If you’re setting up a physiotherapy practice and want to process private health fund claims on the spot, you need a HICAPS terminal. Patients expect it. Without it, you’re asking them to pay in full and claim the rebate themselves – which is a friction point that sends some people elsewhere.
This guide walks through how to get a HICAPS terminal in your physio business, from the application through to installation day and the ongoing fees.
It’s a good idea to read this in conjunction with the direct info at the hicaps website.
What Is HICAPS and Why Does Your Physio Practice Need It?
HICAPS – Health Industry Claims and Payments Service – is the system that lets your patients swipe their private health insurance card and have their rebate deducted from the consultation fee at the point of payment. Instead of paying $120 and waiting days for a bank transfer from their insurer, they pay the gap on the spot.
Most patients with private health cover assume this service exists at every physio. If you don’t have it, you’re not just inconveniencing them – you’re signalling that your practice isn’t fully set up, which is the last impression you want to give.
It’s one of those foundational things, like having a proper booking system (we like Cliniko for small clinics, but larger ones may need to look around). If you want to understand the full picture of what “fully set up” looks like for a physio clinic, the guide to setting up a physiotherapy clinic the right way covers the broader setup in detail.
Step One: Get Your Medicare Provider Number
Before you can apply for HICAPS, get a Medicare provider number. This is your individual registration as a healthcare provider with Services Australia, and it’s location-specific – meaning you’ll need a separate provider number for each practice location you work at.
To get one, you need to be registered with your relevant professional body. For physiotherapists, that’s the Australian Health Practitioner Regulation Agency (AHPRA). Once your AHPRA registration is in order, you apply for a Medicare provider number through PRODA – the Provider Digital Access portal – at servicesaustralia.gov.au.
The process is reasonably straightforward but can take a couple of weeks, so don’t leave this until the week before you want to open. Also a special note for married women who changed their names after they registered – often you’ll need to clean up any name changes first, and this is a major hassle – my wife took weeks to clean hers up! That involves making sure your medicare, your mygov, and your AHPRA names all match.
Apply early. Your provider number is what links your HICAPS terminal to you as a recognised health professional, and without it, the application stalls.
If you’re working as a sole trader under your own name, one provider number is usually sufficient. If you’re setting up a practice with multiple practitioners, each clinician needs their own. This is doubly important if you use contractors as physios.
Step Two: Apply for HICAPS at hicaps.com.au
Once you have your Medicare provider number, you can apply for a HICAPS terminal directly at hicaps.com.au. The application is online and asks for your provider number, practice details, ABN, and banking information for settlements.
Bear in mind – they aren’t a free service. So make sure you understand what you’re signing up for.
There are a couple of things worth knowing before you sit down to fill it in.
First, HICAPS is owned by NAB, which means your payment settlements go through an NAB merchant facility. You don’t need to bank with NAB personally, but the processing infrastructure sits on their network. This doesn’t affect how you use the terminal day to day – it’s just worth understanding if you’re wondering why the application asks for merchant banking details.
If you do have a matching Bank setup, things are easier and (I believe) cheaper.
Second, the application process typically takes one to two weeks to be approved, and then there’s a lead time for the terminal to be delivered and installed. Plan for three to four weeks from application to having a working terminal on your front desk – possibly longer if there are any issues with your provider number or merchant account setup.
Make sure the name on your application matches your AHPRA registration and your ABN. Mismatches between these slow things down, and you WILL end up starting all over again.
Step Three: Sort Your Internet Before the Terminal Arrives
This one gets skipped a lot, and it causes unnecessary headaches on installation day.
Your HICAPS terminal connects to the internet to process claims in real time. If your internet is unreliable, slow, or drops out, claims fail – which means patients have to pay in full, which is exactly what you were trying to avoid.
Before your terminal arrives, set up your internet connection and test it. The practical recommendation is to run an ethernet cable from your router directly to the reception desk where the terminal will sit. Ethernet is more stable than Wi-Fi. In a clinic environment where you might have multiple devices, multiple physios uploading data, a busy waiting room full of phones all connecting to the same network, and walls between the router and the desk, Wi-Fi can drop at the worst moments.
A physical ethernet cable costs almost nothing and eliminates a whole category of connection problems. Run it once, cable tie it neatly to the skirting board, and forget about it. The HICAPS terminal has an ethernet port for exactly this reason.
If running a cable is genuinely not possible in your space, a dedicated Wi-Fi network for the terminal – one that patients and staff aren’t also hammering with streaming and downloads – is a reasonable alternative. But ethernet is simpler and more robust. If you use wifi in your physiotherapy clinic, make sure you’re there to give the installer your password on installation day.
How to Get a HICAPS Terminal Installed in your physio clinic: What Happens on the Day
Once your application is approved and your terminal arrives, a HICAPS technician will either install it in person or walk you through setup remotely, depending on your location and the arrangement made during your application.
