Most allied health practices set fees by reference to what other practices charge, and adjust when a rebate schedule moves.
Neither of those is your cost. Here is how to work out what an appointment actually costs to deliver.
Building cost per appointment
Take a practitioner delivering 1,150 billable appointments a year (roughly 25 a week, 46 weeks).
Practitioner cost
| Line | Annual |
|---|---|
| Salary | $95,000 |
| Superannuation 12% | $11,400 |
| Payroll tax (if above state threshold, ~5%) | $4,750 |
| Workers compensation ~2% | $1,900 |
| Professional indemnity, registration, CPD | $3,500 |
| Total | $116,550 |
| Per appointment | $101.35 |
Award rates rose 4.75% and the minimum wage 5.97% from 1 July 2026 — so if your fees have not moved since last financial year, this line grew and your revenue did not.
Practice overhead
| Line | Annual | Per appointment |
|---|---|---|
| Rooms / rent | $48,000 | $41.74 |
| Reception and admin | $52,000 | $45.22 |
| Practice software, bookings, claiming | $6,000 | $5.22 |
| Insurance, utilities, consumables | $14,000 | $12.17 |
| Marketing | $9,000 | $7.83 |
Overhead allocated across two practitioners: roughly $56.09 per appointment.
Base cost per appointment: ≈ $157.44 — before the line almost nobody counts.
The no-show line
A no-show or late cancellation costs you the full delivery cost and returns nothing. The practitioner is paid, the room is held, reception has done the work.
At a 9% no-show and late-cancellation rate, every 100 booked appointments produce 91 paid ones — so the true cost per paid appointment rises by roughly 10%.
Adjusted cost per appointment: ≈ $173.
If your standard fee is $155, you are losing $18 on every appointment and cannot see why a full book does not produce profit.
Most practices have never calculated this number. It is the single most common reason a busy practice is not a profitable one.
Reducing no-shows before raising fees
Usually cheaper and faster than a fee increase.
Automated reminders at 48 and 4 hours, by SMS. Typically reduces no-shows by 3–5 percentage points on its own.
A cancellation policy that is actually applied. A policy nobody enforces trains patients that it does not exist. Enforcing it consistently is uncomfortable once and effective permanently.
Card on file for booking, with the policy explained at the time. Standard practice now and rarely resisted when it is normalised at intake.
Waitlist to backfill. A same-day cancellation filled from a waitlist converts a total loss into a full recovery.
A 4-point reduction in no-shows on 1,150 appointments is worth roughly $7,000 a year per practitioner — from process, with no fee change and no additional patients.
The other pressures
Insurance. Professional indemnity and practice cover have risen sharply — insurance is up 51.7% across small business since March 2020, with some premiums up as much as 60% since 2019.
Payday Super from 1 July 2026 moved superannuation from quarterly to every pay run, compressing cash flow in practices that often carry receivables from third-party payers.
Rebate schedules move independently of your costs. Where a funder sets the fee, your margin is entirely determined by your cost base — which makes cost per appointment the only number you actually control.
What to do
- Calculate cost per appointment for each practitioner and service type. Initial consultations, standard consultations and group sessions have different economics.
- Measure your actual no-show rate over three months. Most practices guess low.
- Attack no-shows before fees. Faster, cheaper, no patient resistance.
- Review fees against cost, not against the practice down the road.
- Check utilisation. An 82%-booked practitioner and a 96%-booked one have completely different cost per appointment on identical fees.
Where to go next
- Gross Margin by Service Line\n- The 2026-27 Award Increase\n- How to Raise Prices Without Losing Customers\n- Payday Super: The $124,000 Working Capital Hole
Sources: Fair Work Commission Annual Wage Review 2026; Australian Taxation Office; AMP Bank GO Small Business Cost Pressure Index 2026. Cost figures illustrative and vary by discipline, location and practice model. General information, not financial advice.