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Fees and Charges for Acute Health Services in Victoria
  
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Section A: Admitted Patients
Section B: Non-Admitted Patients
Section C: Other Services
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Section B: Fees for Non-Admitted Patients

5.Compensable Non-admitted Patient Fees

Summary  

Fee Schedule 1:

Allied Health

Fee Schedule 2:

Medical Services

Fee Schedule 1

Service Provided Session Item Number Fee for Service ($) From
1 Nov 2011 - 31 Oct 2012		 Fee for Service ($) From
1 Nov 2012 - 31 Oct 2013
Allied Health Assistant   Individual (15min) PUB 76 A $15.42 15.89
Individual (30min) PUB 76 B $30.84 31.79
Individual (45min) PUB 76 C $46.25 47.68
Individual (60min) PUB 76 D  $61.67 63.58
Worksite / Home Inspection (15min) PUB 77 A  $16.96 17.48
Worksite / Home Inspection (30min) PUB 77 B  $33.92 34.97
Worksite / Home Inspection (45min) PUB 77 C $50.88 52.45
Worksite / Home Inspection (60min) PUB 77 D $67.84 69.94
Travel time ^^ (30min) PUB 78 B  $38.55 39.74
Travel time ^^ (45min) PUB 78 C $57.82 59.60
Travel time ^^ (60min) PUB 78 D $77.09 79.47
Chiropody/Podiatry Individual (15min) PUB41AA $19.62 20.23
Individual (30min) PUB41BB $39.24 40.45
Individual (45min) PUB41CC $58.86 60.68
Individual (60min) PUB41DD $78.48 80.91
Dietician Individual (15min) PUB17AA $19.62 20.23
Individual (30min) PUB17BB $39.24 40.45
Individual (45min) PUB17CC $58.86 60.68
Individual (60min) PUB17DD $78.48 80.91
Worksite / Home Inspection (15min) PUB 83 A  $21.59 22.26
Worksite / Home Inspection (30min) PUB 83 B  $43.19 44.52
Worksite / Home Inspection (45min) PUB 83 C $64.78 66.78
Worksite / Home Inspection (60min) PUB 83 D $86.37 89.04
Travel time ^^ (30min) PUB 84 B  $38.55 39.74
Travel time ^^ (45min) PUB 84 C $57.82 59.60
Travel time ^^ (60min) PUB 84 D $77.09 79.47
Hydrotherapy Individual (15min) PUB23AA $19.62 20.23
Individual (30min) PUB23BB $39.24 40.45
Individual (45min) PUB23CC $58.86 60.68
Individual (60min) PUB23DD $78.48 80.91
Group (15min) PUB22AA $11.92 12.29
Group (30min) PUB22BB $23.84 24.57
Group (45min) PUB22CC $35.75 36.86
Group (60min) PUB22DD $47.67 49.14
Nursing services ** Individual (15min) PUB09A $19.62 20.23
Individual (30min) PUB09B $39.24 40.45
Individual (45min) PUB09C $58.86 60.68
Individual (60min) PUB09D $78.48 80.91
Worksite / Home Inspection (15min) PUB 85 A  $21.59 22.26
Worksite / Home Inspection (30min) PUB 85 B  $43.19 44.52
Worksite / Home Inspection (45min) PUB 85 C $64.78 66.78
Worksite / Home Inspection (60min) PUB 85 D $86.37 89.04
Travel time ^^ (30min) PUB 86 B $38.55 39.74
Travel time ^^ (45min) PUB 86 C $57.82 59.60
Travel time ^^ (60min) PUB 86 D $77.09 79.47
Occupational Therapy Worksite / Home Inspection (15min) PUB67AA $21.59 22.26
Worksite / Home Inspection (30min) PUB67BB $43.19 44.52
Worksite / Home Inspection (45min) PUB67CC $64.78 66.78
Worksite / Home Inspection (60min) PUB67DD $86.37 89.04
Individual (15min) PUB20AA $19.62 20.23
Individual (30min) PUB20BB $39.24 40.45
Individual (45min) PUB20CC $58.86 60.68
Individual (60min) PUB20DD $78.48 80.91
Group (15min) PUB19AA $11.92 12.29
Group (30min) PUB19BB $23.84 24.57
Group (45min) PUB19CC $35.75 36.86
Group (60min) PUB19DD $47.67 49.14
Travel time ^^ (30min) PUB 92 B $38.55 39.74
Travel time ^^ (45min) PUB 92 C $57.82 59.60
Travel time ^^ (60min) PUB 92 D $77.09 79.47
Orthoptics Individual (15min) PUB42AA $19.62 20.23
Individual (30min) PUB42BB $39.24 40.45
Individual (45min) PUB42CC $58.86 60.68
Individual (60min) PUB42DD $78.48 80.91
Orthotist/Prosthetist Individual (15min) PUB70AA $19.62 20.23
Individual (30min) PUB70BB $39.24 40.45
Individual (45min) PUB70CC $58.86 60.68
Individual (60min) PUB70DD $78.48 80.91
Orthotist/Prosthetist - Manufacture time to manufacture (per hour) Greater than 1 hour should be charged pro-rata at hourly rate PUB608 $89.00 91.75
Minor Repair (Prosthesis). Total cost of consumables, materials, consultation and manufacturing time (Minor repairs are any repairs up to $250) PUB610 Depends on the total cost of the repairs or change of prescription costs (<$250) Depends on the total cost of the repairs or change of prescription costs (<$250)
