Estimate Example - Gap (Standard)
Scenario: The practitioner or practice does not have an agreement with a health fund and has not opted into a scheme; they charge their own fees. Therefore there will be an out-of-pocket expense for the patient, which will be displayed in the Gap column of the New Estimate of Fees window.
The calculations are based on the following:
- The doctor's fees are displayed under Fee.
- The Medicare rebate of (75%) is displayed under Medicare.
- Health fund (25% of MBS Fee) is displayed under Health Fund.
- Gap difference is displayed under the Gap.

This table shows an example of a practitioner charging above the schedule fee for item 32090.
Practitioner Charges for Item 32090 $603.00 Less Rebate Medicare ($376.90)
Health Fund ($125.60)
502.50 Gap to pay $100.50