Medicare Exercise Physiology Services at Palms Physiotherapy & Allied Health At Palms Physiotherapy & Allied Health, we provide Medicare-funded exercise physiology services to help manage chronic conditions such as diabetes, heart disease, arthritis, and obesity. If you have a Medicare Care Plan or Team Care Arrangement, you may be eligible for up to five exercise physiology sessions per year. Our accredited exercise physiologists create customized fitness plans to improve strength, mobility, and overall health. Book your Medicare-funded exercise physiology session with us today!

Understanding Bulk Billing for Exercise Physiology Care Plan Sessions

At Palms Physiotherapy & Allied Health, we are committed to helping you improve your health, fitness, and overall well-being through tailored exercise programs. If you have a Medicare Care Plan (Team Care Arrangement - TCA), you may be eligible for exercise physiology (EP) services. However, it’s important to understand how billing options, including bulk billing and gap fees, may influence your care.

This page outlines the pros and cons of bulk billing for exercise physiology and explains why some clinics, including ours, offer both bulk-billed and gap-fee options. Our goal is to help you make an informed decision that ensures the best possible outcomes from your exercise treatment.

Bulk Billing for Exercise Physiology: The Pros and Cons

What is Bulk Billing for Exercise Physiology?
Bulk billing means we bill Medicare directly for your EP session, so there are no out-of-pocket costs for you. Under a Medicare Care Plan, you can receive up to five sessions per year, with Medicare reimbursing $60.35 per session.

Pros of Bulk Billing for Exercise Physiology:

1. No Out-of-Pocket Costs:

   • Bulk billing makes exercise physiology accessible for those who might not otherwise be able to afford private services. This can be helpful for individuals managing chronic conditions such as Type 2 Diabetes, heart disease, or obesity, where ongoing exercise support is crucial.

2. Basic Exercise Support:

   • Even with shorter sessions, bulk-billed exercise physiology can still provide essential support, such as basic exercise instruction, education on managing your condition, and some progress monitoring.

Cons of Bulk Billing for Exercise Physiology:

1. Shorter Session Length:

   • Medicare’s reimbursement rate of $60.35 per session often limits the length of bulk-billed EP appointments to around 20 minutes. This may not be enough time to develop a comprehensive exercise plan, provide ongoing supervision, or monitor progress effectively.

   • Evidence-Based Fact: Research shows that exercise interventions lasting 30-60 minutes are significantly more effective for improving outcomes in patients with chronic conditions, such as cardiovascular disease, metabolic syndromes, and musculoskeletal issues. Shorter sessions may not allow enough time to fully assess your needs or guide you through a personalized program.

2. Limited Scope for Complex Cases:

   • Exercise physiology is most effective when it involves careful assessments, detailed programming, and long-term monitoring. For patients with complex conditions such as chronic fatigue syndrome (CFS), multiple sclerosis (MS), or postural orthostatic tachycardia syndrome (POTS), shorter bulk-billed sessions may not provide enough time for thorough care.

3. Sustainability for Clinics and Staff:

   • The reimbursement Medicare provides for bulk billing is insufficient to sustain longer, more in-depth consults. Offering extended sessions at bulk-billed rates would mean our exercise physiologists are being underpaid, which can affect the quality of service and limit what we’re able to offer in terms of personalized care.

Why Some Clinics Charge a Gap Fee for Exercise Physiology

While bulk billing makes exercise physiology accessible, it comes with limitations. At Palms Physiotherapy & Allied Health, we offer the option to pay a gap fee for longer, more comprehensive exercise physiology sessions, which offer significant advantages for managing your health.

The Benefits of Paying a Gap Fee for Exercise Physiology:

1. Longer Sessions (30-45 minutes):

   • Gap-fee sessions allow for 30-45 minute consultations, giving your exercise physiologist enough time to thoroughly assess your health, create a tailored exercise plan, and monitor your progress over time. This is particularly beneficial for patients with more complex needs, such as those with Type 2 Diabetes, hypertension, or recovering from musculoskeletal injuries.

