Founder Guide · Updated 18 May 2026
Practical, action-ordered, and AU-specific. Covers AHPRA, business structure, ABN/GST, professional indemnity, premises and fit-out, HICAPS and Medicare billing rails, your clinical software stack, and how to win your first 50 patients.
In this guide
Before you sign a lease or take a single patient, confirm your registration with the Australian Health Practitioner Regulation Agency (AHPRA) is current, your endorsements cover the services you plan to deliver, and you are not operating outside your defined scope of practice. Any conditions, undertakings, or reprimands on your registration are public — patients, insurers, and referrers will see them. New graduates must also satisfy supervised practice and continuing professional development (CPD) obligations under the relevant National Board (Medical, Dental, Physiotherapy, Psychology, Nursing, etc.).
Check your AHPRA record
Search yourself on the public register. Verify endorsements (e.g. acupuncture for physios, scheduled medicines for nurse practitioners).
Scope of practice
Document the procedures and patient cohorts you are competent and indemnified to treat. Stay inside it.
Registration conditions
Conditions, undertakings, or notations follow you. Address before opening — they affect PII and contracts.
CPD obligations
Most boards require 20-50 hours per year. Track from day one — audits do happen.
Supervised practice
Limited registration or provisional psychologists need an approved AHPRA supervisor in place before billing.
Professional indemnity declaration
You must declare PII annually at AHPRA renewal. No PII = no registration = no practice.
Health practitioners face structuring choices that ordinary businesses don't — chiefly the Personal Services Income (PSI) rules and the long-standing practice of service-entity arrangements (especially in medicine). A solo physio earning fees personally is almost always caught by PSI, meaning the income is taxed in the practitioner's hands regardless of structure. A medical practice that owns rooms, employs reception staff, and pays GPs as contractors typically runs a service trust or Pty Ltd alongside the practitioner's sole-trader ABN. Get this wrong and you may face Part IVA general anti-avoidance scrutiny from the ATO.
Sole trader
Simple, cheap. Personal liability. Most allied-health solo practitioners start here.
Pty Ltd
Limited liability, ~$500 setup, ~$300/yr ASIC. PSI rules still attribute fee income to you unless you pass the PSB tests.
Service trust / service entity
Common in medicine. Service entity provides rooms, staff, admin; practitioner pays a service fee (must be commercially reasonable per TR 2006/2).
PSI / Personal Services Business test
Results test, 80/20 rule, unrelated-clients test, employment test, business-premises test. Talk to a tax adviser.
Group practice
Multiple practitioners under one banner. Decide associateship vs employment vs facility-fee model up front.
Tax-effective accounting
Workpapers, BAS, FBT on company cars, Div 7A on loans. Don't DIY in year two.
Health professionals are in an unusual GST position — most services supplied by a recognised practitioner are GST-free under Division 38-7 of the GST Act, provided the service is generally accepted in the profession and the supply is to the patient (not a third party). But ancillary supplies — room rental to other practitioners, administration fees, medico-legal reports, non-recognised services — are taxable. You still need an ABN, and you still register for GST once your turnover (including taxable supplies) hits or is expected to hit $75,000.
ABN
Free, instant, mandatory before you can invoice or claim Medicare. Apply via the Australian Business Register.
GST-free services
Direct patient care by a recognised practitioner (medical, dental, physio, psych, OT, podiatry, chiro, optical, nursing, etc.).
Taxable supplies
Room rental, medico-legal/IME reports, employer assessments, cosmetic-only procedures, retail product sales.
Mixed supplies
Many practices have both. Apportion GST accurately — the ATO has audited this hard.
BAS quarterly
Even mostly-GST-free practices lodge BAS quarterly because of the taxable component.
PAYG instalments
Once you have a profitable year, the ATO will issue quarterly PAYG instalment notices.
Professional indemnity insurance is non-negotiable. AHPRA registration requires it. Medicare credentialing requires it. Health-fund provider agreements require it. NDIS registration requires it. The catch: PII is occurrence-based for some specialties and claims-made for others, and moving practices triggers a run-off cover obligation that often runs 7 years or longer. Get PII in place before you see your first patient — and re-check cover whenever you add a new procedure, telehealth jurisdiction, or contracted clinician.
Avant Mutual
Largest medical defence organisation in Australia. Doctors, dentists, students.
MIGA
Medical Indemnity Group Australia. Doctors, dentists, eligible midwives.
MIPS
Medical Indemnity Protection Society. Doctors, students, eligible midwives, dental.
Guild Insurance
Allied health (physio, OT, psych, podiatry, chiro, dietitian, speech).
BMS / Aon / Berkshire
Brokered cover for allied health and smaller specialties.
Run-off cover
Continued cover for claims arising from past practice. 7+ years standard. Check before changing insurer.
Cosmetic / high-risk extras
Cosmetic injectables, IUDs, surgical assist often need top-up cover. Declare every service line.
