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  • Writer's pictureJay Kasthuriarachchi

"I Thought it was free": Why we charge a gap for medicare

We are lucky to live in a country with such as strong medical system, that allows everyone access to affordable healthcare. Unfortunately the reality is that in the last 20 years or so, outside of the hospital system, Medicare has been neglected.


Since 1995, the rise of the Medicare rebate has not kept up with the cost of living.


In 2006, the rebate was $46.80. Today it is $55.50. That is less than a $10 price rise in 16 years. And unfortunately, for high quality physiotherapy care it is not feasible to bulk bill.




Then why does my GP bulk bill?


GPs are on a different system with Medicare. So even though their rebate has not increased much over the years, they have a bit more flexibility with how they do appointments. A GP rebate is $37.60 at a minimum (more for complex consultations). However, there is no set minimum time for them. Whether they see you for 1 minute or 15 minutes, they will get paid the same amount. A longer consult (15- 30 minutes) is $75.75.


For physios, we will always provide 45 minutes for an initial, and 30 minutes for a standard consult. Regardless of the time we spend, we are limited to only a $55.50 rebate.


In saying that, there have been more and more medical centres that do charge a gap in recent times, and there will be more that emerge in the future.


But the other physio doesn't charge a gap


There are some physio clinics that may not pay a gap. Here are a few reasons why that might be:


They spend much less than 30 minutes for a session

If they are spending less time with you, that allows them to squeeze in more sessions per a day


They are based in a single room with low overheads

A single room in a medical centre is not going to provide high quality physio or rehab. But it is extremely cheap.


They are trying to get in good with the doctors

Some doctors prefer to send patients to cheaper options. By offering bulk billing sessions, they are hoping that doctors will favor them when a non- EPC patient comes along


Conclusion


As much as we would like to bulk bill medicare sessions, the reality is we simply can't. We still maintain the most competitive fees in the area, but until more investment is put into Medicare, us (and most other high quality physiotherapy clinics) will have to continue to charge a gap.

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