How much does it cost to see a specialist in Australia?

There is no single price. Medicare sets a schedule fee for a referred specialist visit and pays a fixed rebate (85% of the schedule fee for a visit in the specialist's rooms). The specialist chooses what to charge above that, and the difference is your out-of-pocket gap. The only way to know your gap in advance is to ask the rooms for the fee when you book.

What is the Medicare rebate for a specialist visit?

For a first referred visit in a specialist's rooms, item 104, the schedule fee is $103.95 and Medicare pays 85% of it, $88.40 (checked on MBS Online, 3 November 2026). A consultant physician first visit, item 110, has a schedule fee of $183.35 with an 85% rebate of $155.85. Follow-up visits are lower. In-hospital attendances are rebated at 75%.

Can I find out what a specialist charges before the appointment?

Yes — ask the rooms when you book. You are entitled to informed financial consent: a clear statement of the fee, the Medicare rebate and your out-of-pocket cost before the service. The Government's Medical Costs Finder was meant to show this, but as of 2026 only about 11 specialists had published their fees, so asking the rooms directly is the reliable route.

Why is the gap not shown on this page?

Because no one can know it in advance except the specialist. The schedule fee and Medicare rebate are fixed and shown here. The gap depends entirely on what your specialist chooses to charge, which can be anything from zero (bulk billed) to several hundred dollars. This page shows the fixed figures and helps you work out your gap once the rooms give you a quote.

Specialist Appointment Costs — What Will I Actually Pay?

📋 Sources: Schedule fees and Medicare benefits read on MBS Online (items 104, 105, 110, 116, 119) on 3 November 2026, effective 1 July 2026. Medicare Safety Net thresholds per the MBS Online 1 January 2026 note (GN.10.27). Medical Costs Finder participation figure: The Medical Republic, May 2026. Fees are indexed on 1 July each year — always confirm at mbsonline.gov.au. Information only, not medical or financial advice.

The three numbers behind every specialist bill

1. The schedule fee

What Medicare decides a service is worth. The same across Australia.

Fixed by Medicare

2. The Medicare rebate

What Medicare pays back. For a visit in the specialist's rooms, that's 85% of the schedule fee.

Fixed by Medicare

3. The gap

The specialist chooses what to charge above the rebate. Anything from $0 (bulk billed) to several hundred.

Set by the specialist

Only the specialist knows number 3 before your appointment. That is why we don't show a “typical gap” here — it would be a guess. We show the two fixed numbers, and help you work out your gap the moment the rooms give you a quote.

Work out your out-of-pocket

Which kind of appointment?

Not sure which? The rooms will tell you the item number. Physicians (cardiology, endocrinology, renal, respiratory, neurology and similar) usually bill 110/116; procedural specialists (surgery, dermatology, ophthalmology, ENT) usually bill 104/105.

Schedule fee

$183.35

Medicare rebate (85%)

$155.85

Rebate shown is for a visit in the specialist's rooms (85%). An attendance while you are admitted to hospital is rebated at 75% ($137.55). Figures verified on MBS Online, 3 November 2026.

What did the rooms quote you for this visit? ($)

Your out-of-pocket for this visit

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What to ask the rooms before you book

You are entitled to informed financial consent — a clear statement of the fee, the Medicare rebate and your out-of-pocket cost before the appointment. It's reasonable to ask for it in writing. These are the questions that get you a real number:

What is the item number and fee for the first appointment?
What will Medicare pay back, and what is my out-of-pocket gap?
Are there extra costs on the day — tests, scans, a procedure, or a second item number?
Will there be follow-up appointments, and what do they cost?
Do you bulk bill, or offer a reduced fee for pension or concession card holders?
If a procedure is likely, can I get the costs in writing before I agree?

What about the government's cost tool?

The Government runs the Medical Costs Finder, which is meant to show typical specialist fees. It's worth a look for averages across a whole procedure. But publishing fees is voluntary, and as of 2026 only about 11 specialists had done so — out of roughly 30,000 (The Medical Republic). So for your own specialist, asking the rooms directly is still the only reliable way to know your cost.

Common questions

Why don't you just show me the typical gap for a cardiologist?

Because the gap isn't a fact we can look up — it's a choice each specialist makes, and it varies from zero to hundreds of dollars for the same item number. We only publish numbers we can verify against an official source. The schedule fee and Medicare rebate are fixed and shown above; the gap is yours to confirm with the rooms. Anyone showing you a precise “typical” gap for your specialist is estimating.

Do I need a referral?

Yes — to get the Medicare rebate for a specialist visit you need a current referral, usually from your GP. A GP referral lasts 12 months; a specialist-to-specialist referral lasts 3 months. Without a valid referral, Medicare does not pay the rebate and you pay the full fee.

What is the Medicare Safety Net?

Once your out-of-pocket costs for the year pass a threshold, Medicare pays a higher share of the schedule fee for the rest of the calendar year, so your gaps get smaller. See safety nets explained for the current thresholds. It resets on 1 January.

Is the first appointment always the dearest?

Usually. The first (initial) attendance has a higher schedule fee than follow-ups because it covers taking your full history. A physician first visit (item 110) has a schedule fee of $183.35; a follow-up (item 116) is $91.70. Your specialist's charge follows a similar shape, but they set the actual figures.

MedCost Finder — estimate GP and service costs
Private hospital cost estimator (for procedures)
Medicare and PBS safety nets explained
Medicare FAQ — bulk billing, rebates, referrals

General information about Medicare fees, not medical or financial advice. Schedule fees and rebates are fixed by Medicare and shown as verified on MBS Online (3 November 2026); your actual out-of-pocket cost depends on what your specialist charges. Always confirm the fee with the specialist's rooms and the current figures at mbsonline.gov.au.

Specialist appointment costs