Exercise physiology plays a significant role in supporting the health and wellbeing of Australians, particularly those managing chronic conditions. Understanding whether these services are covered by Medicare or private health insurance is essential for individuals looking to access professional support without unexpected out-of-pocket expenses. This article outlines what exercise physiology involves, how it contributes to patient care, and the eligibility criteria for Medicare and private health rebates in Australia.
What Is Exercise Physiology?
An accredited Exercise Physiologist (AEPs) is a university-trained allied health professionals who specialise in the assessment, prescription, and delivery of safe and effective exercise interventions. Their primary focus is to help individuals prevent or manage chronic diseases, recover from injury or surgery, and improve functional capacity and overall quality of life.
Exercise physiologists work across a variety of settings, including private clinics, hospitals, aged care facilities, and community health centres. They design evidence-based programs tailored to the specific needs and goals of each client, often working in collaboration with general practitioners and other healthcare providers.
How Exercise Physiologists Support Your Health
Exercise physiology services can assist in managing a wide range of chronic and complex conditions such as:
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Type 2 diabetes
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Cardiovascular disease
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Obesity
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Mental health conditions (e.g. depression, anxiety)
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Arthritis
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Osteoporosis
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Chronic pain
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Respiratory diseases like COPD
By improving physical activity levels safely and sustainably, AEPs can enhance mobility, reduce symptoms, prevent disease progression, and promote long-term health improvements.
Is Exercise Physiology Covered by Medicare?
Yes, under certain conditions, exercise physiology is covered by Medicare through the Chronic Disease Management (CDM) program. This allows eligible patients to receive Medicare rebates for a limited number of sessions per calendar year with an accredited exercise physiologist.
To be eligible for Medicare-subsidised services:
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The patient must have a chronic medical condition and complex care needs, and
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Their care must be managed by a general practitioner (not a specialist or consultant physician), and
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The GP must develop or review one of the following in the past 18 months:
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A Chronic Disease Management (CDM) Plan
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(Until 30 June 2027) A GP Management Plan and Team Care Arrangements prepared prior to 1 July 2025
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A Multidisciplinary Care Plan
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Additionally, the exercise physiology service must be:
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Recommended in the patient’s care plan
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At least 20 minutes in duration
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Limited to a maximum of five sessions per calendar year, which may be shared across other allied health services under the CDM scheme
Medicare Rebate Details:
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Fee: $72.65 per session
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Benefit (85% of the fee): $61.80
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Extended Medicare Safety Net cap: $217.95
It’s important to note that while the CDM plan allows for up to five allied health sessions annually, this total includes all eligible allied health services (not just exercise physiology), so it’s vital to plan accordingly with your GP.
What About Private Health Insurance?
Many private health funds in Australia offer rebates for exercise physiology under extras cover. The level of cover and rebate amount varies between insurers and policy tiers. Typically, coverage applies when:
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The services are provided by a recognised AEP
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The service is not already being claimed through Medicare
Some funds may require a medical referral, while others may not. It’s best to contact your health insurer directly to confirm:
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Whether your policy includes exercise physiology
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The rebate amount per session
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Annual limits and any waiting periods
Conclusion
Exercise physiology is a valuable service for individuals managing chronic health conditions and looking to improve their long-term health outcomes. While Medicare does offer rebates for eligible patients through a GP-managed care plan, the number of subsidised sessions is limited. Private health insurance can help bridge the gap, offering additional support depending on your level of extras cover.
To make the most of available rebates, speak with your GP about your eligibility for a Chronic Disease Management Plan and consult your health fund to understand your entitlements. With the right support, exercise physiology can play a pivotal role in helping you lead a healthier, more active life.
