook with the same clinician (Abby Health internal data, Q1 2026). That rebook rate is not a marketing metric — it is the mechanism by which telehealth becomes genuinely continuous rather than episodic, which is exactly what the Medicare framework is designed to support.

Frequently asked questions

Is every Abby telehealth appointment bulk billed?

Abby telehealth appointments are bulk billed for eligible patients with a valid Medicare card. Eligibility depends on the specific Medicare item, the clinical nature of the consultation, and whether conditions such as the 12-month rule or an MMM6/7 exemption apply to you. The booking flow checks eligibility automatically and routes you to the correct consultation type.

Do I need a video call, or is a phone call enough?

For most Medicare telehealth items, phone and video consultations are treated equivalently. Your clinician may recommend video where visual assessment adds clinical value, but phone consultations remain fully rebated under the framework.

What if I haven't seen a GP in the last 12 months?

If you live in MMM6 or MMM7, the 12-month rule doesn't apply. If you don't, your booking at Abby may be routed to a first-appointment pathway — including the option of an in-person visit at a participating clinic — so that future telehealth consultations fall within the rebated framework. See the 12-month face-to-face rule explained.

Are mental-health telehealth consultations covered differently?

Yes. The Better Access initiative provides a separate framework for mental health items, including the creation of a Mental Health Care Plan and access to rebated psychology sessions. See how to get a Mental Health Care Plan online.

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