Transparent $45 Pricing Policy — Accessible Care for All Australians

Understanding our transparent $45 maximum out-of-pocket pricing model

Last updated: January 13, 2025

How Our Mixed-Billing Model Works

Consultation Fee: $45 maximum out-of-pocket (all appointments)

FOR MEDICARE-ELIGIBLE PATIENTS:

  • You pay the full consultation fee upfront at booking ($96.25 initial, $72.05 review)
  • We process your Medicare claim as "Patient Claim (Private)"
  • Medicare deposits your rebate directly into your bank account within 1-2 business days
  • Initial consultations: You receive $51.25 back → Your final cost: $45
  • Follow-up consultations: You receive $27.05 back → Your final cost: $45

FOR NON-MEDICARE-ELIGIBLE PATIENTS:

  • You pay $45 total (no Medicare claim lodged)
  • We absorb the Medicare rebate difference ourselves ($27.05-$51.25 per consultation)
  • Simple, straightforward pricing with no hidden fees

This is called "mixed billing" — it's completely legal, transparent, and allows us to keep care accessible for everyone.

Patient-First Healthcare

As Nurse Practitioners, we believe:

  • Quality clinical care should be accessible to all Australians, regardless of Medicare eligibility
  • Transparency builds trust — you know exactly what you're paying upfront
  • Healthcare should never force patients to choose between quality and affordability
  • Supporting our patients means we're building a sustainable, patient-centred clinic

THE FINANCIAL REALITY:

We're absorbing between $27.05 and $51.25 per consultation for non-Medicare-eligible patients. This is our commitment to accessibility over profit.

Medicare Changes & Our Response

Following Medicare telehealth changes effective November 1st, 2025, we've implemented a transparent $45 maximum out-of-pocket pricing model for all weight loss consultations.

Our Commitment: All consultations are $45 maximum out-of-pocket for transparent, accessible healthcare regardless of Medicare eligibility status.

This pricing model ensures compliance with current Medicare regulations while maintaining accessible care for all Australians.

Compliance & Transparency

We comply with all MBS requirements:

  • Document eligibility carefully for every Medicare claim
  • Obtain informed financial consent before consultations
  • Follow all AHPRA advertising and billing regulations
  • Provide itemised receipts for all consultations

Before booking, we inform you:

"Our telehealth fee is $45 maximum out-of-pocket. If you are eligible under Medicare telehealth rules, we will charge the full consultation fee ($96.25 or $72.05) and process your Medicare rebate so you receive $27.05-$51.25 back within 1-2 days. If you are not eligible, you will pay $45 and no rebate applies."

Medicare Questions?

Our team can help you understand your Medicare entitlements and billing processes.

Email: office@downscale.com.au

ABN: 23 693 026 112

ACN: 693 026 112

Medicare Provider Number: Available upon request