Why Doesn't Lion Rocker Health Bulk Bill Pensioners and Concession Card Holders?
Why Doesn't Lion Rocker Health Bulk Bill Pensioners and Concession Card Holders?
Understanding the difference between Medicare-funded healthcare and private physiotherapy
One of the most common questions we receive is:
"I'm a pensioner. Can't you bulk bill me?"
or:
"I have a concession card. Why do I still need to pay for physiotherapy?"
These are completely understandable questions.
Many Australians have experienced bulk billing with their GP and naturally assume that the same system applies to physiotherapy.
However, the way Medicare funds doctors and allied health professionals such as physiotherapists is very different.
To understand why many private physiotherapy clinics cannot simply bulk bill every pensioner and concession card holder, we need to understand the economics behind providing healthcare.
Why Can My GP Bulk Bill Me But Lion Rocker Physio Can't?
General practitioners and physiotherapists operate under different Medicare funding arrangements.
When a GP bulk bills eligible patients, such as pensioners and concession card holders, Medicare may provide additional bulk billing incentive payments to encourage doctors to continue offering no-gap appointments for these groups.
These incentives recognise that doctors are providing a publicly funded service while absorbing the costs of running a medical practice.
Physiotherapists do not receive the same bulk billing incentive payments.
For a Medicare-funded physiotherapy appointment under a Care Plan, the clinic receives the standard Medicare rebate.
Currently, that rebate is approximately $63.40.
Whether the patient is:
A pensioner
A Health Care Card holder
A Commonwealth Seniors Health Card holder
A concession card holder
the rebate does not increase.
The cost of providing care, however, stays exactly the same.
The receptionist still needs to be paid.
The clinic still needs to pay rent.
Equipment still needs maintenance.
The physiotherapist still needs ongoing education.
Why Do Some Physios Still Bulk Bill?
This is a great question. The answer lies in the economics of bulk billing — or, more accurately, the un-economics of it. We have a whole article explaining it
The reality is that bulk billing only works when the numbers can somehow be made to fit. And for many clinics, that means running on a loss.
A Simple Example: The Economics of Bulk Billing
Imagine a physiotherapy clinic that bulk bills every Medicare Care Plan appointment.
The physiotherapist sees:
16 patients per day
5 days per week
48 weeks per year
Annual Medicare revenue:
16 × $63.40 × 240 days = $243,456
At first glance, that sounds like a solid income.
But then we look at what it actually costs to run a professional clinic.
Expense
Approximate Annual Cost
Reception and administration
$80,000
Rent and clinic expenses
$30,000
Management and leadership
$20,000
Senior physiotherapy mentoring
$15,000
Professional development
$5,000
Software and IT
$6,000
Insurance
$3,000
Equipment maintenance
$5,000
Utilities, cleaning and consumables
$8,500
Accounting, marketing and compliance
$16,500
Total operating costs:
Approximately $189,000
After paying these costs:
$243,456 revenue
minus $189,000 expenses
= approximately $54,000 remaining
And that is before super and personal income tax.
So once the clinic has covered the cost of actually staying open, the physiotherapist may be left earning around:
$25–30 per hour before tax
That is not a thriving business model. It is a survival model.
If A Clinic Bulk Bills, Something Has To Give
This is not a criticism.
It is simply the reality of business.
Every healthcare practice has limited resources.
If revenue is lower, the clinic has to make decisions about how to stay sustainable.
Some clinics may choose to:
See more patients per day
Reduce appointment lengths
Minimise administrative costs
Invest less in equipment
Reduce mentoring and training
Operate with fewer support staff
But It Is Not Fair
Yes, you are right. It is not fair that people who can afford private care often have access to more choice, shorter wait times, and a different level of service.
The reality is that the Medicare funding model does not fully cover the cost of running a physiotherapy practice. If a clinic chooses to bulk bill, the shortfall has to be absorbed by the business or offset through lower wages, shorter appointments, fewer staff, or reduced services. In many cases, the only way for the practice to remain sustainable is to pass some of that cost on to patients.
At Lion Rocker Health, we believe patients deserve a high level of care, not just the minimum service that can be delivered within a constrained funding model. Our fees help us invest in experienced clinicians, longer and more thorough appointments, modern equipment, ongoing professional development, and the systems needed to provide safe, consistent, and effective treatment. We see this as part of delivering a better healthcare experience, rather than simply offering the cheapest one.
This is not unique to physiotherapy. Australia has always had a mixed healthcare system, with public and private options operating side by side. The public system exists to make sure people who cannot afford private care still have access to treatment, while private hospitals and clinics exist because some people choose to pay for a different environment and level of service.
The Role of Public Healthcare
Public healthcare is the safety net. It provides low-cost or fully funded care for people who need support and cannot reasonably access private services.
Depending on eligibility and location, patients may be able to access:
Public hospital physiotherapy departments
Community health physiotherapy services
Hospital outpatient programs
Government-funded rehabilitation programs
Other community support services
Although these services are free or low cost, they usually come with trade-offs such as:
Long wait times
Shorter appointment lengths
No choice over which physiotherapist you see
Fewer and less frequent follow-up appointments
Limited access to specialised equipment or treatment options
Eligibility restrictions
Less flexibility with appointment times
More group-based or standardised care pathways
These trade-offs are not a criticism of public healthcare. They are simply the reality of a system that must spread limited resources across many people.
For that reason, some people choose private physiotherapy instead. They may want faster access, longer appointments, more continuity with the same clinician, and a treatment plan that can be more individualised. Private physiotherapy costs money because those extra resources, time and flexibility have to be funded somehow.
Why Does Lion Rocker Physiotherapy Cost Money?
At Lion Rocker Health, we respect that everyone has different circumstances.
We understand that cost is a genuine concern for many Australians.
However, our decision as a private physiotherapy practice is to focus on providing a level of care that requires investment.
We invest in:
Experienced physiotherapists
Senior clinical support
Ongoing education
Interventional physiotherapy techniques
Modern equipment
Clinical systems
Patient education
Our fees allow us to maintain the environment and resources required to provide this level of care.
Choosing The Right Healthcare Option For You
If your priority is accessing physiotherapy at the lowest possible cost, bulk billing clinics and public healthcare services may be the most appropriate option.
If your priority is accessing a privately funded clinic with additional investment in staff, facilities, and services, private physiotherapy may be the better fit.
The important thing is understanding that these are different healthcare models.
A lower-cost service and a privately funded service are not designed in exactly the same way.
Like many things in life, healthcare involves choices.
The best choice is the one that matches your needs, expectations, and circumstances.