   • Evidence-Based Fact: Longer EP sessions are shown to have better outcomes in managing conditions like diabetes and obesity, as they provide enough time to address physical fitness, functional capacity, and education on lifestyle changes that improve long-term health.

2. Personalized Exercise Programs:

   • With more time, your exercise physiologist can develop a program that is completely tailored to your needs, abilities, and goals. This can include supervised exercise sessions, functional fitness training, and education on how to self-manage your condition outside of the clinic.

3. Better Long-Term Results:

   • Research supports the fact that consistent, supervised exercise over longer periods leads to more significant health improvements. Paying a gap fee for longer sessions ensures that you’re not only getting the time you need during each session but also the guidance to maintain your progress long-term.

4. Fair Compensation for Professional Care:

   • A gap fee allows us to ensure our exercise physiologists are fairly compensated for their time and expertise. This not only supports the sustainability of our practice but ensures that we can continue to offer high-quality, personalized care to each of our patients.

Why We Offer Both Bulk Billing and Gap-Fee Options for Exercise Physiology

At Palms Physiotherapy & Allied Health, we understand that every patient’s needs and circumstances are unique. That’s why we offer both bulk-billed and gap-fee options for exercise physiology, allowing you the flexibility to choose the care that best fits your situation:

1. Bulk Billing: For those who require basic exercise instruction or have straightforward conditions, we offer 20-minute bulk-billed sessions. These can provide guidance on general exercise plans and basic progress checks.

2. Gap-Fee Sessions: For patients with more complex conditions, longer gap-fee sessions (30-45 minutes) offer more time for detailed assessments, personalized programming, and education that goes beyond the basics. These sessions allow you to take full advantage of the skills and expertise of our exercise physiologists to maximize your health outcomes.

The Importance of Session Length in Exercise Physiology Outcomes

20-minute sessions (bulk billing):

• Best suited for basic exercise guidance, simple conditions, or quick follow-ups.

• May not be enough time to develop or adjust complex exercise programs or address the full scope of chronic conditions like cardiovascular disease, musculoskeletal injuries, or metabolic syndromes.

30-45 minute sessions (gap fee):

• Provide sufficient time to conduct thorough assessments, implement tailored exercise programs, and monitor long-term progress. This is especially important for individuals with complex conditions that require a more in-depth approach to physical activity management.

  • Evidence-Based Fact: Longer, supervised exercise sessions have been shown to improve patient outcomes in managing chronic conditions. For example, patients with diabetes or hypertension benefit from detailed exercise instruction and continuous monitoring, which is often not feasible within short, bulk-billed appointments.

Making the Best Choice for Your Exercise Physiology Care

The decision between bulk-billed and gap-fee sessions depends on your health goals, the complexity of your condition, and your financial situation. While bulk-billing is a great option for quick, essential care, paying a gap fee ensures longer, more thorough sessions that can lead to better long-term health outcomes.

Our team is here to help you decide which option best suits your needs. Whether you choose bulk-billed or gap-fee sessions, we are dedicated to helping you achieve your health goals through personalized, evidence-based care.

FAQ: How to Access Medicare-Funded Allied Health Sessions through a TCA or GPMP

1. What is a Team Care Arrangement (TCA) or GP Management Plan (GPMP)?
A Team Care Arrangement (TCA) and GP Management Plan (GPMP) are programs under Medicare that allow patients with chronic medical conditions to access a range of allied health services, including physiotherapy, occupational therapy, speech therapy, and exercise physiology. These plans are created by your GP to coordinate care between your general practitioner and other healthcare providers.

2. Am I eligible for a TCA or GPMP?
To qualify for a TCA or GPMP, you must have a chronic medical condition that has been present for six months or longer. This may include conditions such as arthritis, diabetes, heart disease, stroke, or musculoskeletal disorders. It’s important to note that eligibility is assessed on a case-by-case basis and is at the discretion of your GP. Your GP will evaluate your medical history and determine whether you qualify for these plans.

