Claiming Pilates on Your Private Health Insurance
UPDATED MAY 2026
From 1 July 2025, Australian health funds can legally offer rebates for Pilates again. Here's everything you need to know — including claiming with our diploma-qualified Pilates teachers, not just our physios and exercise physiologists.
From 1 July 2025, Australian health funds can legally offer rebates for Pilates again. Here's everything you need to know — including claiming with our diploma-qualified Pilates teachers, not just our physios and exercise physiologists.
What's changed - and what it means for you.
From 1 April 2019, the Federal Government banned private health funds from paying rebates for Pilates and 15 other natural therapies. After a major government-commissioned review finalised in 2024, the Albanese Government accepted the recommendations of the Natural Therapies Review Expert Advisory Panel and reinstated Pilates as a rebateable therapy.
On 19 June 2025, the Private Health Insurance Legislation Amendment Rules (No. 5) 2025 were issued. From 1 July 2025, health funds are legally permitted to pay rebates for Pilates under extras cover — in the same category as Alexander Technique, naturopathy, tai chi, yoga, and western herbalism.
On 19 June 2025, the Private Health Insurance Legislation Amendment Rules (No. 5) 2025 were issued. From 1 July 2025, health funds are legally permitted to pay rebates for Pilates under extras cover — in the same category as Alexander Technique, naturopathy, tai chi, yoga, and western herbalism.
IMPORTANT TO UNDERSTAND
The law changing doesn't mean every fund immediately pays rebates. Each fund must individually decide to include Pilates, set benefit levels, define item codes, and establish credentialling requirements. This rollout is happening fund by fund throughout 2025–2026.
HCF was the first major fund to confirm Pilates rebates (from July 2025). Several others are progressing through early–mid 2026. Always contact your fund to confirm current availability before booking.
The law changing doesn't mean every fund immediately pays rebates. Each fund must individually decide to include Pilates, set benefit levels, define item codes, and establish credentialling requirements. This rollout is happening fund by fund throughout 2025–2026.
HCF was the first major fund to confirm Pilates rebates (from July 2025). Several others are progressing through early–mid 2026. Always contact your fund to confirm current availability before booking.
TWO PATHWAYS TO CLAIM
Health Management Programs (available now at some funds): Most major funds already offer rebates for exercise programs — including Pilates — when used to manage a specific health condition documented by a GP or allied health provider. Available at HCF, Medibank, Bupa, nib, Westfund, and Health Partners.
General Treatment / Natural Therapy ancillary benefits (rolling out 2025–2026): This is the new "Pilates as a profession" rebate — where funds issue Pilates-specific item codes and provider numbers to qualified teachers. The PAA expects this to be broadly available from mid-2026.
Health Management Programs (available now at some funds): Most major funds already offer rebates for exercise programs — including Pilates — when used to manage a specific health condition documented by a GP or allied health provider. Available at HCF, Medibank, Bupa, nib, Westfund, and Health Partners.
General Treatment / Natural Therapy ancillary benefits (rolling out 2025–2026): This is the new "Pilates as a profession" rebate — where funds issue Pilates-specific item codes and provider numbers to qualified teachers. The PAA expects this to be broadly available from mid-2026.
Fund-by-fund guide
Information current as of April 2026. Requirements change frequently — always verify directly with your fund. Our admin team is happy to help.
HCF was the first major fund to confirm Pilates rebates under their Health Management Program, effective July 2025. Members with appropriate Extras cover (Top Extras, Essential Extras, Vital Extras and Lifestyle Extras) may claim using the Exercise & Gym Benefits form, with a medical condition specified by a practitioner.
Requirements
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Westfund members on eligible Extras cover can claim Pilates under their Health Management Program benefit (fitness centre category — membership, classes, and personal training). A two-month waiting period applies.
Requirements
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AHM brought Pilates cover in from April 1st 2026. Members with appropriate Extras cover may claim using the Health Improvement Benefits Approval Form, with a medical condition specified by a practitioner.
Requirements
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Bupa provides Health Management benefits for Pilates when used to address a specific diagnosed health condition. Available on Corporate Everyday, Mid, Advanced, and Total Extras products. The natural therapy Pilates provider pathway is being defined through 2025–2026.
Requirements
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Medibank offers Pilates rebates under their Health Management program for members managing a GP-identified health condition. Applies to My Choice Extras Support and My Choice Extras products. The broader natural therapy pathway is expected through 2025–2026.
Requirements
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nib's Healthier Lifestyle Benefits program allows eligible members to claim for Pilates used to manage existing health conditions. Natural therapy Pilates rebates are expected to follow through 2025–2026 as nib updates its ancillary framework.
