Pilates and Private Health Insurance


Recently there has been a lot of confusion surrounding the changes the Department of Health have made to legislation regarding private health insurance. Many of you have questions surrounding how this may impact your classes and appointments at The Physio and Pilates Clinic.




How will these changes to legislation affect my ability to claim for Pilates classes?


The purpose of these changes is to remove private health insurance funding for therapies which are not medically based. Several types of natural therapies, including Pilates, will no longer be eligible for private health insurance rebates from 1st April 2019.

As you may be aware, there are many different types of Pilates classes that run across Australia, including many which are not run by Physiotherapists. Some classes are run for fitness purposes only and group exercise. These types of classes will no longer be claimable with private health insurers.


How will this affect my classes at The Physio and Pilates Clinic?


At The Physio and Pilates Clinic, Clinical Exercise classes (private/group) meet the criteria to claim the Group Consultation code by including:

  • Thorough initial assessments with a Physiotherapist

  • Sessions led by a Physiotherapist only

  • Accurate clinical records with appropriate outcome measures

  • Regular reviews to track progression and set appropriate goals at 6 weeks and 12 weeks

  • Individual programs with a combination of clinically appropriate exercises

  • Using the correct language on our programs & invoices that accurately reflects the service provided


What Classes are not claimable on Private Health at The Physio and Pilates Clinic?


Mixed Equipment Group Class, Beginner, Intermediate or Advanced are not claimable on private health as they are considered a group exercise class format, and therefore do not meet the criteria of the Physiotherapy Group consultation code.

If you have any further questions about Private Health Insurance or how it affects you, send me an email info@thephysioandpilatesclinic.com

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