Obstetrician billings & income calculator
Model a private obstetrician's income the way it really runs — not by the week, but by the pregnancies you manage in a year. Each one is an episode: an antenatal course, a private booking / management fee charged above the Medicare rebate at ~28 weeks, and a delivery. Set your births per year, your private-vs-public split and your fee, then take off the two things that define obstetric economics — the highest medical indemnity of any specialty and practice overhead — and see the after-tax take-home. Every figure is an editable, indicative default.
Interactive Australian private obstetrician income planner: set the number of pregnancies managed per year, the private-vs-public split, the private booking / management fee charged above the Medicare rebate (item 16590, 85% out-of-hospital benefit), the share of bookings reaching 28 weeks, the high-risk delivery share (items 16519 and 16522) and any delivery gap; take off the highest medical indemnity of any specialty and practice overhead; and see the practice revenue split and after-tax take-home.
Public / sessional & salaried work (optional)
Item rebates (editable — rooms items 85%, admitted delivery items 75% of schedule fee, indicative post-1-July-2026, verify on MBS Online)
How private obstetric billing works — the 60-second version
The booking fee is a private charge, not a Medicare item. A private obstetrician charges an out-of-pocket management fee — commonly $3,000-$5,000 in metro areas — around 28 weeks, which is when item 16590 (planning & management of a pregnancy, for the practitioner who intends to deliver) becomes claimable. Medicare rebates only the schedule fee for the eligible items; that rebate flows to the patient. Your income is the gap above the rebate, not the whole fee.
Once per pregnancy, and only after 28 weeks. Item 16590 is billed once per pregnancy, not per antenatal visit, and only once the pregnancy passes 28 weeks — which is why the fee is raised then, not at booking, and why a patient who miscarries earlier is generally not billed the full fee. A valid referral is required or no rebate is payable, and the item includes a mental-health assessment.
Delivery is one item regardless of mode. For the managing obstetrician, item 16519 covers birth by any means — spontaneous, instrumental or caesarean — at $830.60 plus 5 days of postpartum care. Only high-risk criteria bump it to 16522. The assistant-at-caesarean fee is ~1/5 of the operation fee and goes to a different practitioner. Anaesthetist, paediatrician and ultrasound fees are also billed by others — not your income.
Indemnity and overhead define the economics. Obstetric indemnity is one of the highest premiums of any specialty (~$65k-$100k+/yr) because of the long birth-injury claims tail. Off the private billings comes practice overhead (rooms, staff, midwife, software), and indemnity is a flat cost on top — before tax. Many obstetricians blend a public appointment (base income, indemnity subsidy) with private practice (the high-margin booking fees).
Frequently asked questions
How does a private obstetrician actually earn per pregnancy?
Most of the income is a private booking / management fee, not a Medicare item. The obstetrician charges an out-of-pocket fee (commonly $3,000-$5,000 in metro areas) around 28 weeks, when item 16590 becomes claimable. Medicare rebates only the schedule fee for the eligible items (16590 management, the delivery item and antenatal attendances), and that rebate flows to the patient. The obstetrician's income is the gap above the rebate, plus the small rebates on any bulk-billed or public work.
Why is the booking fee not just added to income?
The booking / management fee is a private charge, not a Medicare item. The patient pays the full fee, then claims the Medicare rebate for item 16590 back themselves. So the obstetrician's income from that fee is the gap — the fee minus the rebate — not the whole fee. Treating the fee as if Medicare pays it on top would overstate income.
Why is obstetric indemnity so high?
Obstetrics carries one of the highest medical indemnity premiums of any specialty — commonly $65,000 to $100,000 or more per year — because birth-injury claims can arise many years after the birth and can be very large. It is the single biggest fixed cost of a private obstetric practice and the main reason take-home is far below gross billings. A practitioner doing gynaecology only, without obstetrics, pays dramatically less.
Does the mode of delivery change the obstetrician's fee?
For the obstetrician who managed the pregnancy, no. Item 16519 covers birth by any means — spontaneous vaginal, forceps or vacuum, and caesarean — at the same schedule fee, plus five days of postpartum care. Only defined high-risk criteria change the item, to 16522. The assistant-at-caesarean fee is a separate item that goes to a different practitioner, not the managing obstetrician.