Major Repair (Prosthesis). Total cost of consumables and materials only. Consultation and/or manufacturing time to be billed separately under corresponding item numbers (Major repairs are any repairs above $250 inclusive of consumables) PUB614 Depends on the total cost of the repairs or change of prescription costs (<$250) Depends on the total cost of the repairs or change of prescription costs (<$250)
New prostheses or change of prescription. Total cost of consumables and materials only. Consultation and/or manufacturing time to be billed separately under corresponding item numbers PUB612 Depends on the total cost of the repairs or change of prescription costs Depends on the total cost of the repairs or change of prescription costs
Prosthetic Management Review Form - lower extremity or upper extremity. Total cost for completion of Form PUB618 $45.25 46.65
Orthosis (purchase) - to be used when submitting invoice for payment for orthotic equipment, aids & appliances - not to be used for clinical or manufacturing services. EQ035 Depends on the total cost of the orthosis. Depends on the total cost of the orthosis.
Physical Education
(Not applicable for WorkCover patients)		 Individual (15min) PUB58A $19.62 20.23
Individual (30min) PUB58B $39.24 40.45
Individual (45min) PUB58C $58.86 60.68
Individual (60min) PUB58D $78.48 80.91
Group (15min) PUB59A $11.92 12.29
Group (30min) PUB59B $23.84 24.57
Group (45min) PUB59C $35.75 36.86
Group (60min) PUB59D $47.67 49.14
Physiotherapy Individual (15min) PUB13A $19.62 20.23
Individual (30min) PUB13B $39.24 40.45
Individual (45min) PUB13C $58.86 60.68
Individual (60min) PUB13D $78.48 80.91
Group (15min) PUB14A $11.92 12.29
Group (30min) PUB14B $23.84 24.57
Group (45min) PUB14C $35.75 36.86
Group (60min) PUB14D $47.67 49.14
Worksite / Home Inspection (15min) PUB66A $21.59 22.26
Worksite / Home Inspection (30min) PUB66B $43.19 44.52
Worksite / Home Inspection (45min) PUB66C $64.78 66.78
Worksite / Home Inspection (60min) PUB66D $86.37 89.04
Travel time ^^ (30min) PUB 93 B $38.55 39.74
Travel time ^^ (45min) PUB 93 C $57.82 59.60
Travel time ^^ (60min) PUB 93 D $77.09 79.47
Psychology Individual (15min) PUB08A $34.86 35.94
Individual (30min) PUB08B $69.73 71.88
Individual (45min) PUB08C $104.59 107.82
Individual (60min) PUB08D $139.45 143.76
Group (15min) PUB07A $20.99 21.64
Group (30min) PUB07B $41.98 43.27
Group (45min) PUB07C $62.96 64.91
Group (60min) PUB07D $83.95 86.54
Report ^ Initial Assessment and preparation of Rehabilitation Plan PUB 94 $77.09 79.47
Social Work Individual (15min) PUB40A $19.62 20.23
Individual (30min) PUB40B $39.24 40.45
Individual (45min) PUB40C $58.86 60.68
Individual (60min) PUB40D $78.48 80.91
Worksite / Home Inspection (15min) PUB 79 A  $21.59 22.26
Worksite / Home Inspection (30min) PUB 79 B  $43.19 44.52
Worksite / Home Inspection (45min) PUB 79 C $64.78 66.78
Worksite / Home Inspection (60min) PUB 79  D $86.37 89.04
Travel time ^^ (30 min) PUB 80 B $38.55 39.74
Travel time ^^ (45 min) PUB 80 C $57.82 59.60
Travel time ^^ (60 min) PUB 80 D $77.09 79.47
Speech Therapy Individual (15min) PUB29A $19.62 20.23
Individual (30min) PUB29B $39.24 40.45
Individual (45min) PUB29C $58.86 60.68
Individual (60min) PUB29D $78.48 80.91
Group (15min) PUB30A $11.92 12.29
Group (30min) PUB30B $23.84 24.57
Group (45min) PUB30C $35.75 36.86
Group (60min) PUB30D $47.67 49.14
Worksite / Home Inspection (15min) PUB 81 A  $21.59 22.26
Worksite / Home Inspection (30min) PUB 81 B  $43.19 44.52
Worksite / Home Inspection (45min) PUB 81 C $64.78 66.78
Worksite / Home Inspection (60min) PUB 81 D $86.37 89.04
Travel time ^^ (30min) PUB 82 B  $38.55 39.74
Travel time ^^ (45min) PUB 82 C $57.82 59.60
Travel time ^^ (60min) PUB 82 D $77.09 79.47
Chemist   PUB005 $19.27 19.87
Facility Fee   PUB100 $70.75 259.00
Interpreting First 2 hours PUB10 $106.88 110.18
per hour after initial 2 hours PUB11 $36.85 37.99
Vocational Counselling (WorkCover patients only) Individual (15min) PUB53A Fees to be advised by the Victorian WorkCover Authority Fees to be advised by the Victorian WorkCover Authority
Individual (30min) PUB53B
Individual (45min) PUB53C
Individual (60min) PUB53D
Group (15min) PUB54A
Group (30min) PUB54B
Group (45min) PUB54C
Group (60min) PUB54D
Hand Splints * Individual (varied) PUB71A $35.00 to $190.00 $35.00 to $190.00
Fee only applies to Workcover patients at present
(Not TAC patients).		 Fee only applies to Workcover patients at present
(Not TAC patients).

