The same change lands differently on two clinics with the same team. The variable is payer mix — and one number, taken before October, tells you where you stand.
The 2026 award changes do not land evenly. Two clinics with the same team and the same revenue can be in very different positions on 1 October 2026, and the variable that separates them is payer mix — how much of the money coming in is priced by somebody other than the owner. Clinic size has very little to do with it.
Last updated 14 August 2026.
The short version
- The wage floor moves on a legislated timetable — 1 October 2026, then 30 June 2027, 2028, 2029 and 2030 — and every date is already published.
- The prices many clinics are paid are not on that timetable. The NDIA's published price for physiotherapy was cut on 1 July 2025 and left unchanged again for 2026-27. DVA's fees rose 2.66% from 1 July 2026 — against a 4.75% rise in the wage floor from the same date.
- Exposure is the share of a clinic's billings sitting in streams where somebody else sets the price. That single sentence is the whole idea — the rest of this page is how to measure it in your own clinic.
- One number tells you where you stand: the clinician cost ratio, worked out from reports you already run, in about half an hour. There is a free worksheet below that walks through it.
What is actually changing, in four lines
The Fair Work Commission's review of awards covering predominantly female workforces found the work of health professionals had been undervalued on gender grounds, and ordered the rates corrected. The correction is phased over five stages: 1 October 2026, then 30 June 2027, 2028, 2029 and 2030. Each stage lifts the floor under every clinician you employ, on dates you already know. What that means for classifications, translation and the two jobs to do first is covered in our 2026 award changes field guide and the 1 October action piece — this page does a different job. If you need where a profession enters the structure, that lookup is here; this page classifies nobody.
Source: [2026] FWCFB 123 at [80] (staging timetable)
The part nobody is costing: your payers are not on that timetable
Every explainer in this space — the Commission's, the Ombudsman's, the law firms', the peak bodies' — answers the same question: what is changing. The question that decides what October does to your clinic is different: who funds it. And the answer depends on which of your payers can be repriced, because the change to your wage bill arrives on legislated dates whether or not your revenue can move with it. (Whether the profession's own pricing habits created part of this squeeze is the subject of our Evidence-Based Economics hub — worth reading beside this page.)
The wage floor moves on published dates
Five stages, all public: 1 October 2026, then 30 June each year from 2027 to 2030. On top of that sits the annual wage review — 4.75% from 1 July 2026, already operating.
Source: [2026] FWCFB 123 at [80]; Annual Wage Review 2025-26 decision
The prices you are paid do not
Two examples from the schemes clinics bill most, both checked against the current instruments this week:
- NDIS. The published price for physiotherapy was cut from $193.99 to $183.99 effective 1 July 2025 (item 15_055_0128_1_3, NDIA Pricing Arrangements and Price Limits 2025-26) — and in the NDIA's 2026-27 pricing arrangements it was left unchanged for the second year running. In the same 2026-27 table, psychology rose 8.58%. By our comparison of those two lines, the gap between the psychology and physiotherapy prices widened from roughly $49 to $69 in a single year — physiotherapy is the only profession in that table carrying a nominal cut.
- DVA. The fees for an initial and a standard physiotherapy consultation (items PH10 and PH20) moved to $77.10 from 1 July 2026 — a rise of 2.66% by our calculation, in the same twelve months the award floor rose 4.75%. The schedule moves; it just moves at just over half the pace of the thing it has to fund.
What the NDIS cut means for physiotherapy specifically — and how practices are responding to it — is covered in our piece on the NDIS pricing decision.
Source: NDIA Pricing Arrangements and Price Limits 2025-26 and 2026-27 (physiotherapy and psychology line items); DVA fee schedule for physiotherapy, 1 July 2026. Percentage and gap calculations are ours, from those documents' own line items.
The Commission was asked about exactly this
Clinic owners raised pricing and funding in the award proceedings. The Full Bench held those matters "beyond the Commission's control." That is not a criticism of the Commission — it is the design. The body that sets your wage floor does not set your prices, and the bodies that set your prices are not required to follow it.
