Medicare and bulk billing
Medicare and Bulk Billing for Telehealth Weight Management in 2026
How bulk billing and Medicare rebates work for telehealth weight management in 2026, and what Medicare doesn’t cover.
- Initial consult bulk billed for eligible patients
- We lodge your Medicare claim when you pay
- The 12-month telehealth rule, explained
Clinically reviewed by Associate Professor Christopher O’Donnell, Nurse Practitioner, FACN · AHPRA NMW0001453715 · Last reviewed 19 October 2026
Medicare has no specific “weight loss” item, but consultations about your weight can attract a Medicare rebate when they meet the Medicare Benefits Schedule (MBS) rules, and some are bulk billed, so you pay nothing. For telehealth, the main rule is that you need to have had a face-to-face consult with the same doctor, nurse practitioner or practice in the past 12 months, unless an exemption applies. At My Weight Loss Clinic, the initial consult is bulk billed for eligible patients, or $59.99 otherwise. Any medicines are priced separately by the pharmacy.
This guide explains how Medicare works for telehealth weight management in 2026, who may be eligible for bulk billing, and which costs Medicare doesn’t cover.
Does Medicare cover weight loss?
Medicare covers eligible consultations, not “weight loss” as a program. There’s no MBS item just for weight management, so a weight-related consult is billed like any other consult, using the standard time-based items.
Medicare can help with:
- consults with your doctor or nurse practitioner about your weight and related health conditions, when the MBS rules are met
- pathology and imaging your doctor or nurse practitioner requests, when they’re Medicare-eligible tests
- dietitian visits, but only with a chronic condition management plan (see below)
- specialist consults with a valid referral, and some surgical procedures
Medicare doesn’t cover membership or program fees, the private part of any consult fee, missed-appointment fees, or the cost of medicines (medicines are covered separately by the Pharmaceutical Benefits Scheme only when PBS criteria are met; your pharmacist can tell you the price).
What bulk billing means
When a consult is bulk billed, the clinic accepts the Medicare benefit as full payment. You sign over (assign) your Medicare benefit to the clinic, and you don’t pay anything for that consult. No extra charges can be added to a bulk-billed service.
Bulk billing is a choice each practice makes for each eligible service. It’s only possible when the service is eligible for Medicare in the first place.
How Medicare rebates work for consults
The Medicare rebate for a consult is set by the MBS and depends on the type and length of the consult. If a consult is eligible for Medicare but isn’t bulk billed, you pay the fee and Medicare pays you the rebate. Your out-of-pocket cost is the difference.
At My Weight Loss Clinic, if your consult is eligible for Medicare but isn’t bulk billed, we lodge your Medicare claim for you when you pay, so you don’t need to claim it yourself.
The 12-month rule for telehealth (from 1 November 2025)
Since 1 November 2025, Medicare telehealth rules apply to consults with our doctors and nurse practitioners, by both video and phone. A telehealth consult can only attract a Medicare benefit if, in the previous 12 months:
- the same doctor or nurse practitioner has given you a face-to-face service, or
- you’ve had at least one face-to-face service at the same practice that was billed to Medicare.
A previous video or phone consult doesn’t count. It has to be face-to-face. The rule was previously called the “established clinical relationship” requirement.
Exemptions. The rule doesn’t apply to some patients and services, including:
- people experiencing homelessness
- people living in a local government area that a state or territory has declared a natural disaster area
- children under 12 months
- blood-borne virus, sexual or reproductive health services
- services at an Aboriginal Medical Service or Aboriginal Community Controlled Health Service
Having a chronic condition isn’t, on its own, an exemption. If an exemption applies, your doctor or nurse practitioner must record it in your notes.
Who may be eligible for bulk billing at My Weight Loss Clinic
The initial consult at My Weight Loss Clinic is bulk billed for eligible patients. Whether you’re eligible depends on your circumstances, including the Medicare rules above. When you book, have your Medicare card ready, and tell us if you think an exemption applies to you. Your doctor or nurse practitioner will discuss eligibility with you.
If you’re not eligible for bulk billing, the initial consult is $59.99. Our other fees are:
| Consult | Length | Fee |
|---|---|---|
| Initial consult with a doctor or nurse practitioner | 20 min | $59.99, or bulk billed for eligible patients |
| Review consult | 10 min | $69.99 |
| Extended follow-up consult | 20 min | $85.99 |
| Dietitian follow-up consult | 20 min | $85.99 |
| Dietitian initial consult | 30 min | $100.99 |
| Medicines, if prescribed | Priced separately by the dispensing pharmacy |
See Fees, Medicare and bulk billing for cancellation terms, and how much an online weight loss clinic costs for worked examples.
