If you’ve recently tried to book an appointment with a specialist—say, a dermatologist or rheumatologist—you might have felt a sting that had nothing to do with your skin or joints. The real pain? The bill.
New data reveals that the cost of seeing a specialist in Australia is rising at a rate that’s leaving Medicare rebates in the dust, and more and more Australians are being forced to put off vital care as a result.
According to a new report from Cleanbill, an online healthcare directory, the average cost of an initial dermatology appointment has soared to nearly $300.
In March 2017, the Medicare rebate for such a visit was $72.75, with patients paying an average out-of-pocket cost of $148.73.
Fast forward to March 2025, and while the rebate has increased to $84.15 (an increase of just $11.40), the average out-of-pocket cost has ballooned to $210.18—a jump of more than $61.
Over eight years, that’s a 40 per cent increase in out-of-pocket costs for an initial consultation and a staggering 55 per cent increase for follow-up visits.
Meanwhile, the Medicare rebate has risen by less than 16 per cent. When Cleanbill looked at all 280 dermatology clinics currently operating, the average upfront cost was $296.71—more than three and a half times the Medicare rebate.
Here’s the kicker: private health insurance doesn’t cover out-of-hospital specialist consultations. While your policy might help with hospital stays, physio, dental, or even psychology, it won’t touch the cost of seeing a specialist in their rooms.
James Gillespie, Cleanbill’s chief executive, puts it bluntly: ‘These out-of-pocket costs far exceed the increases that we’ve seen to the Medicare rebate.’
It’s no wonder the number of Australians putting off specialist care due to cost has exploded—from 176,000 in 2016-17 to a whopping 900,000 in 2023-24, according to the Australian Bureau of Statistics.
The domino effect
Getting to a specialist isn’t as simple as just making an appointment. You’ll need a referral from your GP (General Practitioner), which means another round of out-of-pocket costs before you even get to the specialist’s waiting room.
And while public outpatient clinics offer free specialist care, you’ll need that referral, and then you’re at the mercy of hospital waitlists and triage systems.
For those with chronic conditions, the situation is even more dire. A recent study published in Health Policy found that a third of people living with chronic diseases can’t afford to attend specialist appointments.
Many are forced to make impossible choices—seeing whichever specialist is treating ‘what’s hurting most at the time,’ as Associate Professor Jane Desborough from the Australian National University puts it.
Professor Yuting Zhang, a health economics expert at the University of Melbourne, said that while some specialist fees are ‘super-high’—up to $1,200 for the same service—there’s no evidence that higher prices mean higher quality.
‘More expensive doesn’t really mean better,’ she said.
What’s being done?
The government has promised $7 million to expand the Medical Costs Finder website, which will provide patients with more information about specialist fees.
But so far, only 70 out of 11,000 registered specialists have chosen to display their fees. Professor Zhang argued that transparency is just the first step—a policy is needed to address the underlying problem of rising costs and stagnant rebates.
Health Minister Mark Butler has called on the private health sector—including insurers and specialists—to do more to protect patients from ‘exorbitant bills’.
There are also calls for specialist medical colleges to develop codes of conduct around fee practices and for the government to open more public clinics offering free specialist care.
For many Australians, the cost of specialist care isn’t just a line item in the budget—it’s a barrier to living a full life.
Some are forced to forgo essentials like healthy food, social activities, or family holidays to afford their needed care.
As Desborough says, ‘That’s not in the spirit of Medicare.’
What can you do?
If you’re struggling with the cost of specialist care, you’re not alone. Here are a few tips:
- Ask about bulk-billing: Some specialists offer bulk-billing, especially for pensioners or concession card holders. It never hurts to ask.
- Shop around: Fees can vary widely, even within the same specialty. Use online directories or call around to compare prices.
- Check public options: Public outpatient clinics may offer free specialist care if you can wait.
- Talk to your GP: They may know which specialists are more affordable or have shorter wait times.
Have you put off seeing a specialist because of the cost? Have you found ways to manage out-of-pocket expenses, or do you have tips for others in the same boat? We’d love to hear your experiences and advice—share your thoughts in the comments below.
Also read: ‘Practices like ours are dying’: GPs explain why Medicare’s investment isn’t enough
This is because people believed the lies of the PM when he waved the medicare card around during the campaign. Same as if aged pensioners get a referral for podiatrist & chiropractic it is only for 5 visits per calendar year between the 2 so if you need to go to both more than twice each year you need to work out which you are going to use them for and pay full price for one and the gap for the other. My husband needed Chiro every week for a number of months so it ran out after a month + 1 visit to the podiatrist so no more visits to the podiatrist & cut Chiro down to every 3rd week & is now thinking of putting up with the pain until January