Changes to exercise physiology claiming arrangements from 1 September 2021

Important changes to exercise physiology claiming arrangements took effect on 1 September 2021. From this date, exercise physiology services cannot be provided on the same day as another musculoskeletal service including chiropractic, osteopathy or physiotherapy services for treatment of the same condition. DVA will continue to pay for exercise physiology services on the same day as another musculoskeletal service where the treatment is for different conditions.

It has long been the case that DVA does not pay for concurrent treatment for the same condition from physiotherapists, osteopaths or chiropractors, because patients may not receive clinical benefit from this. Under these changes, exercise physiology will be considered in a similar way.

The change takes into consideration a number of factors including safety, clinical advice, the best available evidence and cost effectiveness. DVA is advised by clinical experts that receiving more than one musculoskeletal service for the same condition on the same day will not necessarily provide a greater clinical benefit. This advice is based on widely accepted evidence-based approaches in clinical practice relating to multidisciplinary care teams that deliver physical and exercise therapies.

A young female exercise physiologist (EP) or physiotherapist assisting an elderly male patient in a gym.

From 1 September 2021, treating allied health providers are responsible for communicating with their DVA clients to ensure that the service they are providing is not on the same day as another musculoskeletal service to treat the same condition.

Exercise Physiologists, physiotherapists, osteopaths and chiropractors can find more information about their obligations in the Notes for Allied Health Providers.

There may be a small number of cases where the clinical needs or personal circumstances of a client may benefit from accessing multiple musculoskeletal therapies for the same condition on the same day. DVA’s prior approval arrangements remain available for these circumstances, where there is a clinical justification to support this course of treatment.