We are a mixed billing general practice committed to providing accessible, high-quality healthcare.

Please review our fees and billing arrangements before booking your appointment. Fees may vary depending on your eligibility, appointment type, Medicare item number billed, insurer arrangements and services provided.

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General Billing for Standard GP Appointment

Patient or cover type	First standard GP consultation each calendar year	Following standard GP consultations this calendar year
Eligible student or concession card holder with Medicare and registered with MCMC under MyMedicare	$50 gap	Bulk billed — $0 out of pocket
Other Medicare patient	$50 gap each visit
Allianz or Medibank OSHC	$50 gap	Direct billed — $0 out of pocket
Bupa, ahm or nib OSHC	$50 gap	$25 each visit*
CBHS OSHC	Full private feePay at the clinic, then claim from CBHS if eligible
Eligible OVHC	$50 gap fee if eligible
No valid Medicare or supported insurance	Full private fee: standard consultation from $95

*WHY DO SOME OSHC PATIENTS PAY A $25 GAP?

When an eligible standard GP consultation is bulk billed under Medicare, the clinic may receive both the standard consultation benefit and an additional bulk-billing incentive payment (item 75870).

OSHC insurers operate under separate billing arrangements. Under the clinic’s current arrangements, Allianz and Medibank pay the clinic an equivalent amount, while BUPA, ahm and nib do not.

Where the insurer does not pay this equivalent amount, a $25 clinic gap applies to help cover the payment shortfall. This is not an additional Medicare charge.

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Routine Nurse Appointment

Routine nurse appointments are bulk billed for Medicare card holders, excluding consumables, vaccines and privately billed services.

Patients with eligible OSHC/OVHC are also eligible for direct billing for routine nurse appointments, excluding consumables, vaccines and privately billed services.

If an insurer does not pay the item 75870-equivalent amount associated with an eligible routine nurse appointment, the clinic will waive the applicable shortfall. The patient will not be charged the additional $25 gap.

CBHS patients may be required to pay at the clinic and claim directly from CBHS.

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Non Standard GP Appointment

Long, complex, prolonged or extended GP consultations are not bulk billed and attract an out-of-pocket fee.

Procedures, specialised services, medical forms, letters and consumables are not bulk billed and may attract private fees.

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Weekend Appointment

Weekend gap fees for eligible standard GP consultations are the same as weekday gap fees. Full private weekend and public holiday fees are higher.

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Private GP Consultation Fees

If Medicare or supported insurance cannot be used, the following private fees apply.

Weekdays

Weekends and Public Holidays

• Standard consultation — $110
• Long consultation — $150
• Prolonged consultation — $190
• Extended consultation — $285

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TAC and WorkCover

TAC and WorkCover are not Medicare rebatable and standard consultation fees range from $90 to $160.

The final fee depends on the consultation length, complexity, documentation and services required.

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Detailed Billing Information

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Medicare Card Holders

Medicare card holders may book Medicare-rebatable consultations with:

• Dr Guo
• Dr Habana after 6:00 pm

If a doctor is not shown as available online, the doctor may be fully booked or unavailable. Please contact reception for assistance.

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Medicare Bulk Billing Eligibility

Standard GP consultations may be bulk billed after the first annual standard consultation when the patient:

• holds a valid Medicare card;
• is an eligible student or concession card holder;
• provides valid evidence of their student or concession status;
• is registered with us under MyMedicare;
• consults with a Medicare-eligible doctor; and
• books an eligible standard GP consultation.

The first standard GP consultation in each calendar year is not bulk billed. A $50 out-of-pocket fee applies.

Following eligible standard GP consultations in the same calendar year may be bulk billed.

Patients who are not students or concession card holders are not eligible for bulk billing. A $50 out-of-pocket fee applies to each standard GP consultation.

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Long or Complex Medicare Consultations

Long, complex, prolonged and extended consultations are not bulk billed.

An out-of-pocket fee generally applies and may vary depending on:

• the consultation length;
• the Medicare item number billed;
• the number or complexity of medical concerns;
• documentation requirements; and
• any procedures or additional services provided.