* Hand Splints, where clinically indicated and fitted under the supervision of a hand therapists. Medical information may be required to justify the need for a splint.

** Note that PUB 09A - PUB 09D and PUB 85A - PUB 85D may relate to the treatment of wound management, medication reviews, continence management, and liaising with a client's general practitioner or specialist.
A charge for the re-application of plaster for treatment of a fracture can also be raised where this service is performed by a nurse in an outpatient clinic. If another suitably qualified person such as an orthotist or prosthetist performs the task, then the PUB item number listed under that discipline can be billed.

*** Note: The facility fee from 1 November 2012 for worksafe is $138.

^ Report refers to completion of 'Outpatient Rehabilitation Plan' only when required.

^^ Requests for travel require prior written approval by TAC and clinical justification from the allied health practitioner. Travel time to the client is for a round trip.

• Includes 10% GST

† If Service is requested by the TAC only

Vocational counselling is a WorkCover approved service, but only if provided by occupational rehabilitation providers approved for that purpose. Approved occupational rehabilitation providers should contact WorkCover to determine the appropriate fee.

TAC will pay the reasonable cost of custom-made splints provided by hospital Outpatient Departments. When submitting accounts for these items, please include a description of the custom-made splint.

TAC and WorkCover insurers require an item number on all accounts for outpatient services (item numbers are listed in the table above).

Before any rehabilitation treatment is commenced on a TAC outpatient, both a Rehabilitation Assessment and a Rehabilitation Plan must be completed, and submitted to the TAC for their approval.

Reference: Circular No.23/2001 and 25/2001

Service Provided

Fee

Registered Medical Practitioners

Registered Medical Practitioners providing services to compensable patients in the Accident and Emergency/Casualty (non - admitted) or Outpatient Departments may charge a consultation fee in accordance with the Commonwealth Medicare Benefits Schedule.

For medical practitioners who are employees of a hospital (including HMOs and registrars), the hospital must invoice the relevant third party payer (e.g. TAC Insurance or a WorkCover insurer) for the service.

 

Specialist & Consultant Physicians with the right of private practice, may continue to invoice TAC according to the TAC Schedule of Medical Practitioner Rates.

Facility Fee

$68.65 per episode (effective from 1 November 2010)

Services delivered in the emergency department of any public hospital should be invoiced by the public hospital using the non-admitted item codes. Medical services should be invoiced using PUB/PMF 104 - initial and PUB/PMF 105 - subsequent.

 

Last updated: 26 November, 2012

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