Health premises carry a stack of obligations that retail or office tenants don't face. Disability Discrimination Act 1992 (DDA) compliance means accessible entry, accessible toilets, and accessible consult rooms. Infection-control standards depend on what you do — a GP clinic doing minor surgery must meet TGA reprocessing requirements for reusable medical devices, while a talking-therapy psychologist has lighter requirements. State health departments and local councils both have a say. Many new operators start in serviced rooms or telehealth to defer fit-out cost.
Full lease + fit-out
Highest cost ($80k-$400k+ fit-out). Best long-term margin. Make-good clauses can be brutal — negotiate hard.
Serviced consult rooms
Hourly or sessional rent in an existing clinic. Low risk, fast start, limited branding.
Telehealth-only
Lowest cost. Allowed for most non-procedural services. Check AHPRA telehealth guidance and Medicare item-number rules.
DDA compliance
Accessible entry, parking, toilet, consult room. Premises Standards 2010 apply on new fit-out or substantial renovation.
Infection control
NHMRC Australian Guidelines for the Prevention and Control of Infection in Healthcare. TGA reprocessing for reusable instruments.
Child-safe environments
Mandatory in NSW, VIC, QLD, SA, WA, TAS, ACT, NT for any service to under-18s. Policies + Working with Children Checks.
Local council DA
Some councils require a development application for change-of-use to a health consulting room. Check before signing.
The billing stack is what most new operators underestimate. Australia has four parallel public/private payer systems plus state-based schemes, and each needs its own credential, account, terminal, or portal. Get the rails right before opening day — chasing a Medicare provider number while a waiting room fills up is no fun. If you take pre-payments (e.g. cosmetic deposits, package plans) you must hold the money in a separate trust-style account in most jurisdictions.
Medicare provider number
Issued by Services Australia per location. Apply early — 4-6 weeks is common. Required for MBS billing and bulk-billing.
HICAPS Trinity terminal
On-the-spot private health rebates: Medibank, BUPA, HCF, NIB, Australian Unity, HBF, Defence Health, etc. ~$33/month + transaction fees.
Medicare Easyclaim
On-the-spot Medicare rebates via HICAPS or Tyro. Mandatory for most bulk-billing workflows.
Tyro Health (Medipass)
Alternative to HICAPS — integrated claims for Medicare, DVA, WorkCover, NDIS, private health. Cliniko/Halaxy integration.
DVA D9000
Department of Veterans' Affairs provider application. Allied-health and medical schemes for Gold/White card holders.
NDIS provider portal
Register as an NDIS provider (or operate as unregistered for plan-managed/self-managed only). Price-limited; see the NDIS Price Guide.
WorkCover / icare / WorkSafe
State-by-state. Each state's scheme requires separate registration and uses different item-number tables.
Trust account for prepayments
If you accept deposits or package payments, hold funds separately until the service is delivered.
Choose your practice management system before opening day — migrating later costs you weeks of data entry and the trust of every recurring patient. The AU market has clear segment leaders: Best Practice and Medical Director dominate GP; Genie and Gentu sit in specialist medicine; Cliniko and Halaxy lead allied health; D4W and Dental4Windows hold dental. All must interoperate with the My Health Record system, secure-messaging providers (Argus, HealthLink, Medical Objects), and your claims terminal. Picking software that doesn't talk to your HICAPS terminal is a daily, expensive mistake.
Practice management (GP)
Best Practice, Medical Director, Zedmed. PIP-compliant, secure-messaging-ready, AIR/AHPRA integrations.
Practice management (specialist)
Genie, Gentu, Shexie, Clinic to Cloud. Theatre lists, correspondence, referral tracking.
Practice management (allied)
Cliniko, Halaxy, Power Diary, Nookal, Splose. Online booking, telehealth, Medicare/HICAPS integration.
Practice management (dental)
Dental4Windows, Praktika, Centaur, Oasis. Charting, imaging integration, HICAPS.
Claims terminal
HICAPS Trinity, Tyro Health (Medipass). Must integrate bi-directionally with your PMS.
Telehealth platform
Coviu (AU-built, RACGP-endorsed), Healthdirect Video Call (free state-funded), Zoom for Healthcare.
Secure messaging
Argus, HealthLink, Medical Objects. Required for GP referrals and specialist letters.
My Health Record
Connect via the National Authentication Service for Health (NASH). Mandatory for PIP eligibility (GP).
Patient acquisition for a new practice runs on three rails: referrer networks, search/local listings, and locum or contract work that backfills the slow weeks. For medical practices, GP referral pads and a one-page service summary distributed locally drive most early flow. For allied health, the Chronic Disease Management (CDM) plan — formerly EPC — is gold, and getting on the referral lists of 5-10 nearby GPs in your first month makes the difference between a profitable and unprofitable year one.
GP referrer outreach (medical)
Branded referral pad, one-page service summary, in-person introduction. Aim for 10 GPs in your first month.
