Why is it getting more expensive to see a specialist?

What is happening to specialist fees?

A referral to a gynaecologist, dermatologist or another specialist can bring relief: someone can help investigate a concern or plan treatment. But the cost of the appointment can be an unwelcome surprise, especially when household budgets are already stretched.

On 8 November 2026, the Grattan Institute published an analysis of Australian specialist fees. It found that fees have risen faster than inflation since 2023 and that more people are paying very high fees. The analysis covers specialist care broadly; the amount you are charged will depend on the specialist and the care you need. Read the analysis.

For an initial private appointment, Grattan reports a median out-of-pocket cost of $351 for a psychiatrist and $217 for a dermatologist. These figures show the middle of the costs in its analysis, not what every patient will pay. Ask the clinic for its current fee and the expected Medicare rebate. Grattan: specialist costs.

Grattan points to several pressures, including a limited supply of specialists and long waits for some public clinics. There is debate about the causes and solutions: the Royal Australian and New Zealand College of Obstetricians and Gynaecologists also calls for attention to Medicare funding, workforce and other pressures on women's healthcare. Neither explanation tells you what an individual specialist will charge. Grattan's discussion; the college's response.

Why might I have to pay if I have a referral?

A valid referral helps an eligible patient claim a Medicare benefit for a specialist appointment. It does not mean the appointment will always be free.

If the specialist bulk bills the appointment, they accept the Medicare benefit as full payment and you do not pay for that service. If they charge more, Medicare may pay part of the fee and you pay the difference, often called the gap or out-of-pocket cost. Healthdirect: bulk billing.

For example, if an appointment costs $250 and Medicare pays $100, your gap is $150. This is an illustration only, not a current fee or rebate: the actual amounts depend on the service and your circumstances. You may need to pay the full fee first and claim the Medicare benefit afterwards. Ask the clinic how it handles payment.

What should I ask before booking?

You can ask the specialist's reception team about costs before you make an appointment. It is reasonable to ask for the information in writing, particularly if you are comparing options.

• What is the full fee for the first appointment, and how much will I get back from Medicare?
• Do you bulk bill, and if so, does that apply to my appointment?
• Do I pay the full amount upfront, or only the gap?
• What do follow-up appointments usually cost?
• Could tests, procedures or other services involve separate fees?
• Do you accept my referral, and how long is the expected wait?

The Australian Government's Medical Costs Finder can help you understand typical costs for some private specialist services. Its figures are a guide, not a quote for your appointment. Ask the clinic for its own fees. Government guide to medical costs.

What if I can't afford the specialist?

Let your GP or referring clinician know. You can discuss whether a public specialist clinic or another suitable specialist is an option, and what the likely wait means for your health. If you are eligible for Medicare, a public specialist clinic may provide care at no cost to you as a public patient. Check the clinic’s eligibility, fees and waiting time before deciding; access and waits vary. Healthdirect: public and private specialist care.

You can also ask about your referral. Healthdirect says you can choose which specialist you see, and some referrals can be addressed generally rather than to a named specialist. A referral that names a specialist does not usually stop you seeing another specialist in the same field, but check with the new clinic before booking. If you have already seen a specialist using the referral, you may need a new one to change providers. Your GP can help you work out the next step. Australian Government: referral guidance; specialist referral rules.

A GP referral usually lasts 12 months from your first appointment with the specialist, unless the referral states a different period. Ask the clinic if you are unsure whether yours is still valid. Services Australia: referral periods.

If you are waiting for an appointment, ask your GP who to contact if your symptoms change, whether any care or tests are needed while you wait, and when to check in again. If symptoms are severe, rapidly worsening or feel like an emergency, seek urgent care rather than waiting for the specialist appointment.

Will private health insurance cover the gap?

Private health insurance does not cover specialist consultations in their private rooms. Different rules can apply to treatment as a private patient in hospital, where Medicare, your insurer and you may each pay part of the cost. Before hospital treatment, ask the specialist and your insurer for an estimate and check what your policy covers. Healthdirect: referral costs; Australian Government: out-of-pocket costs.

Are the rules changing?

The Grattan Institute has proposed changes to address high specialist fees, including action directed at specialists charging very high fees. These are proposals, not new rules that make your next appointment cheaper. The institute also calls for more specialists and better access to public clinics. Grattan's policy brief.

For now, asking about the fee before booking and discussing concerns with your GP can help you plan the next step.