After conducting a review of the Private Health Industry, the Department of Health concluded that Natural Therapies were no longer to be included as therapies covered by Private Health Insurers. Included in many policies under ‘Natural Therapies’ is Pilates, effective as of 1st April 2019.
Exercise Classes conducted by Physiotherapists that include some Pilates exercises are still covered and will continue to be claimable under member’s Physiotherapy Cover as long as the following conditions are met:
- Classes are not to be called Pilates or Clinical Pilates nor be advertised as such. From April 1st our Clinical Pilates stream will be renamed Clinical Physiotherapy Classes;
- Classes must not consist of purely Pilates based exercises but instead use a range of different physiotherapy based exercises (which is what we currently do anyway);
- To attend these classes and receive a rebate you must undergo an Initial individual assessment (this we already do) and ongoing re-assessment, at least once every 6 months. Further assessment may also be recommended by your physiotherapist if your condition changes.
- Receipts will continue to have Group Physiotherapy listed as the item descriptor with Item code 560 to enable participants to make claims with their health funds.
What does this mean for Current Clinical Pilates participants?
You will most likely not notice any difference. Classes will run the same as they have been.
We will be more vigilant however in enforcing participants’ 6 monthly reviews. Group Physiotherapy is treated like any Physiotherapy intervention and as clinicians we must be able to justify why Clinical Physiotherapy Classes are required and how it’s helping to achieve specific goals. If we cannot demonstrate this in a health fund audit, we will be required to reimburse the private health insurance companies. Please assist us in this matter by booking your reassessments promptly when reminded to do so. If a participant continues to book into classes without having had a recent assessment / reassessment we will be forced to ask that participant to not attend OR issue them a receipt without the item codes so they will not be able to claim those classes back.
What does this mean for Current Lifestyle Pilates participants?
Nothing! Lifestyle Pilates Classes will continue to be a great value for money Pilates class run by Physiotherapists and degree qualified Health Professionals.