The 12-month face-to-face rule explained

Under Medicare rules, most GP telehealth consultations in Australia require that you have seen a doctor at the same practice in the last 12 months. This is called the established clinical relationship rule. There are exemptions for rural patients, people experiencing homelessness or domestic violence, children under 12 months, and other specific circumstances. Abby Health works within these rules and bulk bills eligible patients.

Why this rule exists

The Australian Government introduced the 12-month face-to-face rule in July 2022. The stated aim was to make sure Medicare-funded telehealth supports continuity of care, not one-off consultations with a doctor who has never met you. The idea is that telehealth works best when a clinician already knows your health story, because they can interpret new symptoms against a familiar baseline. For the full MBS Online policy, see the Medicare telehealth arrangements fact sheet.

What counts as an "established clinical relationship"

An established clinical relationship means you have had at least one face-to-face appointment at the same medical practice in the previous 12 months. The appointment does not need to have been with the exact same doctor — any doctor at the same practice counts, provided it is the same ABN.

Telehealth appointments on their own do not establish a relationship for Medicare purposes. The rule specifically asks for an in-person consultation.

What happens if you don't have an established relationship

If you do not have a recent face-to-face visit and no exemption applies, Medicare will not rebate a GP telehealth consultation. You may still see the doctor privately, but the consultation would not be bulk billed under Medicare. Abby is transparent about this upfront — before you book, our booking flow checks whether a Medicare-eligible pathway is available to you.

Exemptions to the 12-month face-to-face rule

The rule has several published exemptions. Medicare rebates are available for telehealth without a prior in-person appointment if any of the following applies:

You live in a declared Modified Monash Model 6 or 7 area — remote and very remote Australia. You can check your classification on the Health Workforce Locator, published by the Department of Health and Aged Care.

You are experiencing homelessness. A patient self-declaration is accepted.

You are affected by a natural disaster declared by the relevant state or Commonwealth authority.

You are a child under 12 months old.

You are an eligible resident of an Aboriginal community-controlled health service or a residential aged care facility.

You have been affected by family and domestic violence.

You are accessing a blood-borne virus, sexual or reproductive health consultation — certain items in this area do not require a prior relationship.

For the current official list, the Services Australia Medicare benefits page is kept up to date.

How Abby fits in

Abby Health operates as an online-first clinic. For many patients, your first consultation at Abby establishes the relationship for future telehealth. Because Abby maintains the same ABN across every clinician in our network, seeing any Abby doctor means all of our clinicians can consult with you by telehealth in the 12 months that follow — you don't have to start over every time.

For patients in rural and remote Australia, or for those who fall within one of the listed exemptions, Medicare-funded telehealth is available from the first appointment.

If you're not eligible for a bulk-billed appointment

Our bulk billing explainer walks through who Abby bulk bills and what private billing looks like when Medicare rebates are not available. We never hide a fee until checkout.

When a face-to-face appointment is still the right call

The 12-month rule is one reason to see a clinician in person, but it's not the only one. Some conditions — chest pain, significant trauma, severe mental health presentations, anything needing a physical examination — belong in a clinic or an emergency department, not on a screen. Our guide on when telehealth is right for you covers this in more detail.

Frequently asked questions

Does a visit to any GP count, or does it have to be the same practice?

It has to be the same medical practice (same ABN). A visit to a different clinic — even on the same street — does not establish a relationship for Medicare purposes at your new practice.

I live in a remote area. Do I still need a face-to-face appointment?

If you live in an MMM6 or MMM7 area you are exempt from the 12-month rule for GP telehealth. Abby can see you under Medicare from your first appointment.

What about Nurse Practitioner appointments?

Nurse Practitioner telehealth follows different Medicare arrangements and is not bound by the same 12-month rule. You can read more in our guide on what a Nurse Practitioner is in Australia.

Does a past telehealth appointment count as establishing a relationship?

No. Only in-person consultations count for this specific rule. A history of telehealth-only appointments does not satisfy it.

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