Exercise Physiology Funded Through Medicare Chronic Disease Management (EPC)

Access clinically-led Exercise Physiology with eligible funding support

Medicare Exercise Physiology funding, delivered through Chronic Disease Management (CDM), allows eligible individuals to access allied health services with a Medicare rebate.

This funding pathway supports coordinated, GP-led care for people with chronic or complex health conditions requiring ongoing management across multiple health providers.

How Medicare Exercise Physiology Funding Works

Medicare Chronic Disease Management is administered by Medicare Australia and operates under the direction of a patient’s General Practitioner. Eligible patients are referred under a GP Management Plan and Team Care Arrangements.

Exercise Physiology services provided under this pathway are designed to support safe, evidence-based physical activity interventions for people with chronic medical conditions, functional limitations, or ongoing health needs. Referrals are initiated and approved by the patient’s GP and reviewed as part of coordinated primary care.

Medicare Exercise Physiology funding is intended to support structured, goal-directed intervention rather than ongoing open-ended care. Sessions are delivered in alignment with GP-defined management plans and are reviewed regularly to ensure they remain clinically appropriate. Where Medicare sessions are exhausted, participants may choose to continue privately or transition to other eligible funding pathways following discussion with their referrer. This clarification helps patients understand funding limits and plan care appropriately with their healthcare team over time safely.

Eligibility Criteria

  • Diagnosed chronic medical condition expected to last 6 months or longer
  • Condition requires a multidisciplinary care approach
  • GP Management Plan and Team Care Arrangements in place
  • Valid referral from a General Practitioner
  • Medicare eligibility confirmed at time of service

What Exercise Physiology Can Address Under This Funding

What’s Included in Your Sessions

  • Comprehensive initial assessment
  • Individualised exercise program aligned with referral goals
  • One-on-one supervised exercise sessions
  • Ongoing progress reviews and program adjustments
  • Communication and reporting back to referring practitioners

Session Limits, Gap Fees & Billing

Medicare Chronic Disease Management typically allows up to five allied health sessions per calendar year, shared across all eligible allied health providers.

A Medicare rebate applies per session. Gap fees may apply depending on session type and setting. Full billing details are provided prior to commencement. No bulk-billing or fee assumptions should be made without confirmation.

Referral & Booking Process

  1. Visit your GP to discuss eligibility for a Chronic Disease Management Plan

  2. GP completes a Management Plan and issues an Exercise Physiology referral

  3. Referral is sent to Healthsmart Exercise Physiology

  4. Eligibility and session availability are confirmed

  5. Appointment is scheduled (clinic-based or home-based, where appropriate)

  6. Progress reports are provided back to the referring GP as required

Frequently Asked Questions

Yes. A valid referral issued under a GP Management Plan is required before Medicare rebates can be applied.

Up to five allied health sessions per calendar year are available in total and may be shared between different allied health providers.

Home-based sessions may be available where clinically appropriate and subject to referral details and location.

Clinic-based sessions are currently bulk billed.  For home-based or hydrotherapy sessions, a gap fee applies. This will be discussed prior to your first appointment.

Session setting depends on clinical need, safety considerations, and referral guidance.

Ongoing services may continue under private funding or other eligible funding pathways if appropriate.