Doctors are warning after-hours home visits will come to a screeching halt if their pay is cut in line with recommendations by an independent taskforce.
The federal government's review of Medicare items has investigated a boom in urgent after-hours home visits following concerns by professional medical bodies, and official data showing a huge growth in costs.
In an interim report the review has recommended restricting the rebate paid for urgent services - but doctors say this will mean a "savage" pay cut of 60 per cent to just $45 an hour.
The review found growth was being driven by a boom in medical deputising businesses which provide after hours care.
It said some are claiming taxpayer-funded benefits for "urgent" services worth $153 for matters that could be dealt with in the daytime by a regular GP at a quarter of the cost.
The taskforce wants rebates for urgent after-hours services to be restricted only to GPs who normally work during the day, but are recalled after-hours for a patient in need of urgent assessment.
Medical deputising services would still be able to access the non-urgent after-hours rebate, worth $75.
Umberto Russo has been making after-hours home visits for 26 years, but says he will give it away if the "insulting" 60 per cent pay cut becomes reality.
"These patients definitely will end up in hospital emergency departments because I won't be seeing them and many other doctors will not be working for $45 an hour to be seeing these sorts of patients," the spokesman for the National Association for Medical Deputising told AAP.
"It's a savage cut - there is no way our doctors will work for such a rate."
The association has warned the taskforce home visits would immediately disappear in cities like Hobart and Darwin, and regional centres such as Townsville, before impacting major cities including Sydney and Melbourne.
The taskforce report says the use of urgent after-hours services swelled 150 per cent in the five years to 2015/16. Meanwhile, the benefits paid increased 170 per cent - from $91 million to $246 million.
Claims that the growth of urgent after-hours home visits had a significant impact on hospital emergency departments were not convincing, it said.
But the association insists usage has now plateaued, after it temporarily boomed while the sector rapidly expanded in recent years.
It says one in three calls received are not billed - with patients instead told to see their GP the following day - meaning a higher proportion of the patients treated are urgent cases.
It insists independent modelling by Deloitte shows states and territories will be coughing up $724 million over four years if home visits dwindle and patients instead present at hospital emergency departments.
The taskforce will make final recommendations to the government later this year.
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