Source: [2026] FWCFB 123 at [75]
| Where the money comes from | Who sets the price | Can you reprice it? | Exposure |
|---|---|---|---|
| Ordinary private consults · Support at Home · NSW CTP | You | Yes | Lowest |
| Medicare CDM · private health extras · QLD & VIC workers comp | The scheme sets what it pays; you set the fee; a gap is permitted | Yes — but the patient's gap widens | Middle |
| NDIS (agency- & plan-managed) · NSW workers comp · DVA | The scheme's published schedule | Not in practice — the schedule is the price the claim is paid against | Highest |
Notes: NSW workers compensation is a regulated maximum — the clean example of a true ceiling. For NDIS, agency- and plan-managed claims are paid against the NDIA's published pricing arrangements; self-managed participants are the carve-out. Scheme mechanics vary by state and change — check the current instrument for any stream that matters to your clinic.
Private fees have moved — administered prices are the problem
The obvious objection is that clinic fees never keep up with costs anyway. The data says otherwise. NAB/HICAPS Health Insights (April 2026) shows average physiotherapy long-consultation fees billed through the HICAPS channel rising in every state from 2016 to 2025 — NSW $104 to $164, QLD $118 to $177, VIC $102 to $153 — "consistently upward over time," in the report's own words. Those are nominal figures, one channel, one consult type — but the direction is not ambiguous. Where owners hold the pricing pen, prices have moved. The squeeze is specifically in the streams where they do not.
Source: NAB/HICAPS Health Insights, April 2026, Figure 6, p.13. Nominal dollars, HICAPS channel only, long consultations only.
Exposure is about payer mix, not clinic size
A clinic's exposure to the 2026 award changes is the share of its billings sitting in streams where somebody else sets the price. A two-clinician NDIS-heavy clinic can be more exposed than a ten-clinician private-practice group, because the question is not how big the wage bill is — it is how much of the revenue that funds the wage bill can be repriced when the floor moves. That is why two owners reading the same award update take away two completely different problems.
There are only four places the money can come from
One line before the levers, because it is the most common way this thinking goes wrong: absorbing the change means absorbing it into the business — through the levers below — not into what you already pay people. With that said, there are exactly four:
Price
Reprice what you control. The caveat travels in the same breath: price is not a lever on your NDIS, DVA or workers-comp revenue — which is precisely why the exposure table matters. On the private side, what a defensible price looks like is its own discipline: our pricing piece covers it.
Productivity
More value per clinical hour — not more hours. Stretching the roster into overtime triggers penalty provisions and burns the people the whole plan depends on. The honest version of this lever is caseload design, and the arithmetic is in how many patients per hour a physio should see.
Structure
Team shape and service mix — the seniority blend you hire toward over time, and the services you grow or let shrink. That is the whole definition. Structure here does not mean restructuring people out or re-papering anyone's engagement; it is the slow lever, and the one that compounds.
Margin
The fourth place is what happens when you do not choose one of the first three. The change lands anyway, and it lands here.
The one number to take before October
You cannot choose between those levers in the abstract. The number that tells you which one you are reaching for is the clinician cost ratio — what your clinicians cost you, as a share of what they bill. Four steps, each from a report you already run:
- Pick one closed quarter. A quarter that has finished, so nothing in it can still move. The last full one is ideal.
- Clinician gross wages for that quarter. Payroll report, clinicians only — base, commission or bonus paid, leave taken and loading. Admin and reception stay out; they go on their own line.
- Super for those same clinicians. Same report, same people, same quarter. Super is a real cost of employing someone — the guarantee sits at 12% — and leaving it out understates what a clinician costs by a material margin.
- What those same clinicians billed. Practice-management billings report, same people, same quarter. Billed, not banked.
Then divide: (wages + super) ÷ billings. Keep admin separate — clinicians and admin behave completely differently, and blending them makes the number uninterpretable.
There is no benchmark on this page, deliberately. What a healthy ratio looks like depends on payer mix, service model and cost base, and a target handed to a business nobody has seen is a verdict, not a diagnostic. The value of the number is the comparison against your own future number — which is exactly why it has to be taken before the floor moves.
Free worksheet
The 30-Minute Check — the clinician cost ratio, step by step
The four numbers, exactly where each one comes from in your payroll and billings reports, the three ways the calculation goes wrong, and a worked example. Two pages, no email required.
Why this number is harder to get after October
Today's ratio is arithmetic on facts already sitting in your own system. October's is not — one of its inputs is a per-person determination that does not exist in your business yet: where each clinician lands in the new structure, and what their floor becomes at each of the five stages. Nothing is being withheld there; the gap is real, and it is the difference between a measurement and a projection.
That per-person work — translating every clinician into the new structure and knowing each person's lawful minimum from 1 October — is exactly what our self-paced course does, end to end.
