The sad truth about 'extreme' specialist fees

Aussies are paying hundreds of dollars more to see medical specialists than they were just a few years ago. Experts say fees are "out of control" and rising faster than they should be, but admit there's only a few things consumers can do to save.

A leading think tank has described the cost of seeing a medical specialist in Australia as "out of control," finding millions of people are paying "extreme fees" for appointments.

New analysis by the Grattan Institute found psychiatrists and dermatologists were among the most expensive.

In the past year, the median fee for an initial consultation with a psychiatrist has gone up by more than 20% (on top of inflation), while the cost of seeing a dermatologist has risen 7%.

Extreme costs putting people off healthcare

The hikes seen over the last 12 months are just the latest in a succession of increases in out-of-pocket fees seen across most medical specialties.

The Grattan Institute says the average cost of an appointment has grown threefold since 2023, faster than the general level of inflation in the economy.

The think tank defines an "extreme fee" as one that is more than triple the cost listed for the procedure under the Medicare Benefits Schedule.

It says 2.2 million patients paid a fee of this size at least once in 2025, double the number in 2020 and more than four times the rate of a decade ago.

Experts say the high cost of seeing a specialist is leading people to "ration" their own care and put off getting help.

The Grattan Institute believes more than 800,000 Australians a year are skipping or delaying seeing a specialist because of the cost.

The organisation says the federal government should withdraw Medicare funding from doctors who charge too many extreme fees, in addition to training more specialists.

Doctors say government support isn't keeping up

The Australian Medical Association (AMA) says it wants to work with government and regulators to tackle extreme outlier fees.

But the group representing the country's medical professionals says a high fee isn't always the fault of the consulting specialist.

"A patient's out-of-pocket cost is not the same thing as a doctor's fee," says AMA President Dr Michael Bonning.

"The gap patients pay is what is left after Medicare makes its contribution and a patchwork of private health insurers make their differing contributions."

The AMA says these rebates, especially those from Medicare, are inadequate and not keeping up with the costs borne by medical practitioners.

What can you do to save on specialist appointments?

Advocates describe the market for medical specialists as "broken", with little opportunity for patients to get a better price by shopping around.

"Consumers should compare where they can, but we shouldn't pretend this is like buying a fridge," says Dr Elizabeth Deveny, CEO of the Consumers Health Forum.

"You may have one referral, one local specialist and a long public wait. That is not much of a market."

"The strategies to save are really limited," agrees Joanne Yates, CEO of Health Consumers New South Wales.

"You either pay the fee [for a private specialist]... or be put on a public waitlist and those can be up to two years in length."

In addition to these hurdles, advocates add that private health insurance may only cover a small part of a specialist's fee.

That being said, there are a few things you can do to prepare your budget for an appointment with a specialist:

1. Get ready for multiple costs: "Ask for the price in writing before you book," says Dr Deveny. "And ask what the scans, tests and follow ups will cost on top. The first appointment is rarely the whole bill."

2. Consider remote treatment: While only suitable for certain appointments in particular situations, talking to a specialist via videocall where possible could help you save on some costs, such as travel.

"If telehealth is an option and one that's accessible and you don't mind not having the face-to-face interaction, then that can be a solution," says Yates.

New promise for website to compare prices

The federal health minister himself admits specialist fees are "getting out of control".

The federal government's Medical Costs Finder website is meant to allow you to compare fees.

But experts say few doctors have uploaded their information to it, so it doesn't give consumers an accurate indication of how much an appointment will cost.

The Grattan Institute says parliament has passed legislation to automatically publish individual specialists' fees on the site, making it more accurate.

But this isn't expected to come into force until next year.

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