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FAQs for providing exercise physiology services to DVA clients

This information is designed to help EPs (EPs) understand DVA-funded exercise physiology treatment for DVA clients.

For detailed information, refer to:

What is the aim of DVA-funded exercise physiology?

The aim of DVA funded exercise physiology is to:

  • assess the DVA client and design an individualised exercise program that addresses the need of their referred, specific clinical condition
  • provide the DVA client with the skills to manage the exercise component of their treatment on their own, through exercise.

Who can provide treatment?

Exercise physiology services must be provided by an exercise physiologist who is accredited by Exercise & Sports Science Australia (ESSA) and is registered with the Department of Human Services.

Who can I treat?

You can treat a DVA client who has both:

  • a referral from their medical practitioner, medical specialist or hospital discharge planner which includes a diagnosis informing you of the patient's condition requiring clinically necessary treatment, and
  • a DVA Health Card (Gold Card or White Card) where the referral for treatment relates to a war-caused or service-related condition accepted by DVA.

Note:

If you receive a referral where the condition to be treated has not been specified, you must contact the referring practitioner. If there is any doubt about a DVA client's eligibility to receive exercise physiology services, contact DVA.

Do I need to prepare a care plan? What are the note-keeping requirements for DVA services?

Yes. You must prepare a patient care plan following an initial consultation. The patient care plan should be revised with any changes in the DVA client's clinical circumstances, such as following a re-assessment, or as part of a discharge plan. Service providers must create and maintain detailed and up-to-date clinical records which note all administrative and clinical aspects of the provision of treatment to a DVA client.

What should I do if the DVA client is not responding to treatment?

Some DVA clients may be non-responsive to exercise physiology treatment, that is, they are not achieving desired outcome measures identified in the patient care plan. This may be due to a number of factors. This situation should be discussed with the DVA client's general practitioner. Further exercise physiology treatment may not be suitable or clinically necessary.

How should I manage indefinite referrals?

Occasionally you may receive a referral for an indefinite period, that is, the referral does not have an end date. An indefinite referral may be used, for example, for a degenerative condition where intermittent check-ups may be necessary to ensure exercise treatment remains effective in managing the DVA client's health needs. All treatment delivered to DVA clients, regardless of the referral type, must be clinically necessary.

If you receive an indefinite referral you can notify the Department of Human Services by:

How long will DVA pay for a DVA client to see an exercise physiologist?

DVA will pay for the DVA client to see an EP for clinically necessary treatment only. The EP can assist the DVA client with their recovery or self-management of referred conditions. It is expected the duration of treatment will be evidence and outcome-based, reasonable in time, and focus on exercise literacy to promote improved condition management and recovery, independent of the need for regular or ongoing treatment.

Importantly, EP treatment of chronic conditions must have a focus on promoting independence from treatment by facilitating the DVA client's self-management of their condition. Treatment must be delivered in accordance with available scientific literature demonstrating that an appropriately prescribed exercise intervention can produce an anticipated health outcome relevant to the referred condition only.

Any treatment must be clinically appropriate and delivered in a timely manner. The presence of chronic or complex conditions does not mean a DVA client requires continuous treatment for 12 months. The responsibility of the DVA client to implement the advice of the healthcare professional as part of their self-management strategy is desirable. Doing so is likely to produce significant health benefits.

A referral is normally valid for 12 months, unless it is an ongoing referral for a DVA client with accepted chronic conditions. This does not mean the DVA client with a chronic condition will clinically require ongoing treatment. The EP should provide advice and clinical guidance and promote better self-management with the view to significant health benefits.

DVA does not fund ongoing, weekly treatment to promote exercise adherence or for general exercise participation purposes.

How should I manage referrals requesting multiple treatments in a week, for example, supervised exercise three times per week?

Based on your clinical judgment of the DVA client's assessed and referred needs you, as the service provider, determine the type, number and frequency of the treatments to be provided for the services that do not require prior financial authorisation from DVA.

What is the purpose of a group consultation?

Treatment of a DVA client in a group format must be clinically necessary and individualised. The group items allow for intermittent treatment of DVA clients in a group of up to 12 participants. It is not appropriate to use group treatment items to supervise ongoing exercise regimes or to provide general gym programs. This includes group exercise classes that work on improving health parameters generally such as to increase fitness, decrease falls risk or lose weight.

Do I need to be present during the entire group consultation?

Yes. All participants must receive constant overall supervision with intermittent individual care throughout the consultation.

I receive payment for a group session from a residential aged care facility (RACF). Can I also claim for payment from DVA?