Requirements
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Teachers Health (TUH) is in the ARHG fund alliance. Pilates natural therapy rebates are expected to roll out through 2025–2026. Their healthy lifestyle and preventative health benefits may already include exercise programs under some products.
Confirm with Teachers Health
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HBF has an existing provider registration framework for wellness providers including Pilates. The natural therapy rebate pathway is expected through 2025–2026. An HBF Provider Registration application for Pilates has been circulated by the PAA.
Likely requirements (confirm with HBF)
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Australian Unity offers extras cover with gym and healthy lifestyle benefits. Their natural therapy Pilates rebate details are being finalised as of April 2026. Selected products include cover for gym memberships and wellness activities that may include Pilates.
Confirm with Australian Unity
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Health Partners recognises providers for gym, personal training, Pilates, yoga, Tai Chi, and fitness classes under their Health Management program when used to manage a health condition identified by a healthcare practitioner.
Requirements
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Teachers Health (TUH)
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GMHBA / Frank
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Defence Health
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CBHS / CBHS Corporate
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Not on this list?
Australia has over 30 registered private health funds. Smaller and industry-specific funds (Navy Health, Police Health, Emergency Services Health, CUA Health, Latrobe, Mildura, etc.) are also updating benefit schedules following the July 2025 changes. Contact your fund and ask specifically about "Pilates natural therapy extras benefits" and "provider credentialling requirements."
The PAA's Health Fund Rebates page is updated regularly with the latest fund-by-fund information.
Australia has over 30 registered private health funds. Smaller and industry-specific funds (Navy Health, Police Health, Emergency Services Health, CUA Health, Latrobe, Mildura, etc.) are also updating benefit schedules following the July 2025 changes. Contact your fund and ask specifically about "Pilates natural therapy extras benefits" and "provider credentialling requirements."
The PAA's Health Fund Rebates page is updated regularly with the latest fund-by-fund information.
How to claim your rebate
The process depends on your fund and pathway. Here's the general process for claiming Pilates sessions with our diploma-qualified teachers
01 |
Check your cover Call your health fund or log in to your member portal and confirm: (a) that your Extras product includes Pilates, natural therapy, or Health Management benefits; (b) that any waiting periods have been served; and (c) what your annual benefit limit is. Quote "Pilates — natural therapy" and "Health Management Program" to cover both pathways. |
02 |
Fill out form if required Under the Health Management Program pathway, a GP, physiotherapist, or exercise physiologist must complete a form specifying your health condition. Our physios and EPs can complete this for you in a 20 minute appointment by just swiping your private health - code 500 or 505 for physio, and code 202 for exercise physiology. Under the natural therapy pathway, some funds may not require a referral — confirm with your fund. |
03 |
Book with a qualified provider Our diploma-qualified Pilates teachers hold PAA Practitioner membership and RTO-accredited Diploma qualifications — the standard expected by health funds. Sessions with our physiotherapists and exercise physiologists remain rebateable under physiotherapy and exercise physiology extras as always. |
04 |
Pay and receive your receipt We issue a detailed receipt including the service date, provider name, PAA membership number, service description, and our clinic ABN and address — all details your fund will require. HICAPS on-the-spot claiming is available for funds that have completed their system setup. |
05 |
Submit your claim Claim via your fund's app, website, or by post with your receipt and completed claim form. For Health Management claims, attach the completed referral form. Keep copies of everything. |
Tyro on-the-spot claiming
We have a Tyro terminal at reception. As funds activate Pilates item codes through 2025–2026, we'll be able to process instant rebates on the spot for more policies. Ask our admin team whether your fund is currently set up for HICAPS Pilates rebates. For physiotherapy services, Tyro instant claiming continues as normal.
We have a Tyro terminal at reception. As funds activate Pilates item codes through 2025–2026, we'll be able to process instant rebates on the spot for more policies. Ask our admin team whether your fund is currently set up for HICAPS Pilates rebates. For physiotherapy services, Tyro instant claiming continues as normal.
Our qualifications — and why they matter
Health funds are credentialling providers carefully, with the Government's framework emphasising verifiable qualifications. Here's how our team measures up.