Installation itself is not complicated. The terminal plugs into power and connects to your network via ethernet (or Wi-Fi if that’s what you’ve set up). The technician configures it with your provider details and tests it by running a few simulated transactions.
During or after setup, HICAPS provides training on how to use the terminal. This covers how to process a standard health fund claim, how to handle Medicare bulk billing if you do any, how to issue receipts, and how to handle a declined or invalid card. The training is practical and tailored to your setup.
Pay attention to the Medicare side of the training even if you don’t plan to bulk bill initially. Knowing how the terminal handles both private health and Medicare transactions gives you flexibility as your practice grows.
Most physios find the terminal intuitive within a few days of real use. The key steps – enter the item code, enter the fee, swipe the health fund card, confirm the gap – become second nature quickly.
HICAPS Fees: What You’ll Pay and Where to Find the Current Rates
HICAPS charges fees for the service – it’s not free.
This is worth knowing upfront, not because the fees are unreasonable, but because they’re a genuine business cost and they should be factored into your pricing model. In particular, these fees affect your gross profit margin, which is an important part of business planning.
The fee structure typically includes a monthly terminal rental fee and a per-transaction fee. As of the time of writing, it’s about $30 per month, and about 1.1% of the transaction. you can find the current fee schedule on the HICAPS website under their pricing or merchant information section. Fees are subject to change, so always check hicaps.com.au directly for current figures rather than relying on what anyone quotes you second-hand.
The per-transaction fee applies each time a health fund claim is processed. For most physio practices, this is a small cost relative to the consultation fee – but if you’re seeing high volume, it adds up and should be reflected in your fee structure. It’s big enough to knock your net profit down by up to 2% – that could be a substantial amount of your salary gone. But then, do you really have a choice?
This is part of a broader conversation about how to price your services correctly. The HICAPS fees aren’t the only processing cost to account for – there are also the merchant fees that apply when patients pay the gap by card. If you want to think through how to build these costs into your rates properly, the article on how to price your services for gross profit is worth reading before you set your consultation fees.
The HICAPS Trinity Terminal: Health Fund and Credit Card in One Device
The current standard terminal offered by HICAPS is the Trinity terminal. It’s worth understanding what this device actually does, because it handles more than just private health fund claims.
The Trinity terminal processes HICAPS health fund transactions and also functions as a full EFTPOS terminal for credit and debit card payments. That means you don’t need a separate card reader sitting next to your HICAPS terminal – one device handles both.
When a patient presents at the end of their appointment, the workflow is: process the health fund claim first (which calculates the rebate and the gap amount automatically), then the patient taps, swipes, or inserts their card to pay the gap on the same terminal. One device, one interaction, clean and fast.
I believe the Trinity terminal also supports contactless payments including Apple Pay and Google Pay, which most patients now expect as standard.
For a front-of-house setup, having a single terminal handle both streams simplifies your desk, reduces the number of devices you need to maintain, and makes the payment process faster for the patient. The only thing to be aware of is that the EFTPOS merchant facility is run through NAB – so the card transaction fees come through NAB’s merchant pricing, which is separate from the HICAPS health fund transaction fees.
If you’re comparing costs before you apply, it’s worth getting NAB’s current merchant rates as part of your assessment. For many small practices, the combined HICAPS and EFTPOS fees through the Trinity terminal are competitive with running a standalone EFTPOS device from another provider, and the simplicity of a single device has real operational value.
A Note on Timing
The single biggest mistake when setting up HICAPS is leaving it too late. If you’re planning to open your practice on a specific date and want HICAPS ready from day one, start the application process at least six to eight weeks out, and get working on your internet connection.
Work backwards: allow two weeks for your Medicare provider number if you don’t already have one (or 4 weeks if you have complications), two weeks for the HICAPS application to be processed, and time for the terminal to arrive and be installed. Add a buffer for any back-and-forth on documentation, because there’s almost always something.
2 Months is my best guess for a safe timeline. It’s impossible to say for sure, as these things are out of our control.
If you’re opening without HICAPS and planning to add it later, that’s fine – but be upfront with patients about it. Don’t let them find out when they go to swipe their health fund card. A simple note in your booking confirmation that says “please note we are not yet processing health fund claims on site – you will need to claim directly from your insurer” avoids a bad experience at checkout. Clients are usually quite happy when you tell the truth with a clear reason why something is still being set up.
Getting a HICAPS terminal for your physio practice is a straightforward process once you know the steps. Get your Medicare provider number first, apply through hicaps.com.au with your practice details, prepare your internet connection before the terminal arrives (and seriously, run an ethernet cable), attend the training on installation day, understand the fee structure from the start, and consider how the Trinity terminal’s dual function as a health fund and EFTPOS device simplifies your front desk.
It’s not a complicated setup. It just requires doing the steps in the right order, early enough that everything is in place when you need it.