Please book a longer appointment if you have:

• multiple medical concerns;
• complex or chronic health issues;
• mental health concerns;
• medical forms or reports;
• WorkCover or TAC matters; or
• a procedure requirement.

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International Students with Overseas Student Health Cover (OSHC)

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Overall OSHC Direct Billing Conditions

Direct billing cannot be guaranteed until the insurer accepts the claim after the consultation.

Direct billing or reduced-gap arrangements apply only when:

• the insurance policy is valid on the consultation date;
• the policy covers the consultation provided;
• the patient provides the required policy number or insurance card;
• the appointment is an eligible standard GP or routine nurse consultation; and
• the insurer accepts the claim.

Long, complex, prolonged and extended consultations are not direct billed.

If the claim is declined or cannot be processed, the patient will need to pay the applicable private consultation fee on the day.

The patient may then contact their insurer to determine whether they can claim a benefit from the insurer.

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Allianz and Medibank OSHC

The first standard GP consultation in each calendar year is not fully direct billed. A $50 out-of-pocket fee applies.

Following eligible standard GP consultations in the same calendar year will be directly billed.

A valid membership or policy number must be provided at the time of the appointment.

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Bupa, ahm and nib OSHC

The first standard GP consultation in each calendar year attracts a $50 out-of-pocket fee.

Following eligible standard GP consultations may have the standard consultation component directly billed. However, these insurers do not currently pay the additional amount linked to item 75870 under the clinic’s billing arrangements.

A $25 out-of-pocket fee applies to each following eligible standard GP consultation in the same calendar year.

For Bupa and nib, A valid physical or digital insurance card must be presented.

If the card (BUPA and nib) or required policy details (ahm) are not provided, the full private consultation fee will apply.

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CBHS OSHC

CBHS OSHC is not supported for direct billing.

Patients must:

1. pay the applicable consultation fee at the clinic; and
2. submit the claim directly to CBHS.

The benefit paid and the patient’s final out-of-pocket cost depend on the individual CBHS policy. This typically results in an out-of-pocket cost of approximately $50, subject to the patient’s individual CBHS policy.

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International Visitors with Overseas Visitor Health Cover (OVHC)

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Patients with valid Overseas Visitor Health Cover may be eligible for partial direct billing, depending on:

• the insurer;
• the individual policy;
• the consultation item;
• the services provided; and
• the clinic’s current billing arrangements.

Where partial direct billing is available, the remaining patient fee is usually approximately $50, depending on the consultation type and item billed.

Some standard nurse appointments may also be eligible for direct billing.

Please present a valid physical or digital OVHC card or provide the required policy details at every appointment.

If the policy is not supported, the details cannot be provided or the insurer declines the claim, the full private consultation fee will apply.

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Patients without Medicare or Supported Health Cover

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Full private fees apply to patients who do not hold:

• a valid Medicare card;
• eligible OSHC supported by MCMC; or
• eligible OVHC supported by MCMC.

Full private fees also apply when:

• the policy is valid but not supported for direct billing;
• the required insurance details are not provided;
• the insurer declines the claim; or
• the consultation or service is not eligible for bulk billing or direct billing.

Please contact reception before your appointment if you are unsure whether your cover can be used.

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Other Services and Private Fees

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Procedures, specialised services and non-standard appointments are not included in standard bulk billing or direct billing arrangements and may attract private fees.

These include, but are not limited to:

• WorkCover and TAC consultations;
• driver’s licence and fitness examinations;
• aviation medical examinations;
• private medical forms, reports and letters;
• pathology services;
• vaccines and consumables;
• dressings and wound-care materials;
• cosmetic procedures;
• termination of pregnancy services;
• specialist consultations;
• general surgery;
• diabetic educator services; and
• dietitian services.

Please contact reception before booking to confirm availability and fees.

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Questions?

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A copy of this Fees Policy is available at reception.

If you have questions about fees, Medicare eligibility or insurance direct billing, please contact:

AIMHealth Melbourne Central Medical Centre
Level 1, 368 Elizabeth Street, Melbourne
Phone: 03 9663 7199

Please kindly confirm your expected fee before attending your appointment. Thank you!