Psychiatrists and paediatricians among specialists most likely to charge ‘extreme’ fees

More than 2.2 million Australians paid an “extreme” fee to see a specialist last year, with psychiatrists and paediatricians among the most likely to routinely unreasonably charge their patients, according to new research.

Specialists cannot justify exorbitant fees by blaming inadequate government rebates, or the costs of running a business, a report from policy thinktank the Grattan Institute found, as these factors explain only a fraction of the fee increases Australians have faced. While Medicare rebates fell in real terms by $9 per between 2012 and 2025, specialists increased patient fees by an average of $37 over the same period, recouping the lost subsidy more than four times over. The average specialist fee rose 4% on top of inflation in 2025.

In September, legislation passed allowing the government to publish the fees of all specialists on the Medical Costs Finder website, which will begin in 2027. The website has been voluntary for specialists to sign up to, with only about 100 out of 6,300 eligible specialists publicly disclosing their fees since it was established in 2019.

The lead author of the report, health economist Peter Breadon, said increased price transparency was important but would not be enough to fix what he described as a broken market failing to self-regulate. The report calls on federal and state governments to invest $500m each year to expand public hospital outpatient clinics; to roll out advice lines for GPs to quickly seek specialist advice so their patients can avoid a referral, wait time and fees; and to impose binding training quotas on medical colleges.