Medicare Exercise Physiology: Item 10953 Explained

Item 10953 is the individual exercise physiology item under a GP chronic condition management plan. The two things that catch people out are what makes a referral valid, and the duty to report back to the GP after the first and the last service.

Last reviewed

Item 10953 and the referral

From 1 July 2025 the GP chronic condition management plan replaced the earlier arrangements, and the older allied health referral forms were retired with no replacement template. There is no mandated form.

What matters is the content of the referral, which item 10953's explanatory notes set out.

  • Written, signed and dated. An electronic signature is acceptable.
  • The referrer's name, and their practice address or provider number.
  • The date.
  • The reasons for the referral, and the relevant information about the condition.
  • It does not have to name a particular professional or a number of services.
  • It is valid for the period stated on it, or for 18 months.

Reporting back to the GP

A written report to the referring practitioner is required after the first service and after the last service, and at other times when it is clinically warranted. There is no Services Australia or Department of Health report template for the 10950 to 10970 items, so the content is yours to structure.

Session limits

Allied health services under a chronic condition management plan are capped per client per calendar year and shared across all the allied health professions the client sees, so what is left for exercise physiology depends on what else they have used. Check the current cap with Services Australia.

Group services for type 2 diabetes

There is a separate group pathway for clients with type 2 diabetes, items 81100 to 81125, and an exercise physiologist can author part of its referral form.

  • Part A is the GP's. Part B is completed by the assessing allied health professional after the assessment item, and the form names exercise physiologists.
  • A written report goes to the referring GP after the assessment, stating suitability and the type of group service.
  • A further written report goes to the GP after the last group service.
  • The departmental guideline says the referral must be on the department's form, or a form containing all of its components.

Follow-up items for Aboriginal and Torres Strait Islander clients

Follow-up allied health items 81300 to 81360 include exercise physiology as 81315. The referral is authored by the GP or health practitioner; the exercise physiologist is the recipient.

Bulk billing consent

From 1 July 2026 a specific Medicare form is no longer required to record a client's consent to assign their benefit. The client signs, physically or electronically, and the practitioner does not need to sign. Verbal assignment is allowed during a transition until 30 June 2027 if a record is kept. Records are kept for two years.

Questions

How many exercise physiology sessions does Medicare cover?
Allied health services under a chronic condition management plan are capped per client per calendar year and shared across all allied health professions, so the number available for exercise physiology depends on what else the client has used. Check the current cap with Services Australia.
Who is eligible for Medicare-funded exercise physiology?
A client with a chronic condition who has a GP chronic condition management plan and a valid referral for allied health services under it.
Do sessions have to be a minimum length?
The MBS sets the service requirements for each item, so read item 10953's own descriptor rather than a summary. epnote does not restate a duration it has not sourced.
What makes a Medicare referral for exercise physiology valid?
It must be written, signed and dated, name the referrer with their practice address or provider number, carry the date, and give the reasons for referral and the relevant condition information. It lasts for the period stated, or 18 months.
What changed in the 2025 chronic condition management framework?
From 1 July 2025 the GP chronic condition management plan replaced the earlier arrangements, and the older allied health referral forms were retired without a replacement template. The referral requirements come from item 10953's explanatory notes instead.

Write this report in epnote, free

epnote is report software for Australian exercise physiologists. Enter your measurements once and it works out the change and lays the report out, ready to sign. What you write about a client stays on your device.

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Sources

Everything on this page comes from one of these. epnote writes nothing clinical from memory.

What this page does not cover yet

  • The brief asks for the current rebate amount and the exact session cap. Neither is in the repo, and both change, so this page points at Services Australia instead of printing a figure.
  • The brief asks about common claiming mistakes. The repo holds no sourced list, so that section is not on the page.

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