Health Fund Claiming Regulations For Classes

In 2019, the Federal Government announced its plans to make certain natural therapies
ineligible for private health insurance rebates – among these therapies was Pilates.
After extensive negotiations and reviews with the Australian Physiotherapy Association, the
Federal Government and Private Health Insurers come to an agreement where
Physiotherapists could continue providing exercise rehab-based group therapy to their
clients, with some strict guidelines in place.
To be eligible for health fund rebates, registered providers must provide:
1. Individualised assessment of patients in one-on-one, group sessions and classes.
2. A program of exercise-based interventions specific to the patient. In group sessions,
this includes adjusting the group program for individuals as required. In group
therapy sessions, the exercises should address a current health problem.
3. High quality clinical notes that reflect physiotherapy practice.
4. Continuing to monitor patient and therapist goals and ensure regular individual
reassessments are made.
To adhere to the guidelines and so you can continue to claim your group therapy rebates
through your health fund, Synergy Physio is committed to following up with all participants
for a review every 6 months at minimum, pending your individual circumstances. To assist
you with this, our admin team will contact you with a reminder to book in for a
physiotherapy class review appointment.
What happens if I do not attend a review appointment?
You will still be able to attend group therapy, however, your health fund will decline your
rebate claims. You may also be at risk of your health fund requesting reimbursement for
your previous class claims if you have not me the above listed requirements.
If you have any questions, our admin team are more than happy to help where they can. For
further information, please visit the APA website – https://australian.physio/
or contact your health fund directly.