Fee schedule
NSW workers compensation exercise physiology fees 2026-27
From 1 February 2026 SIRA's Accredited Exercise Physiology Fees Order pays $148.90 for an initial consultation (EPA001) and $100.90 for a subsequent one (EPA002), GST free, up about 4.6 per cent on the 1 February 2025 schedule. These maximum fees match the physiotherapy, chiropractic and osteopathy consultation fees exactly, since SIRA sets all four on the same scale.
Last checked 25 Sep 2026 against the sources listed at the end of this page.
- Payer
- SIRA (State Insurance Regulatory Authority, NSW)
- Effective from
- 1 Feb 2026
- Official schedule
- Source document
What changed this year
- The two fees clinics bill most, the initial consultation (EPA001) and subsequent consultation (EPA002), rose from $142.40 to $148.90 and from $96.50 to $100.90, both about 4.6 per cent, matching the rise on SIRA's physiotherapy, chiropractic and osteopathy order for the same date.
- Group or class intervention (EPA004) held at $65.50 per participant, unchanged from the prior schedule.
- The consultation structure is unchanged: a standard initial and subsequent (EPA001/EPA002), plus a Consultation C item (EPA009) for complex presentations billed per 5 minutes up to a one hour maximum, at $19.60 per 5 minutes.
All 12 exercise physiology items
| Item | Description | Fee | Previous |
|---|---|---|---|
| EPA001 | Initial consultation, in rooms | $148.90 | $142.40 |
| EPA301 | Initial consultation, via telehealth, requires insurer pre-approval | $148.90 | $142.40 |
| EPA002 | Subsequent consultation, in rooms | $100.90 | $96.50 |
| EPA302 | Subsequent consultation, via telehealth, requires insurer pre-approval | $100.90 | $96.50 |
| EPA009 | Consultation C: three or more entirely separate injuries, extensive burns, or complex neurological/orthopaedic/pain/cardio-respiratory conditions. Per 5 minutes, max 1 hour | $19.60 | |
| EPA004 | Group or class intervention. Per participant | $65.50 | $65.50 |
| EPA005 | Incidental expenses (strapping tape, theraband, exercise putty). Over $110 per claim needs pre-approval. Cost price | cost price | |
| EPA006 | Case conference. Over 2 hours per practitioner needs pre-approval. Per 5 minutes | $19.60 | |
| EPA007 | Report writing, requires pre-approval and must be requested by the insurer. Per 5 minutes, max 1 hour | $19.60 | |
| EPA008 | Travel, requires insurer pre-approval. Private vehicle rate | $0.88/km | $0.88/km |
| WCO005 | Copies of clinical notes and records held electronically, all records requested | $71.30 | $68.20 |
| OAS003 | Submission of an initial Allied Health Treatment Request (AHTR), per claim | $46.10 | $44.10 |
The same consultation prices as physiotherapy, chiropractic and osteopathy
SIRA prices accredited exercise physiology on the same scale as physiotherapy, chiropractic and osteopathy. An initial consultation (EPA001) and a standard initial consultation for the other three professions (PTA001, CHA001, OSA001) are all $148.90 from 1 February 2026, and the subsequent consultation fees match too, at $100.90. The two schedules are published as separate documents under separate fees orders, the Accredited Exercise Physiology Fees Order 2026 and the Physiotherapy, Chiropractic and Osteopathy Fees Order 2026, but the practical effect for a multidisciplinary clinic is one consistent consultation fee across all four disciplines.
Where exercise physiology differs is in the absence of a Consultation B tier. Physiotherapy, chiropractic and osteopathy have a middle tier for two distinct injured areas or complicated hand injuries; exercise physiology goes straight from the standard consultation to Consultation C for genuinely complex presentations, billed in 5 minute units up to a one hour cap.
Pre-approval works the same way across the four allied health orders
The pre-approval exceptions for exercise physiology are written to align with physiotherapy, chiropractic and osteopathy rather than stand alone. Up to eight consultations can proceed without insurer sign-off for a new injury not previously treated by any of the four professions, provided treatment starts within three months. That count resets if a different practitioner picks up the same injury after it was previously treated, in which case one consultation without pre-approval is allowed.
Group or class intervention (EPA004) stayed at $65.50 per participant this year, the one line on the table that did not move with the indexation applied to everything else.
