Specialist doctors charging fees up to five times the benchmark in Australia
A government report found that specialist doctors billed more than five times the standard fee on over a million occasions, while overall out-of-pocket costs have risen faster than inflation.
According to a Department of Health consultation paper, specialist doctors in Australia charged more than five times the government-set schedule fee on 1.24 million occasions, and a further six million services were billed at three to five times the benchmark. Out-of-pocket costs for out-of-hospital specialist visits rose by $458 per patient since 2019, a jump of over 75 percent to $4.17 billion, while private-insurance gap fees increased at a similar pace.
Dermatologists topped the list of over-charging specialties, followed by obstetricians, gynaecologists and sports and exercise specialists; anaesthetists led in-hospital excesses. The paper warned that opaque pricing and the provider-patient power gap are restricting access, particularly for those with chronic conditions or ongoing psychiatric care. Private Healthcare Australia’s chief executive called for broader action beyond the extreme outliers, citing delayed diagnoses and higher downstream costs. Health Minister Mark Butler said the government is seeking options to curb the rapid growth in out-of-pocket expenses and will publish more specialist billing information.
Why it matters
Excessive specialist fees strain household budgets and can delay essential medical care.
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