3. How do I get a TCA or GPMP?

To get a TCA or GPMP, you need to book an appointment with your GP. During your visit, discuss your chronic condition and how allied health services might support your treatment plan. If your GP agrees, they will create a GP Management Plan (GPMP) and/or a Team Care Arrangement (TCA). They will refer you for up to five allied health sessions per year, depending on your condition and healthcare needs.

4. What allied health services can I access under a TCA or GPMP?

With a TCA or GPMP, you may be eligible to access allied health services such as:

• Physiotherapy

• Occupational therapy

• Speech therapy

• Exercise physiology

The number of sessions allowed is typically up to five per year, but this may vary depending on your needs and the advice of your GP.

5. Is the cost of allied health services covered under Medicare with a TCA or GPMP?

Medicare may cover the cost of your allied health sessions, but this will depend on the clinic’s billing policy. Some clinics bulk bill for these services, while others may charge a gap fee. It is important to confirm the payment structure when booking your appointment.

6. Can I see any allied health professional for my TCA or GPMP?

While your GP will refer you to allied health professionals as part of the plan, you can choose from a range of qualified providers. Be sure to confirm with the clinic whether they are Medicare-registered and accept TCA or GPMP referrals.

7. Can I request a longer session if I need more time with the therapist?

If you require more time with your therapist, you can choose to pay a gap fee for longer sessions. Under Medicare, your sessions for TCA or GPMP are usually limited to a shorter duration (e.g., 20 minutes). If you would like additional time to fully address your chronic condition, speak to the clinic staff about arranging an extended session for an additional cost.

8. How often can I access Medicare-funded allied health services under a TCA or GPMP?

You can access up to five sessions per year for each chronic condition that is covered under your TCA or GPMP. However, these sessions are reviewed annually by your GP. If your condition improves or worsens, your GP may adjust the plan accordingly.

9. What should I do if my GP doesn't think I am eligible for a TCA or GPMP?

If your GP determines that you are not eligible for a TCA or GPMP, you can discuss alternative options for managing your chronic condition. Many clinics offer private appointments or can direct you to other forms of support and care that may be more suitable for your needs.

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Exercise Physiology in Perth – Expert Rehabilitation & Chronic Disease Management

What is Exercise Physiology?
Exercise Physiology involves the use of clinical exercise interventions to prevent or manage chronic diseases, rehabilitate injuries, and improve physical function. Our accredited exercise physiologists at Palms Physiotherapy & Allied Health work with individuals of all ages, whether you’re recovering from surgery, managing a chronic illness, or looking to improve your overall health.

How Can Exercise Physiology Help You?
Exercise physiology is a science-backed approach that provides a wide range of benefits, including:

• Chronic Disease Management: Tailored exercise programs to manage conditions like Type 2 Diabetes, cardiovascular disease, and chronic pain.

• Injury Rehabilitation: Post-surgical or injury recovery programs to restore strength, mobility, and function.

• Exercise for Disabilities: NDIS-supported exercise programs for individuals with disabilities, aimed at improving independence and quality of life.

• Weight Management and General Fitness: Programs designed to support weight loss, fitness improvement, and long-term health goals.

Our Exercise Physiology Services

At Palms Physiotherapy & Allied Health, our Exercise Physiology services are tailored to meet the unique needs of every client:

• Chronic Disease Management
  Exercise is critical in managing conditions like Type 2 Diabetes, heart disease, and arthritis. Our exercise physiologists design evidence-based programs to help you stay active, manage symptoms, and reduce the risk of further complications. Bulk billing is available through Medicare for eligible patients.

• Injury Rehabilitation
  Whether you’re recovering from a motor vehicle accident (MVA), workers’ compensation injury, or surgery, our exercise physiologists will work closely with you to create a rehabilitation plan that promotes healing, reduces pain, and restores mobility.