Medicare-rebated dietitian visits
Medicare rebates for dietitian visits require a chronic condition management plan, prepared by your usual general practice for a patient with a chronic condition. Under a plan, you can get Medicare rebates for up to five allied health visits a year in total, which can include a dietitian.
If you have a plan and a referral for dietitian visits, you may be able to claim a Medicare rebate for consults with our dietitians. Otherwise, dietitian consults at My Weight Loss Clinic are private; some private health extras policies include dietitian visits, so check with your insurer.
If you have a chronic condition such as type 2 diabetes, it’s worth asking your usual healthcare provider whether a chronic condition management plan is right for you. They and our doctors and nurse practitioners can work together.
Medicare and specialist referrals
Our doctors and nurse practitioners can refer you to a specialist, and the specialist’s consult can attract a Medicare rebate. Referrals to specialists are usually valid for 12 months. If weight loss surgery is something you want to explore, your doctor or nurse practitioner can talk with you about a referral.
The Medicare Safety Net
If you have a lot of out-of-pocket costs for out-of-hospital Medicare services in a calendar year, the Medicare Safety Net may lower them once you reach a threshold. Families and couples can register to combine their costs. Services Australia publishes the current thresholds.
How to check what you'll pay
Before any consult, with us or anywhere else, ask:
- Is this consult bulk billed for me? If not, what is the fee?
- If it’s not bulk billed, is it eligible for a Medicare rebate, and how much is the rebate?
- Are there other costs, such as pathology, medicines, delivery or a membership fee?
- Does the 12-month telehealth rule affect me, or does an exemption apply?
or call us on 1300 295 139, 8am to 8pm AEST, 365 days a year.
Is weight loss covered by Medicare?
Medicare doesn’t have a specific weight loss item, but consults about your weight can attract a Medicare rebate when they meet the MBS rules. Medicare doesn’t cover program or membership fees, and medicines are covered separately by the PBS only when PBS criteria are met.
How do I qualify for medical weight loss under Medicare?
There’s no separate Medicare weight loss program to qualify for. Your consults can attract a Medicare rebate if they meet the MBS rules. For telehealth, you usually need a face-to-face consult with the same doctor, nurse practitioner or practice in the past 12 months, unless an exemption applies. Clinical eligibility for treatment is a separate question; see am I eligible?
Is My Weight Loss Clinic bulk billed?
The initial consult is bulk billed for eligible patients, or $59.99 otherwise. Your doctor or nurse practitioner will discuss whether bulk billing applies to you.
Can telehealth consults be bulk billed?
Yes, when the consult is eligible for Medicare. Since 1 November 2025, that usually means a face-to-face visit with the same doctor, nurse practitioner or practice in the past 12 months, unless an exemption applies.
How much is the Medicare rebate for a consult?
It’s set by the Medicare Benefits Schedule and depends on the type and length of the consult. If your consult with us is eligible for Medicare but not bulk billed, we lodge the claim for you when you pay.
Can I get Medicare-rebated dietitian visits?
Yes, if your usual general practice prepares a chronic condition management plan for a chronic condition. You can then claim rebates for up to five allied health visits a year, which can include our dietitians.
Does Medicare pay for medicines?
No. Medicare doesn’t pay for medicines. Some medicines are subsidised under the Pharmaceutical Benefits Scheme when PBS criteria are met. If your doctor or nurse practitioner prescribes a medicine, the pharmacy will tell you the price.
Sources (7)
- Services Australia. Bulk billing. https://www.servicesaustralia.gov.au/bulk-billing
- healthdirect. Bulk billing for medical services. https://www.healthdirect.gov.au/healthcare-and-services/costs-and-financial-support/bulk-billing-for-medical-services
- Department of Health, Disability and Ageing. AskMBS advisory: MBS telehealth eligible telehealth practitioner requirements (November 2025). https://www.health.gov.au/sites/default/files/2025-11/askmbs-advisory-mbs-telehealth-eligible-telehealth-practitioner-previously-known-as-established-clinical-relationship-requirements-clarification.pdf
- Department of Health, Disability and Ageing. Telehealth. https://www.health.gov.au/topics/health-technologies-and-digital-health/about/telehealth
- MBS Online. Item 10954 (dietetics under a chronic condition management plan). https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=10954&qt=item
- Services Australia. Medicare Safety Nets. https://www.servicesaustralia.gov.au/medicare-safety-nets
- Department of Health, Disability and Ageing. What private health insurance covers. https://www.health.gov.au/topics/private-health-insurance/what-private-health-insurance-covers