Gap fee

A gap fee refers to the difference between a healthcare provider’s total charge and the rebate provided by Medicare for a specific health service. 

How the gap fee is determined 

• The provider establishes their consultation fee. 

• Medicare provides a set rebate. 

• The patient is responsible for paying the remaining balance. 

Payment options and rebates 

• Payment can be made either in advance or after the doctor consultation 

• Patients can claim the Medicare rebate through Easyclaim or online 

• The rebate is issued to the patient, not the practice 

Being aware of gap fees assists Australians in budgeting for healthcare costs and helps prevent surprise expenses when consulting with privately billing providers. 

Medical Disclaimer: The content on this page is for informational purposes only.