Are you wondering if Medicare covers Exercise Physiology services? Well, the quick answer is yes! But, as you might have guessed, there are a few conditions with Medicare Rebates for Exercise Physiology…
The Chronic Disease Management (CDM) Program
A Medicare rebate for Exercise Physiology can be accessed under the Chronic Disease Management (CDM) Program, which was formerly known as the Enhanced Primary Care (EPC) program. Accessing Medicare rebates should be an easy process, but unfortunately, things might not always be straightforward.
Qualifying for a Medicare Rebate
To qualify for a Medicare rebate, you must have a chronic condition or injury. A chronic medical condition is one that has been or is likely to be present for six months or longer, such as asthma, cancer, cardiovascular disease, diabetes, musculoskeletal conditions, depression, stroke, and many others. Exercise Physiology services are an invaluable resource for individuals with these types of conditions, which is why it’s essential to better understand the Medicare rebate process.
The Rebate Amount
If you qualify, you will receive a $58.30 rebate for a maximum of 5 sessions in a calendar year. Clients with type 2 diabetes also qualify for an additional referral under Medicare Allied Health Group Services, entitling them to an initial assessment, plus eight group exercise sessions with our accredited Exercise Physiologists. There are additional consultations available for clients of Aboriginal or Torres Strait Islander descent.
Getting a Referral
Firstly, you must meet the criteria which revolves primarily around chronic conditions. Secondly, you need the appropriate referral form from your General Practitioner (GP), who needs to send you to a specific Exercise Physiology clinic. The Medicare CDM Program allows for a total of up to five rebated consultations per year with any referred allied health practitioner, such as Exercise Physiology, Podiatry, Dietetics, Physiotherapy, and Speech Pathology. Keep in mind that you will need a new referral each year.
Understanding the Rebate Process
At EP360, we have set up an easy system for processing Medicare rebates. All you need to do is pay the full fee at your consultation. We will then process the Medicare rebate, and you will have the rebate deposited directly into your account.
Wrap up
- Medicare rebates for Exercise Physiology can be accessed through the Chronic Disease Management Program.
- You need a GP’s referral for Exercise Physiology services.
- Clients can get a $58.30 rebate for up to five visits per year.
- At EP360, we process the rebate on the day of your session and deposit the rebate into the account you have registered with Medicare.
If you have any questions regarding Exercise Physiology services and Medicare, don’t hesitate to contact us. Our team is more than happy to answer your queries and help you understand how it can work for your health needs. Alternatively, speak to your GP to determine if you are eligible for a CDM referral to see an Exercise Physiologist at EP360.
Get back on your feet, feel better, and move more pain-free with Exercise Physiology from EP360. Our goal is to help you regain control of your health and get back to doing what you love.
EP360 Exercise Physiology — Five Dock & St Peters
EP360 has two clinics in Sydney’s Inner West — at Club Lime Five Dock (49 Queens Road) and Club Lime St Peters. Both are accessible, fully equipped commercial gyms, and both accept Medicare CDM referrals.
If you’re based in Five Dock, Drummoyne, Leichhardt, Burwood, Rozelle, Marrickville, Newtown, Tempe, or anywhere nearby — we’re close to you.
I’m Chris Dounis, founder and senior exercise physiologist at EP360. I’ve been working with Inner West clients for over 15 years, and Medicare care plans are one of the most common ways people first come through our doors. If you’d like to know whether you’d be a good fit, get in touch — or have a conversation with your GP first and ask them to refer you to EP360.
Frequently asked questions
Does Medicare cover exercise physiology? Yes, through the Chronic Disease Management (CDM) program. You need a referral from your GP and a qualifying chronic condition.
How much is the Medicare rebate for exercise physiology? Currently $58.30 per session, for up to five allied health sessions per calendar year. Rebate amounts are set by Medicare and subject to change.
Do I need a new referral every year? Yes. CDM referrals are renewed annually. Your GP will issue a new referral each calendar year.
Can I use my Medicare sessions at EP360 specifically? Yes. Your GP can refer you directly to EP360 Exercise Physiology at Five Dock or St Peters. Just ask them to name EP360 on the referral form.
What’s the gap fee at EP360? $25 for a standard EPC session. $50 for a 45-minute session.
Can I split my five sessions across different providers? Yes. The five sessions cover all allied health providers combined under your CDM plan — exercise physiology, podiatry, dietetics, physiotherapy, and speech pathology all draw from the same pool.
What if I don’t qualify for Medicare? Can I still see EP360? Absolutely. Many of our clients are private-paying or use private health insurance. Contact us to talk through your options.
