The PHI (Private Health Insurance) Reforms on Pilates – How this affects our clients.
In 2018, the Federal Government announced its plans to make certain natural therapies ineligible for private health insurance (PHI) rebates. Among these was Pilates. The Government’s original position was that Pilates would not be rebatable, regardless of who delivers it or how it is delivered.
However the Department considers that an insurer may lawfully pay benefits if a physiotherapist, providing services to a patient within the accepted scope of clinical practice, uses exercises or techniques drawn from Pilates as part of that patient’s treatment, as long as the exercises or techniques are within the accepted scope of clinical practice.
As long as the group exercise class is performed within the scope of physiotherapy, it does not need to change. It should be underpinned by individualised assessment, treatment and follow-up, and backed by thorough notes. The Department and private health insurers agree that physiotherapy is physiotherapy, and therefore fundable through private health insurance.