What clinics get wrong billing SIRA for exercise physiology
The most common mistake is applying WorkCover Queensland's exercise physiology structure to a NSW claim, since the two schedules use different item codes, different consultation tiers and different pre-approval thresholds despite covering the same profession. The second is missing that exercise physiology has no equivalent to physiotherapy's home visit item numbers (PTA007 to PTA011); if you need to bill a home visit, confirm the approach with the insurer rather than assuming a PTA-style uplift applies.
As with the other NSW allied health fee orders, this year's change was indexation only. If your practice software still shows EPA001 at $142.40, every initial consultation invoice is going out under-billed by $6.50 until the price is updated.
Claiming notes
- Insurer pre-approval covers face-to-face and telehealth services, with the same exceptions that apply to physiotherapy, chiropractic and osteopathy: up to 8 consultations without pre-approval where the injury was not previously treated by an exercise physiologist, physiotherapist, chiropractor or osteopath and treatment starts within 3 months; up to 3 consultations if treatment starts more than 3 months after the injury and it has not been treated before; and single-consultation exceptions for a new episode of care or a change of practitioner.
- Exercise physiology treatment is GST free. Case conferences, report writing, travel and the AHTR fee attract GST on top of the schedule amount.
- Invoices must reach the insurer within 30 calendar days of the service and include the worker's name and claim number, your ABN, SIRA approval number where applicable, AHPRA or professional accreditation number, the payment classification code, service cost, and the dates of service and invoice.
- Unlike physiotherapy, there is no SIRA-approved Certificate of Capacity item for exercise physiologists: OAS004 is physiotherapist-only, so it does not appear on this schedule.
- There is no separate home visit item on the exercise physiology table, unlike physiotherapy's PTA007 to PTA011. Confirm with the insurer how a home-based session should be billed if one is required.
- The Accredited Exercise Physiology Fees Order and the SIRA Workers Compensation Guidelines are the legally binding sources. This page summarises SIRA's own practice requirements document, gazetted 23 January 2026.
Load these fees into your practice software
- Cliniko supports bulk import of billable items under Settings, then Data & docs, then Data imports, choosing Billable items.
- Add a GST tax type first if you have not already. Leave Taxable blank for EPA001, EPA002, EPA009 and EPA004 (treatment, GST free) and set it for case conference, report writing, travel and the AHTR item, which carry GST on top of the schedule fee.
- Build a CSV with Item code, Name, Price (ex. tax), Taxable and Item type. Name each item with SIRA and the code, for example "SIRA EPA001 Initial consultation", so it is not confused with the identically priced physiotherapy PTA001.
- EPA005 (incidental expenses) has no fixed fee, it is cost price. Either skip it in the import and add the actual cost on the invoice, or load it at $0 as a placeholder.
- Update prices each 1 February when SIRA republishes the Fees Order: export existing billable items as a CSV, keep the Item ID column, update only the price column, then re-import with just the price field enabled. Keep the original export as a backup.
Sources
- From 1 February 2026 SIRA's Accredited Exercise Physiology Fees Order pays $148.90 for EPA001 (Initial consultation) and $100.90 for EPA002 (Subsequent consultation), excluding GST. State Insurance Regulatory Authority (SIRA), checked 25 Sep 2026.
- Under the schedule effective 1 February 2025, EPA001 was $142.40 and EPA002 was $96.50. State Insurance Regulatory Authority (SIRA), checked 25 Sep 2026.
- Up to 8 consultations may be provided without insurer pre-approval where the injury was not previously treated by an accredited exercise physiologist, physiotherapist, chiropractor or osteopath and treatment begins within 3 months of the injury. State Insurance Regulatory Authority (SIRA), checked 25 Sep 2026.
- Exercise physiology treatment is GST free; case conferences, report writing, travel and the AHTR fee are subject to GST on top of the listed maximum. State Insurance Regulatory Authority (SIRA), checked 25 Sep 2026.
- Group or class intervention (EPA004) has a maximum amount of $65.50 per participant. State Insurance Regulatory Authority (SIRA), checked 25 Sep 2026.
- Cliniko's data import tool can create billable items from a CSV with the fields Item code, Name, Price (ex. tax), Taxable and Item type. Cliniko, checked 25 Sep 2026.