The course
REBUILD — the October reclassification, start to finish
Nine short segments and nine worksheets: translating every clinician into the new structure, running the higher-of-two-rates comparison one person at a time, and knowing each person’s lawful minimum from 1 October. Self-paced, one payment, yours to keep. A$197.
217 community members · $15M+ clinic revenue under advisory · 14 years in the private sector, Australia and the UK · invited to speak at APA, AOPA and the Physio Symposium
"I'd never been through a growth period before and there was no one who had walked the walk at that particular moment I needed. In four months we went from the early fifties to just under $70K a month. It's way simpler now." — Ryan Taylor, Director, Glide Physio
If you are running a bigger team, the exposure work is a bigger job — payer-mix modelling to 2030, the wage curve, the pricing architecture. That is advisory work, and there are only a handful of seats.
Related reading
- The 2026 award changes field guide — what is changing and what it costs, in full.
- Clinic owners: your second pay rise hits October 1 — the compliance actions before the date. That page owns the to-do list; this one owns the economics.
- Evidence-Based Economics — the hub this page belongs to.
- The NDIS pricing decision and physiotherapy
FAQ
Does the 2026 award increase affect all clinics equally?
No — the same change lands very differently depending on payer mix. The wage floor rises on legislated dates for every clinic, but a clinic whose billings sit mostly in scheme-priced streams (NDIS agency- and plan-managed, DVA, NSW workers comp) cannot reprice that revenue in response, while a mostly-private clinic can. Size is not the variable; the share of revenue priced by somebody else is.
When do the increases actually happen?
Five published stages: 1 October 2026, then 30 June 2027, 2028, 2029 and 2030, each from the first full pay period on or after the date. The annual wage review (4.75% for 2026) already applied from 1 July 2026.
Is the NDIS price for physiotherapy rising to match the award increase?
No. The NDIA's published price for physiotherapy was cut from $193.99 to $183.99 effective 1 July 2025 and was left unchanged in the 2026-27 pricing arrangements — two years without an increase, over the same period the award floor rose and psychology's line rose 8.58%.
Can I raise my fees to cover it?
Only where you hold the pricing pen. Private consult fees are yours to set. Medicare and private-health work lets you set the fee, with the patient carrying a widening gap. Agency- and plan-managed NDIS, DVA and NSW workers comp claims are paid against the scheme's published schedule — repricing is not a lever there in any practical sense.
What number should I work out before October?
The clinician cost ratio: clinician gross wages plus super, divided by what those same clinicians billed, over one closed quarter. It takes about 30 minutes from reports you already run, and it is the baseline every later decision compares against.
What should my clinician cost ratio be?
There is no single right number, and anyone who hands you one without seeing your clinic is guessing. The ratio depends on payer mix, service model and cost base. The value of taking it now is the comparison against your own number after the changes land — not against someone else's clinic.
Does paying above the award mean this doesn't affect me?
Not by itself. The floor is a per-pay-period test, and headroom above today's floor is not the same as being unaffected by five scheduled rises to it. The only way to know your position is the per-person translation — which is exactly the work the October change introduces.
Where does admin and reception sit in all this?
On their own line, always. Admin wages are real costs but they behave nothing like clinician wages — mixing them into the ratio makes it uninterpretable. Their own award stream is a separate topic with its own timetable.
Where to check this against the primary sources
| Claim | Where it comes from |
|---|---|
| The five staging dates | [2026] FWCFB 123 at [80] |
| Pricing and funding held "beyond the Commission's control" | [2026] FWCFB 123 at [75] |
| NDIS physiotherapy price cut 1 July 2025; unchanged for 2026-27; psychology +8.58% | NDIA Pricing Arrangements and Price Limits, 2025-26 and 2026-27 editions (physiotherapy item 15_055_0128_1_3) |
| DVA physiotherapy fees $77.10 from 1 July 2026 | DVA fee schedule for physiotherapy, effective 1 July 2026 (items PH10, PH20) |
| Private long-consult fees rising in every state, 2016–2025 | NAB/HICAPS Health Insights, April 2026, Figure 6, p.13 |
About this information
Culture of One is a business advisory firm, not a law firm. This is general information about the economics of the 2026 award changes — not legal, financial or workplace-relations advice — and it doesn't take account of your clinic, your contracts, your payer agreements or any individual's circumstances. The Fair Work Commission's decisions and each scheme's current published instruments are the authority; where this page and those documents differ, those documents govern.
Current as at 14 August 2026.
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