DVA arrangements for exercise physiologists

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Find the information you need to deliver and claim for exercise physiology services to Veteran Card holders.

If you’re a member of the veteran community, go to Exercise physiology services.

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COVID-19 arrangements

Visit COVID-19 information for healthcare providers for details about DVA arrangements during the pandemic, including access to telehealth services.

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Become a DVA health care provider

Register as a DVA health care provider so you can provide and claim services for DVA clients.

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

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Services covered by Veteran Cards – Gold and White

Please check What a DVA health card covers for full details about card entitlements to ensure your client’s condition is covered.

A Veteran Card – Gold or White covers exercise physiology treatment that is clinically necessary:

If you receive a referral where the condition to be treated has not been specified, you must contact the referring practitioner.

If you are unsure whether a DVA client is eligible to receive exercise physiology services, contact us on 1800 550 457.

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Referrals and treatment cycle

If you are treating a Veteran Card holder, they will need a valid referral from their GP. For an initial treatment cycle, the referral could alternatively come from a:

  • medical specialist
  • treating hospital doctor
  • hospital discharge planner.

Under DVA treatment cycle arrangements, a referral to an allied health provider will last up to 12 sessions or one year, whichever ends first.

Once a treatment cycle has ended, the client needs a new referral from their GP before you can provide further treatment. The client can have as many treatment cycles as their GP determines are clinically necessary.

The treatment cycle does not apply to exercise physiology treatment for clients who hold a Veteran Gold Card embossed with TPI (Totally and Permanently Incapacitated).

Veteran Card holders with severe or complex needs may have tailored referral arrangements through the At Risk Client Framework, approved by their usual GP.

For full details about the treatment cycle and referral arrangements, please check Treatment cycle information for allied health providers

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DVA Provider Notes

By accepting a patient’s Veteran Card – Gold or White, you agree to follow the Notes that apply to your profession.

The Notes are legally binding, and it is your responsibility to become familiar with them. They are divided into two sections, and you need to comply with both.

Section 1: General notes for allied health providers

Section 2: Specific to exercise physiologists

Please also refer to:

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Schedule of Fees

The Schedule of Fees – Exercise Physiologists defines the treatments and services you can provide to DVA clients and the payment amounts you can claim.

By accepting a Veteran Card – Gold or White, you agree to accept the DVA fee as full payment. You cannot charge the Veteran Card holder any ‘gap’ fee.

Schedule of Fees:

Software vendor files:

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Claiming

Visit Provider claiming for full details on how to claim payment from us.

Please note you are responsible for your provider number and you will be accountable for any claiming errors.

If someone else submits claims on your behalf, you should ensure they do not make any mistakes.

Your provider number cannot be shared, and multiple providers cannot claim under the one provider number. The provider who owns the number will bear the consequences of misuse.

For invoicing and billing enquiries, call 1300 550 017.

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Your obligations

Each year we review unusual provider claiming, which may result in an education process or financial recoveries.

For full details about complying with our requirements, please refer to Provider compliance.

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Common compliance issues

Before you treat a DVA client, please check the Schedule of Fees and Notes for full details about limits and restrictions on exercise physiology services.

Some common compliance issues include the following. Please note these are not exhaustive and you must check the Schedule of Fees for complete details about your profession’s Schedule of Fees item numbers.

Treatment aims and requirements

We will pay for an exercise physiologist to provide treatment to an eligible DVA client that is:

  • compliant with referral and treatment cycle arrangements
  • specific to the client’s referred condition
  • clinically necessary for that condition
  • evidence and outcome based.

The aim of treatment is to give the client the skills and knowledge to manage their own condition and promote independent recovery.

Subsequent consultations

A subsequent consultation must be:

  • the only consultation or session for the same client on the same day
  • one-on-one rather than in a group setting
  • at least 20 minutes long.

Patient care plan

You must prepare a patient care plan following an initial consultation. The plan should be revised with any changes in the client’s clinical circumstances, such as following a reassessment or as part of a discharge plan.

You must create and maintain detailed clinical records. The records should include all administrative and clinical aspects of the client’s treatment.

Qualified provider

The treatment must be provided by a qualified exercise physiologist, who is accredited through ESSA and registered with Services Australia.

An aide or trainee student cannot provide treatment on behalf of the claiming exercise physiologist.

Group consultation/exercise sessions

Treatment of a DVA client in a group format must be clinically necessary and tailored specifically to that client.

You must be present for the entire session, and provide constant group supervision with intermittent individual care.

Item numbers EP30 and EP32 can only be used to claim sessions that are:

  • part of an individual treatment plan for the client’s specific, referred condition
  • undertaken intermittently as clinically required
  • part of group sessions of no more than 12 participants.

You cannot use item numbers EP30 and EP32 to claim payment from DVA for:

  • ongoing general fitness
  • general gym programs
  • gym memberships
  • pool or gym entry fees.

Your consultation fee must cover any gym or pool entry fees for a client to access clinically required treatment.

Massage therapy and dry needling

We will only pay for treatments recognised as part of the Scope of Practice for exercise physiologists. Massage therapy and dry needling are outside of exercise physiologists’ Scope of Practice and we will not pay for these.

Please refer to Exercise and Sports Science Association (ESSA) for further advice.

Mental health care

We will not fund exercise physiologists to provide mental health treatments. Exercise physiologists cannot claim for any services provided under Non Liability Health Care (NLHC) arrangements.

Missed sessions

We will only pay for sessions the client attends.

If your standard practice is to charge a missed session fee, you need to tell your client about the fee when they make the appointment.

If the client misses a session, they will be responsible for paying the fee.

Kilometre allowance

We may pay a kilometre allowance if:

  • you are not a mobile provider
  • you have a fixed practice location
  • there is a genuine need to visit a client at home
  • your client’s home is more than 10 km from their nearest exercise physiology clinic.

We will only pay the allowance for the part of your trip that is more than 10 km from the practice nearest to the client.

We will not pay for you to travel:

  • between one office and another
  • from your practice to a treatment facility such as a gym or pool.
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Prior approvals

In exceptional circumstances, you may claim payment for treatments not included in the Schedule of Fees, if they:

  • can be clinically justified for the client’s referred condition
  • are evidence-based.

You must ask us for prior approval before providing the treatment.

To submit a request, please complete the D1328 Treatment Prior Financial Approval Request Form and email it to health.approval [at] dva.gov.au.

For inquiries, contact us on 1800 550 457

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Rehabilitation Appliances Program (RAP)

Exercise physiologists can prescribe aids and appliances to eligible Veteran Card holders through the RAP National Schedule of Equipment.

The item must be clinically necessary and support the patient’s referred condition.

You cannot supply these items yourself. You need to place an order through RAP, using the relevant RAP Form. The items will be supplied by a DVA-contracted RAP supplier.

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Residential Aged Care Facilities (RACF)

The provision of allied health services for residents of aged care facilities, including DVA clients, has been increased until 30 June 2022 in response to the Royal Commission into Aged Care’s recommendations on COVID-19.

For full details, please refer to DVA Provider News article, Increased allied health services for DVA clients in residential aged care.

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DVA Forms

Visit Provider forms to access all the forms you need to do business with us. This includes forms for prior approvals, RAP orders and claims.

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Health programs and services for DVA clients

Open Arms – Veterans & Families Counselling

Travel for a client's treatment

Training for providers

Research 

Health Providers' Partnership Forum (HPPF)

Contact us

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