Exercise Physiology Clinic

EXERCISE PHYS COVER

You may be able to claim rebates on our fees through a variety of third party payers.

Medicare & DVA (Department of Veterans Affairs)

You may have been referred to us under a Team Care Arrangement (TCA) from your Doctor with a Chronic Disease Management (CDM) plan. This was formerly known as Enhanced Primary Care (EPC) and allows up to 5 sessions/rebates per year split with a team of allied health professionals. The referrals last for 12 months from date of referral and you can only have 5 sessions per calendar year. At PXP you must pay our fees in full and will be reimbursed by Medicare after your appointment. For information about out of pocket expenses please email or call the clinic. If you have a health care card, seniors card, or any other type of approved concession card then we are able to bulk bill your CDM appointment to Medicare with no out of pocket expense to yourself but only on 30 minute appointments.

For more information click below.

https://www1.health.gov.au/internet/main/publishing.nsf/Content/mbsprimarycare-chronicdisease-pdf-infosheet

DVA Health Cards (Gold and White) are accepted as payment upon a GP referral. We follow the DVA treatment cycle which stipulates communication with your referring GP and a clinical treatment plan based on 12 sessions or 12 months (whichever comes first) to formulate an appropriate exercise prescription & treatment plan that you can self manage when you are ready.

For more information click below.

https://www.dva.gov.au/health-and-treatment/injury-or-health-treatments/health-services/exercise-physiology-services

Private Health Insurance

Your private health insurance (PHI) may pay rebates on consultations with us in both initial appointments, personal sessions and group bookings.

Private health item codes are as follows:

  • 102 for initial consultation
  • 202 for personal consultations
  • 502 for group sessions

We have a HICAPS terminal onsite for on the spot claiming.Exercise Physiology is a part of your ‘Extras’ cover but because the funds vary so much you will need to check with your own individual insurer to make sure your policy includes Exercise Physiology to see how much they will pay.

See link below to check if you are covered or call your insurer directly.

https://www.essa.org.au/wp-content/uploads/2010/08/Healthfund-factsheet-info-V2.pdf

Workcover

For worker’s compensation in Victoria you will need a Doctors referral from your GP that states your injury and a recommendation to see an Exercise Physiologist. Once you have the referral you will then need an approval letter from your case manager that specifies how many appointments are covered. Worksafe dictates the fees and appointment length for workers compensation in Victoria. We can invoice the insurer directly only if the above requirements are met prior to your initial appointment otherwise you will have to pay our private consultation fees and be reimbursed by the insurer.

TAC

For claims managed by the TAC (Transport Accident Commision) in Victoria you will need a referral from your GP, Physiotherapist, Osteopath or Chiropractor. Generally this will allow you up to 5 sessions with us. For more than 5 sessions we will need to submit an “Allied Health Treatment and Recovery Plan” to the TAC for approval before we continue sessions. In Victoria the TAC dictates the fees and appointment lengths for Exercise Physiology services. We can invoice the TAC directly only if the above requirements are met prior to your initial appointment otherwise you will have to pay our private consultation fees and be reimbursed by the insurer.

NDIS

Currently Performance X Physiology Pty Ltd (PXP) is not a registered company with the NDIS (NDIA). In the future as we grow we aim to be able to be a registered provider however in the meantime we are able to see self managed participants who can pay us in full for our services and be fully reimbursed through their funding. We can also see plan managed participants and invoice the plan manager directly. We are not able to see NDIA ‘Agency’ managed participants at this time.

We apologise for any inconvenience this may cause, feel free to contact us if you have any suggestions.