No. You cannot claim for services that have been paid or will be paid for by a third party (for example, the residential aged care facility).

Can my aide or student provide treatment on my behalf?

No. A student cannot provide treatment on your behalf.

Can I provide consultations via Skype?

No. You must be physically present during all consultations.

The DVA client needs an exercise band. How can I claim for this?

Therapeutic exercise bands can be obtained through the Rehabilitation Appliances Program (RAP) National Schedule of Equipment (item AV10) if they are clinically necessary.

You will need to complete the following form:

For more information, refer to AV00 Physiotherapy Appliances on the RAP National Schedule of Equipment.

Can I provide massage therapy as part of my exercise physiology treatment?

No. DVA only funds massage therapy if it is delivered during a consultation by a physiotherapist, chiropractor or osteopath.

Additionally, DVA will only pay EPs to deliver treatments recognised as part of their Scope of Practice. Activities such as dry needling or massage therapy are not recognised within the Scope. Please refer to ESSA for further advice.

Does DVA pay for pool or gym entry, general exercise programs, fitness centre or gym memberships?

No. Any treatment that is not clinically necessary cannot be billed under DVA's arrangements. If the DVA client wants to join a generalised exercise class, fitness or gym program, this needs to be a private arrangement between them and the EP or the fitness centre/ gym.

All consultation fees include any fees that might be payable to access a facility, such as payment for the DVA client's entry cost into a gym or pool.

What other options are there for DVA clients?

DVA's Heart Health Programme helps DVA clients to increase their physical health and wellbeing through practical exercise, nutrition and lifestyle management support. For more information, see Heart Health Programme.

The fee I charge is more than the DVA fee. Can I charge the difference to the DVA client?

No. You must charge your service according to the DVA Exercise Physiology Schedule of Fees.

Can I charge DVA if the DVA client does not show up for an appointment?

No. However, if it is your standard practice to charge a fee for missed appointments then the DVA client will be responsible for this payment provided they have been advised beforehand.

When can I claim a kilometre allowance?

If you are registered as a mobile provider, that is, you have no fixed practice location, then you are unable to claim a kilometre allowance for any travel you undertake to see DVA clients, regardless of meeting DVA travel requirements.

For providers with a fixed practice location, you are able to claim an allowance for home visits per kilometre where a genuine need for the DVA client to be seen in their home exists and where:

  • the distance is greater than 10km
  • the DVA client is physically unable to travel to your clinic, and
  • there is no suitable provider located closer to the DVA client.

You are not able to claim kilometre allowance from DVA for travel between one office to another, or from your practice to an outside facility, such as a gym or the pool.

Generally not. As stated in the Notes for Allied Health Providers Section One: General clause 72-74, the only permissible words providers can use to indicate the availability of allied health services to the veteran community are 'DVA Health Cards (Gold and White) are accepted as payment upon a GP referral'.

This means material that targets DVA clients on the type of service that can be delivered using their health card for payment will not meet DVA requirements. For example terms such as 'DVA', 'ex-service personnel' or 'veterans' in your advertisements, websites or promotional material are not appropriate to be used where readers might infer specific providers are endorsed by DVA. Phrasing such as 'fully funded by DVA', 'Treatment is bulk billed', 'Treatment is free' or 'Gym membership included' should not be used in your advertising.

You must seek permission in writing from DVA to include any reference to DVA or DVA clients. Changes to material that has been previously approved must be re-approved by DVA. Advertising requests can be sent to providerengagement@dva.gov.au or posted to:

Sector Engagement
Department of Veterans' Affairs
GPO Box 9998
Brisbane Qld 4001

Do I need to use a Recipient Created Tax Invoice for claiming?

Yes, you will need to complete a Recipient Created Tax Invoice agreement if you, or the business you work for, are registered for GST purposes.

Can I claim online?

Yes. You can participate in online claiming through Medicare Online Claiming. This method is paperless, fast and efficient. Ask your software vendor for the latest version to maximise the benefits of electronic claiming.

DVA Webclaim is a free online service designed primarily to help providers who only have a small number of DVA clients to lodge claims for. Webclaim will provide instant responses to most claims. You can also access online payment statements for processed claims. DVA Webclaim is available on the DHS Health Professional Online Services (HPOS) portal.

Claim enquiries

For more information about the claim process, phone 1800 700 199 (option 3 then option 1), or email DHS at eBusiness. Current fee schedules are also available.

Where can I get further information?

The following documents are recommended readings prior to providing treatment to DVA clients:

How do I contact DVA?

For DVA contact information and options, visit Contact us.

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