Should You Bulk-Bill Your Exercise Physiology Services? A Pros & Cons Guide

One of the biggest pricing decisions for new exercise physiologists is whether to bulk-bill services. Bulk-billing means accepting the Medicare rebate as full payment, meaning the client pays nothing out of pocket. While this can help attract clients, it also has financial and operational implications for your business.

Let’s break down the pros and cons of bulk-billing so you can make an informed decision.

✅ Pros of Bulk-Billing

1. Increased Accessibility for Clients

  • Many clients, particularly those with chronic health conditions or financial limitations, prefer bulk-billed services because they don’t have to pay anything upfront.

  • You may attract more clients who wouldn't otherwise afford private exercise physiology services.

2. Steady Referral Flow from GPs

  • General practitioners (GPs) often prefer referring to practitioners who bulk-bill, as it removes financial barriers for their patients.

  • Being on a GP’s go-to list can provide a consistent stream of new clients.

3. Faster Payments (with Some Caution)

  • Medicare pays claims relatively quickly (usually within 24-48 hours), which can help with cash flow.

  • However, if there are billing errors, payments may be delayed.

❌ Cons of Bulk-Billing

1. Lower Income Per Session

  • The Medicare rebate for Exercise Physiology (under the Chronic Disease Management Plan) is $58.30 per session (as of 2024). If you bulk-bill, this is the total amount you receive.

  • Compare this to private clients who may pay $100-$150 per session, and you can see how bulk-billing may significantly limit revenue.

2. Potential for High No-Show Rates

  • When clients don’t have to pay for a service, they may be less committed, leading to more cancellations and no-shows.

  • You may spend time following up with clients or struggling to fill last-minute gaps.

3. High Volume = More Pressure

  • To make bulk-billing viable, you need to see more clients per day to earn a sustainable income.

  • This can lead to burnout or reduce the quality of care if you're rushing through appointments.

Alternative Approaches to Bulk-Billing

Instead of fully committing to bulk-billing, you may consider:

  1. Partial Bulk-Billing: Bulk-bill only select clients (e.g., pensioners, people with financial hardship).

  2. Gap Fees: Charge a small out-of-pocket fee in addition to the Medicare rebate (e.g., rebate + $20-$40 gap).

  3. Tiered Pricing: Offer premium services (longer sessions, more personalized care) for private clients while bulk-billing for standard appointments.

Final Verdict: Should You Bulk-Bill?

  • YES, if: You want to attract high GP referrals, focus on lower-income clients, or need quick payments.

  • NO, if: You want higher profitability, better client commitment, and less appointment volume pressure.