Is Clinical Exercise Physiology Covered by Medicare in Australia?

If you’ve been told you might benefit from seeing an Exercise Physiologist, one of the first questions you probably have is: “Does Medicare cover this?” The good news is yes — Medicare does provide rebates for accredited Exercise Physiology services in certain situations.

Like many health services, there are some eligibility rules and limits you need to know about. Let’s break it down in plain English.

When Does Medicare Cover Exercise Physiology

Medicare will contribute towards the cost of seeing an Accredited Exercise Physiologist if:

• You have a chronic medical condition (something that’s been present or is likely to last for 6 months or more).

• Your GP prepares a Chronic Condition Management (CCM) Plan for you.

• The GP refers you specifically to an Exercise Physiologist under this plan.

Medicare does cover Exercise Physiology when you have a chronic condition and a GP-managed care plan. Rebates are available for up to 5 individual allied-health sessions per year under item 10953. If you live with type 2 diabetes, you may also qualify for up to 8 group Exercise Physiology sessions annually.

“What counts as a chronic condition?
A chronic condition is one that has been, or is expected to be, present for 6 months or more. There is no fixed list — your GP decides based on clinical need.”

What Does Medicare Pay?

For an individual Exercise Physiology session (item number 10953 on the Medicare Benefits Schedule), the rebate as of July 2025 is $61.80. The full schedule fee is $72.65, but it’s important to know that clinics set their own fees.

This means:

• If a clinic bulk-bills, you won’t pay anything out of pocket.

• If a clinic charges above the rebate amount, you’ll pay the difference (often called the “gap”).

You can view the full schedule fee and rebate breakdown here: MBS item 10953

Did You Know?

“According to the Australian Institute of Health and Welfare, over 351,750 Exercise Physiology sessions were delivered under Medicare item 10953 in a single year. Despite this, referral rates remain low — with less than 1% of at-risk Australians being referred to an Accredited Exercise Physiologist.”

What About Group Sessions?

If you’re living with type 2 diabetes, there’s a separate pathway. Medicare recognises the importance of exercise for diabetes management and allows rebates for group Exercise Physiology programs.

Here’s how it works:

• 81110: Initial assessment for group services

• 81115: Group EP sessions (60+ minutes, 2–12 participants)
  You can access up to 8 group services per calendar year in addition to your individual sessions.

These group programs can be a more affordable option while still providing expert guidance in a supportive setting.

Medicare provides separate funding for group Exercise Physiology services for people with type 2 diabetes. : MIS item 81115

Can I Use Telehealth for Exercise Physiology?

In recent years, telehealth has been added for some allied health services, including Exercise Physiology. Whether you can access telehealth under Medicare depends on your referral and the specific rules at the time — so it’s best to confirm with your GP and chosen Exercise Physiologist.

Steps to Access Medicare Rebates

1. Book an appointment with your GP. Discuss your health condition and ask whether a Chronic Condition Management Plan is appropriate.

2. Ask for a referral to an Accredited Exercise Physiologist.

3. Ask for a referral to an Accredited Exercise Physiologist.

4. Check fees beforehand so you know if there will be a gap payment.

How Many Australians Use Medicare for Exercise Physiology?

• Over 8.2 million allied health services are claimed each year through chronic disease management.

• Exercise Physiology accounts for 351k+ of those sessions.

• Group diabetes EP sessions add another 64,000+ services annually.

Why These Numbers Matter

Despite Australia's high chronic disease rate, EP services remain significantly under-utilised, meaning many people who could benefit are not accessing care.

Final Thoughts

Medicare rebates make Exercise Physiology more accessible for Australians living with chronic conditions. While the subsidy won’t usually cover the full cost of treatment, it can significantly reduce your out-of-pocket expenses and support long-term management of conditions like diabetes, arthritis, heart disease, or persistent pain.

If you want personalised exercise support — whether through Medicare rebates or private pathways — the team at Movement Therapy EP can guide you through eligibility, referrals, and tailored exercise plans.
Book your appointment today and start moving better with expert support.

FAQs

• How many Exercise Physiology sessions can I claim through Medicare?

  You can access up to 5 individual allied-health sessions per calendar year. These are shared across physio, EP, podiatry, dietetics, and more.

• What is the Medicare rebate for Exercise Physiology?

  As of July 2025, the rebate for item 10953 is $61.80.

• Does Medicare cover Exercise Physiology for diabetes?

  Yes. If you have type 2 diabetes, you can claim up to 8 group sessions per year after an initial assessment (items 81110 + 81115).

• Can I use Medicare and private health insurance for the same session?

  No — you must choose one or the other.

• Do Exercise Physiologists bulk-bill Medicare sessions?

  Some do. It depends on the clinic. Always ask about any “gap” before booking.