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Understanding health fund claiming of pilates informed exercise with our physios in 2019

Dec 20, 2018 | Physiotherapy

Understanding health fund claiming of pilates informed exercise with our physios in 2019

PHYSIOTHERAPY is PHYSIOTHERAPY!

The Australian Physiotherapy Association have won a battle with many health funds ensuring Pilates-informed exercises prescribed by physiotherapists as part of an individualised program will continue to receive rebates in one-on-one, group and class settings.

As previously advised and in keeping with the intention of the natural therapy reforms, Pilates-only sessions will no longer be funded as of 1 April next year.

The reform of natural therapies was designed to eliminate rebates for non evidence-based therapies, and not intended to impact physiotherapy.

However, the review into natural therapies conducted by the government and announced last year did not differentiate between Pilates-informed exercises prescribed by physiotherapists as part of a treatment program and Pilates offered by fitness instructors and in other contexts.

We at the living well studio have worked very hard to make sure we are in alignment with this reform as we are passionate about evidence based preventative and rehabilitative health care. 

As part of these standards we as physios working with the service we provide at The Living Well Studio 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 both groups and classes, 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 reassessments when appropriate.

Service descriptors have not been impacted by the PHI reforms. You can continue to claim item code 560 and 561 where the insurance company allows it.

HCF – The APA have stated that members with HCF have had a harder time getting clear on what they can claim if you are a member of HCF and you want to claim group physiotherapy sessions please let our reception know and our practice managed will liaise with them to work it out.