Bookkeeping for Privately Practising Midwives Melbourne

Medicare Billing Splits Every Episode of Care in Two

An eligible midwife who meets the requirements to access a Medicare provider number can bill MBS items across antenatal, intrapartum and postnatal care. Each billed service generates a Medicare rebate paid to the client, plus a gap fee payable directly to the midwife, meaning every episode of care a Melbourne PPM delivers typically has two separate payment streams landing at different times, against the one client record. Bookkeeping that doesn't reconcile both streams against the same episode of care makes it very difficult to know whether a client's full course of care has actually been paid for, or whether a gap payment has quietly gone unpaid for months.

Professional Indemnity Insurance Is a Compliance Item, Not Just an Expense

Providing intrapartum care, labour and birth, as a privately practising midwife requires professional indemnity insurance that specifically covers that care, which is a materially different requirement to general allied health PII. Many PPMs rely on the Commonwealth-supported exemption scheme to access this cover, and that scheme carries its own reporting and eligibility requirements that need to be tracked and renewed alongside standard business insurance, treating it as just another insurance line item in the books risks missing a renewal that directly affects whether the midwife can legally continue attending births.

GST Treatment of Maternity Services

Midwifery services provided by a recognised midwife are generally GST-free under the health services exemption in the GST Act, covering the clinical care itself. Where this needs care is anything sold alongside that clinical relationship, postnatal care packs, equipment hire, or resource materials can be taxable supplies distinct from the GST-free maternity service, and a practice invoicing everything as one line item risks under-reporting GST on the taxable portion.

Solo Practice Versus Midwifery Group Practice Models

A midwife working within a caseload model or Midwifery Group Practice, often attached to a public hospital, is typically paid a salary or sessional rate through that employer rather than billing Medicare or clients under her own ABN, a fundamentally different bookkeeping structure to a fully privately practising midwife. Some midwives move between both models across a year, or run a partial private caseload alongside hospital sessional work, which means income needs to be clearly separated by source rather than blended, both for accurate reporting and because the two income types can carry different superannuation and tax withholding treatment.

KPIs and Compliance Points to Track

• Medicare rebate vs gap payment reconciliation, matched per client, per episode of care, not left as a running unreconciled balance.
• PII renewal and exemption scheme compliance dates, tracked separately from general business insurance.
• Clinical service vs product sales split, for accurate GST-free vs taxable reporting.
• Caseload capacity, number of active clients against the midwife's safe caseload limit, a workload as well as a revenue metric.