Allied-health letters (CDM/EPC)
Send back a concise outcome letter for every CDM-referred patient. This is your single biggest re-referral driver.
Google Business Profile
Free. Critical for 'physio near me' / 'dentist near me'. Reviews and recent photos matter more than you think.
HealthEngine / HotDoc
Online booking marketplaces. HotDoc dominates GP; HealthEngine covers GP + allied + dental. Per-booking fees.
Professional society directories
APA (physio), AHPA (psychology / health-policy bodies), ADA (dental), RACGP/ACRRM, OT Australia, Speech Pathology Australia.
Locum work
Fills gaps in your calendar in year one without diluting your brand. Use locum agencies or peer networks.
NDIS plan-manager outreach
Plan managers refer to providers they trust. Direct introductions to 5-10 plan-management firms compound quickly.
Aged-care facility contracts
Allied health visits to RACFs (residential aged-care facilities) under the AN-ACC funding model — stable, recurring.
Every one of these has cost a real Australian practitioner a notification, a Medicare repayment, or worse. Read them once now — re-read them six months in.
Seeing a patient before PII is bound
Indemnity isn't retrospective. A single consult before your policy starts can leave you personally liable. Get written cover confirmation, not just a quote.
Billing compensable patients to Medicare
Section 20A of the Health Insurance Act 1973 prohibits Medicare billing for services payable under workers' compensation, motor accident, or third-party schemes. Bill the scheme, not Medicare — getting this wrong triggers PSR review.
Inadequate consent documentation
Verbal consent is insufficient for procedural work, sedation, cosmetic services, and anything involving children. Use written, service-specific consent and store it for the full record-retention period.
Scope creep beyond training
Adding dry needling, cosmetic injectables, paediatric-specific therapy, or scheduled-medicine prescribing without the AHPRA endorsement and training record is the fastest route to a notification.
Skipping record-retention obligations
Adults: 7 years minimum from last entry. Children: until age 25 (or 7 years post-18, depending on state). Some states require longer. Digital records must be backed up and recoverable.
Treating telehealth as a Medicare loophole
Post-COVID telehealth MBS items are tightly scoped — established-patient rules, geographic eligibility, video vs phone-only restrictions. Read the item descriptors before billing.
Only if you want to bill Medicare or DVA, or refer to specialists who require a referring provider number. Many allied-health practices operate cash/private-health-only without one. You apply through Services Australia's HPOS portal once you have AHPRA registration and a confirmed practice address — allow 4-6 weeks. A provider number is location-specific, so if you operate from two clinics you need two numbers.
Realistically 3-6 months from decision to opening day, even with everything moving in parallel. The slowest steps are usually fit-out (8-16 weeks), Medicare provider number (4-6 weeks), HICAPS terminal (2-4 weeks), and DA/council approval if change-of-use is required (6-12 weeks). Telehealth-only or serviced-room starts can compress this to 4-6 weeks.
Most startup costs are deductible — capital fit-out depreciates over its effective life, professional fees and registration costs are deductible, equipment under the relevant instant-asset write-off threshold is immediately deductible, and pre-trading expenses can often be claimed in the year you start trading. Speak to a health-sector accountant about the small-business CGT concessions and the 'commencement of business' tests under TR 2017/1.
AHPRA requires a recognised supervisor for practitioners with limited or provisional registration — for example, provisional psychologists completing their 4+2 or 5+1 pathway, and overseas-qualified practitioners on a supervised practice order. The supervisor must hold full registration in the same profession, meet the National Board's supervision standards, and submit periodic reports. Have your supervisor formally appointed and AHPRA-approved before seeing any patients.
Yes for most non-procedural services, subject to AHPRA's Telehealth Guidance for Practitioners and the relevant Medicare item-number rules. You must still have a registered practice address, hold appropriate PII (some insurers exclude cross-border consultations), comply with privacy and consent requirements, and have an emergency-escalation protocol. Some services — physical examination-dependent care, certain Medicare items, in-person-only state-scheme assessments — are not eligible.
Section 20A prohibits Medicare benefits being paid for services where the patient is entitled to compensation or damages — typically workers' compensation, motor-accident schemes (CTP), or public-liability claims. Practitioners must bill the compensation scheme directly and not double-dip via Medicare. Breaches are referred to the Professional Services Review (PSR) and can result in repayment orders, disqualification from Medicare, and AHPRA notifications. Always confirm payer source before each consult with a compensable patient.
OneBookPlus is the all-in-one platform for Australian health practices — bookings, intake, clinical notes, claims, invoices, and patient communications. Free to start, AUD billing, AU-hosted.
Last reviewed and updated: by Bishal Shrestha
About the author
Founder & CEO, OneBookPlus
Bishal has over a decade of experience in digital marketing, web development, and small business consulting across Australia. Bishal has guided Australian allied-health and medical practitioners through opening their first clinic — from AHPRA-aligned structure choices to HICAPS, Medicare and NDIS billing rails.
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