Specialists may soon have to make their fees public after legislation to allow the government to publish such details was introduced to Parliament.
The government has put forward the Health Legislation Amendment (Improving Choice and Transparency for Private Health Consumers) Bill 2026 to allow it to publish details online about what individual medical specialists charge for particular services on its Medical Costs Finder site.
This was a commitment made by Labor in the lead up to the last election.
The Australian government launched the Medical Costs Finder website in 2019, when the Liberal/National coalition was in power, in an effort to improve transparency around specialist fees for the general public.
However just six of 6300 specialist doctors across the country had chosen to voluntarily display their fee information by the end of 2022.
According to Health Minister Mark Butler that number has since risen to 88 individual doctors.
The government also proposes to publish Medicare, hospital and insurer billing data already collected, on the Medical Costs Finder in an effort to improve transparency.
The Bill requires insurers to seek ministerial approval for premiums for new products and if making certain changes that reduce the cover or value of existing products.
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AMA (WA) President Dr Kyle Hoath told Medical Forum other drivers of rising out-of-pocket costs should not be overlooked.
“We have endured decades of inadequate Medicare indexation and increasingly restrictive private health insurance policies characterised by rising premiums and benefits which do not keep pace with wage growth and inflation,” he said.
In addition, the legislation aims to outlaw a practice known as “product phoenixing”, where private health insurers close a product and re-open an identical one at a higher price, or reduce the value of a product.
AMA National President Dr Danielle McMullen said the association had consistently called for this practice to be banned and welcomed the government’s action to put an end to it.
“The AMA has pushed hard for Medicare rebates and insurer benefits to be included on the Medical Costs Finder, so that patients get the full picture of why they may face an out-of-pocket cost,” she said.
Dr McMullen said while the AMA had been an advocate for the Medical Costs Finder website, earlier versions were unworkable for practice managers and doctors.
“Private health insurers have been extremely reluctant to upload their information, which also created a significant disincentive for doctors to upload their own billing data,” she said.
“Access to insurer data is crucial for patients, alongside clear information on Medicare rebates, which have failed to keep pace with inflation for decades and remain a major driver of out‑of‑pocket costs.”
Dr McMullen said the AMA expected close consultation to occur with the profession to ensure upgrades to the Medical Costs Finder were implemented effectively, with a focus on accuracy and ensuring the information genuinely supports patients.
Private Healthcare Australia (PHA) chief executive Dr Rachel David welcomed the move, adding that health funds stood ready to contribute more data to help consumers better understand typical charges and expected out-of-pocket costs.
“Health funds want their members to be able to compare fees and know what they are signing up for so they can access private healthcare with confidence,” she said.
Enhancing fee transparency on the Medical Costs Finder was identified as a key reform in PHA’s recent report, Restoring affordable access to specialist care in Australia.
Informed by a survey of more than 4000 Australians it also highlighted a need for stronger consumer protections to eliminate surprise billing, boosting specialist supply, particularly in regional areas, and workforce reforms to expand patient choice.
It found some specialist doctors such as psychiatrists and surgeons were charging $500–$1000 upfront for a first appointment, and some were charging illegal ‘booking’ or ‘admin fees’.
Other findings included that the median in-hospital specialist gap fee had risen 22% since 2022, one in two patients did not know their fee before attending an appointment, and more than a third (38%) of patients had received an unexpected bill.
According to PHA, nearly 30% of Australians delayed or cancelled specialist care in the past three years due to cost pressures.
Minister Butler said the purpose of the legislation was to help Australians find the best value when they need specialist medical advice and treatment.
“We know an increasing number of Australians are not taking up referrals from their GP to see a specialist due to concern about cost, but this legislation will give hard working Australians the clarity they deserve about costs and more choice in their health care,” he said.
“Specialists and private health funds have been given the opportunity to be upfront about patient costs and out of pocket expenses but frankly, have failed to do so.”
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