Psychiatrists and paediatricians among Australia’s highest-charging specialists, report says

More than 2.2 million Australians paid what the Grattan Institute defines as an “extreme” fee to see a specialist in 2025. Its report says psychiatrists and paediatricians are among the specialists most likely to charge far above the government’s Medicare benchmark, and argues that rising fees cannot be explained mainly by reduced rebates or business costs.

The report defines an extreme fee as at least three times the Medicare schedule fee, and says the number of patients facing such charges has grown by about 250,000 a year. The average specialist fee rose 4% above inflation in 2025; fewer than a quarter of initial consultations were bulk-billed. Recommendations include requiring specialists whose average annual fees exceed three times the benchmark to repay rebates, while patients keep theirs, and investing $500m a year to expand public outpatient clinics.