Great News for Families: Medicare Now Funds Exercise Physiology for Kids with Complex Needs
Written by Paediatric Exercise Physiologist, Ben Hall – Ocean Kids Health
As of 1 July 2025, Medicare now includes Accredited Exercise Physiologists as part of the MBS-funded support for children and young people under 25 with Complex Neurodevelopmental Disorders (CND) or eligible disabilities. This is a huge win for families who have been seeking better access to movement and participation supports.
What Conditions Are Included?
Children and young people with the following may be eligible:
- Autism Spectrum Disorder (ASD)
- ADHD
- Global Developmental Delay (GDD)
- Cerebral Palsy
- Genetic syndromes or neurological conditions affecting development
These changes fall under the M10 item group and support both diagnosis and treatment planning, as well as direct therapy.
How Can Exercise Physiology Help?
At Ocean Kids Health, our AEPs support children and teens to:
- Build strength, balance and coordination
- Improve motor skills and reduce fatigue
- Support engagement in school, play, and sports
- Increase confidence, independence, and participation
We tailor sessions to each child’s interests and abilities – movement is fun, achievable, and meaningful.
What’s Funded Under Medicare?
Medicare will partially fund:
- Assessment and planning sessions (minimum 50 mins)
- Treatment sessions (minimum 30 mins)
- Telehealth and phone options
- Case conferences with your broader care team
All sessions must be part of a formal treatment and management plan and are provided by referral only.
Up to 20 sessions (lifetime cap) per eligible child or young person.
Who Can Refer?
You now have two clear pathways to access Exercise Physiology under Medicare:
Pathway 1 – Via Paediatrician or Psychiatrist:
- GP (optional, but can assist with initial referral)
- Paediatrician/Psychiatrist confirms diagnosis and creates a Treatment & Management Plan
- Referral is made to an Accredited Exercise Physiologist
Pathway 2 – Via General Practitioner (GP):
- GP refers directly to an AEP
- This is only for children with a confirmed eligible disability (not suspected)
All referrals must be:
- In writing
- Include the number of sessions requested
- Linked to a formal Treatment & Management Plan
Where Can Sessions Take Place?
Exercise Physiology can now be accessed through:
- In-clinic sessions
- Video (telehealth)
- Phone consultations
- Case conferences (with your care team)
This flexibility supports families across metro, rural, and remote settings.
A Milestone for Allied Health and Families
This long-awaited change recognises the important role Exercise Physiologists play in supporting young people with complex needs. It follows years of advocacy by ESSA and other peak bodies.
Quick Summary for Parents
- Who is it for? Kids and young people under 25 with CND or eligible disability
- How many sessions? Up to 20 Medicare-funded sessions (lifetime cap)
- Who refers? Paediatricians, Psychiatrists or GPs (for eligible disabilities only)
- When? Available now – from 1 July 2025
- Where? In person, via telehealth/phone, or in case conferences
Need Help Navigating the Process?
We know the system can be confusing – that’s where we come in. The Ocean Kids Health team can:
- Help you understand your child’s eligibility
- Liaise with your GP or specialist
- Provide supportive, goal-based sessions
hello@oceankidshealth.com.au
(03) 7009 3652
www.oceankidshealth.com.au