• Exercise for Disabilities (NDIS)
  We offer tailored exercise programs for individuals on the National Disability Insurance Scheme (NDIS). These programs help people with disabilities improve strength, coordination, and functional capacity to increase independence and participation in daily activities.

• Weight Loss & Fitness Programs
  For clients looking to improve their fitness, manage weight, or address conditions related to obesity, our exercise physiologists design personalized exercise programs based on your goals, current fitness level, and medical history.

Why Choose Palms Physiotherapy & Allied Health for Exercise Physiology?

• Experienced, Accredited Exercise Physiologists: Our team is qualified, experienced, and passionate about helping individuals achieve their health goals.

• Medicare Bulk Billing Available: Eligible clients can access Medicare-funded sessions, making our services affordable.

• NDIS Provider: We support individuals with disabilities through the NDIS framework, offering inclusive and effective exercise programs. We can see plan and self managed participants.

• Multi-Disciplinary Team: Our exercise physiologists work alongside physiotherapists, occupational therapists, and speech therapists to offer a holistic approach to care.

Sensory Room and Kids Therapy Gym
Our state-of-the-art sensory room and kids therapy gym are designed to provide sensory integration therapy and gross motor development in a fun and safe environment. These spaces are equipped with a trampoline, climbing frames, swings, and other tools to help children and adults with sensory processing challenges or developmental delays.

Why Choose Palms Physiotherapy & Allied Health for Exercise Physiology?

• Qualified and experienced occupational therapists with a passion for helping people

• State-of-the-art facilities, including sensory rooms and rehabilitation gyms

• Tailored therapy plans for all ages and abilities

• NDIS provider offering individual and group sessions (plan and self managed participants)

• Multidisciplinary team working alongside physiotherapists, exercise physiologists, and speech therapists

Frequently Asked Questions (FAQs) on Exercise Physiology

Q: What is the role of an exercise physiologist?

An exercise physiologist designs and implements clinical exercise programs to help individuals prevent or manage chronic diseases, recover from injury, and improve their overall health. Unlike personal trainers, they work with patients who have specific health conditions or physical limitations.

Q: What conditions can exercise physiology help manage?

Exercise physiology can assist with the management of several chronic conditions, including:

• Type 2 Diabetes

• Cardiovascular disease

• Osteoarthritis and other musculoskeletal disorders

• Chronic pain

• Respiratory conditions like COPD

• Neurological disorders, including Multiple Sclerosis (MS) and Parkinson's Disease (PD)

Q: Is exercise physiology covered by Medicare?

Yes, exercise physiology is covered by Medicare for eligible patients. You’ll need a referral from your GP under a Chronic Disease Management Plan (CDM), which allows you to access up to 5 subsidized sessions. There is  another plan that enables you to 8 x Medicare sessions of exercise if you are a Type 2 Diabetic.

Q: How is exercise physiology different from physiotherapy?
While both exercise physiologists and physiotherapists work to improve physical health, exercise physiology focuses on designing exercise programs for chronic disease management and fitness improvement. Physiotherapy tends to focus on hands-on treatment and rehabilitation after injuries or surgeries.

Q: Can I access exercise physiology under NDIS?
Yes, Palms Physiotherapy & Allied Health is a NDIS provider, and our exercise physiology services are available for individuals with NDIS funding. We work with people with disabilities to create exercise programs that improve strength, mobility, and independence. We can see participants who are self or plan managed.

Q: Can exercise physiologists help with weight loss?

Yes, our exercise physiologists create tailored exercise programs to support weight loss and improve overall fitness. We take into account your health status, medical history, and personal goals to ensure the program is safe and effective.

Conditions & Disabilities Exercise Physiologists Can Assist With

Head to this page to see the different conditions that we can help with, and get you the best life and function you deserve!!