Provider type |
Qualification |
Fund Recognition |
Rebate Pathway |
Physiotherapists |
Bachelor/Masters Physiotherapy, AHPRA registered |
All major funds |
Physiotherapy extras (PHY codes). Unchanged — unaffected by 2019 or 2025 changes. |
Exercise Physiologists |
Bachelor Exercise Physiology, AHPRA registered |
All major funds |
Exercise physiology extras (AEP codes). Unchanged — unaffected by 2019 or 2025 changes. |
Diploma Qualified Pilates Teachers |
RTO-accredited Diploma in Pilates Instruction; PAA Practitioner Member (Level 1+) |
Rolling out — HCF confirmed; others in progress |
Natural therapy / Health Management Program. New from July 2025. Item codes rolling out fund by fund. |
About our Pilates teachers
Our diploma-qualified Pilates teachers hold RTO-accredited Diploma qualifications in comprehensive Pilates instruction and are current PAA Practitioner members. PAA membership requires ongoing professional development (20 PDPs per year), professional indemnity insurance, and current first aid certification.
Some health funds may specify a minimum PAA Level 2 membership (Diploma + 3,000 hours experience) for provider eligibility. Ask our team about the specific credentials of the teacher you're booking with so you can confirm with your fund.
Our diploma-qualified Pilates teachers hold RTO-accredited Diploma qualifications in comprehensive Pilates instruction and are current PAA Practitioner members. PAA membership requires ongoing professional development (20 PDPs per year), professional indemnity insurance, and current first aid certification.
Some health funds may specify a minimum PAA Level 2 membership (Diploma + 3,000 hours experience) for provider eligibility. Ask our team about the specific credentials of the teacher you're booking with so you can confirm with your fund.
Note on "clinical Pilates"
Physiotherapy-led and Exercise Physiologist led Pilates sessions remain claimable under physiotherapy codes (560, 595, 296) and exercise physiology codes (502) as always — this is entirely unchanged. The Department of Health does not differentiate between "Pilates" and "clinical Pilates" for natural therapy rebate purposes. The new pathway is specifically for Pilates delivered by diploma-qualified Pilates teachers as a standalone modality.
Physiotherapy-led and Exercise Physiologist led Pilates sessions remain claimable under physiotherapy codes (560, 595, 296) and exercise physiology codes (502) as always — this is entirely unchanged. The Department of Health does not differentiate between "Pilates" and "clinical Pilates" for natural therapy rebate purposes. The new pathway is specifically for Pilates delivered by diploma-qualified Pilates teachers as a standalone modality.
Frequently asked questions
Can I claim pilates under my physio's existing provider number?
Yes. Physiotherapy-led Pilates sessions have always been and remain claimable under physiotherapy extras codes at all major health funds. This pathway is entirely unaffected by the 2019 and 2025 changes. Sessions with our physiotherapists are billed using physiotherapy item codes 500 & 505 for appointments, and 560 for Clinical Pilates.
do i need a doctors referral to claim pilates?
This depends on the fund and pathway. Under Health Management Programs (most funds), a GP, physiotherapist, or exercise physiologist must complete a form specifying your health condition. Under the natural therapy pathway (rolling out 2025–2026), some funds may not require a referral. Always confirm with your fund before your first session
What if my fund hasn't set up pilates rebates yet?
We recommend: (1) checking whether a Health Management Program pathway is already available under your existing cover; (2) keeping receipts from all Pilates sessions as some funds may allow retrospective claims once their systems are ready; (3) checking back with your fund every few months as rollout is actively in progress.
is there a waiting period?
Yes — all extras benefits have waiting periods, typically 2 months for general extras. Natural therapy and Health Management waiting periods are typically 2–6 months. If you've held your extras cover for more than 6 months, you've likely already served it. Confirm with your fund.
how much will i get back?
Benefit levels vary by fund and product — expressed as a percentage of the fee (e.g. 60–80%) or a fixed dollar amount per session (e.g. $15–$25), subject to annual limits. More comprehensive Extras products typically have higher benefit limits. Specific figures for the new Pilates natural therapy pathway are not yet publicly available for all funds. Contact your fund for details.
what information do i need on my receipt?
Your receipt should include: date of service, provider's full name and PAA membership number, description of service, fee charged, our clinic name, ABN, and address. We ensure all receipts from our Pilates teachers include this information. Keep copies.
why are only diploma qualified teachers eligible?
The Government's reinstatement framework emphasised "credentialling" — verifying qualifications before granting rebate eligibility. The PAA and health funds have determined that a minimum RTO-accredited Diploma qualification is required, reflecting the higher level of training in anatomy, physiology, assessment, and clinical application that Diploma holders possess compared to Certificate IV instructors.
do group classes qualify for rebates?
This is being defined fund by fund. Some funds may only rebate individual or semi-private sessions; others may include small group therapeutic sessions. Under the physiotherapy pathway, group physio-led Pilates classes are already rebateable at most funds. Confirm group vs. individual rules with your fund for the new Pilates teacher pathway.