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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
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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 ($) From 1 Nov 08 to 31 Oct 09 Fee for Service ($) From 1 Nov 09 to 31 Oct 10
Chiropody/Podiatry Individual (15min) PUB41A $18.15 $18.75
  Individual (30min) PUB41B $36.25 $37.40
  Individual (45min) PUB41C $54.40 $56.15
  Individual (60min) PUB41D $72.50 $74.80
Dietitian Individual (15min) PUB17A $18.15 $18.75
  Individual (30min) PUB17B $36.25 $37.40
  Individual (45min) PUB17C $54.40 $56.15
  Individual (60min) PUB17D $72.50 $74.80
Hydrotherapy Individual (15min) PUB23A $18.15 $18.75
  Individual (30min) PUB23B $36.25 $37.40
  Individual (45min) PUB23C $54.40 $56.15
  Individual (60min) PUB23D $72.50 $74.80
  Group (15min) PUB22A $11.00 $11.35
  Group (30min) PUB22B $22.00 $22.70
  Group (45min) PUB22C $33.00 $34.05
  Group (60min) PUB22D $44.00 $45.40
Occupational Therapy Worksite / Home Inspection (15min) PUB67A $19.95 $20.60
  Worksite / Home Inspection (30min) PUB67B $39.90 $41.20
  Worksite / Home Inspection (45min) PUB67C $59.80 $61.70
  Worksite / Home Inspection (60min) PUB67D $79.75 $82.30
  Individual (15min) PUB20A $18.15 $18.75
  Individual (30min) PUB20B $36.25 $37.40
  Individual (45min) PUB20C $54.40 $56.15
  Individual (60min) PUB20D $72.50 $74.80
  Group (15min) PUB19A $11.00 $11.35
  Group (30min) PUB19B $22.00 $22.70
  Group (45min) PUB19C $33.00 $34.05
  Group (60min) PUB19D $44.00 $45.40
Orthoptics Individual (15min) PUB42A $18.15 $18.75
  Individual (30min) PUB42B $36.25 $37.40
  Individual (45min) PUB42C $54.40 $56.15
  Individual (60min) PUB42D $72.50 $74.80
Orthotist/Prosthetist Individual (15min) PUB70A $18.15 $18.75
  Individual (30min) PUB70B $36.25 $37.40
  Individual (45min) PUB70C $54.40 $56.15
  Individual (60min) PUB70D $72.50 $74.80
Orthotist/Prosthetist - Manufacture time to manufacture (per hour) Greater than 1 hour should be charged pro-rata at hourly rate PUB608 $82.20 $84.80
  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 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 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 $41.75 $43.10
  Orthosis (purchase) - to be used when submitting invoice for payment for orthotic equipment, aids & appliances - not to be used for clinical or manufactoring services. EQ035 Depends on the total cost of the orthosis. Depends on the total cost of the orthosis.
Physical Education Individual (15min) PUB58A $18.15 $18.75
(Not applicable for WorkCover patients) Individual (30min) PUB58B $36.25 $37.40
  Individual (45min) PUB58C $54.40 $56.15
  Individual (60min) PUB58D $72.50 $74.80
  Group (15min) PUB59A $11.00 $11.35
  Group (30min) PUB59B $22.00 $22.70
  Group (45min) PUB59C $33.00 $34.05
  Group (60min) PUB59D $44.00 $45.40
Physiotherapy Individual (15min) PUB13A $18.15 $18.75
  Individual (30min) PUB13B $36.25 $37.40
  Individual (45min) PUB13C $54.40 $56.15
  Individual (60min) PUB13D $72.50 $74.80
  Group (15min) PUB14A $11.00 $11.35
  Group (30min) PUB14B $22.00 $22.70
  Group (45min) PUB14C $33.00 $34.05
  Group (60min) PUB14D $44.00 $45.40
  Worksite / Home Inspection (15min) PUB66A $19.95 $20.60 • †
  Worksite / Home Inspection (30min) PUB66B $39.90 $41.20 • †
  Worksite / Home Inspection (45min) PUB66C $59.80 $61.70 • †
  Worksite / Home Inspection (60min) PUB66D $79.75 $82.30 • †
Psychology Individual (15min) PUB08A $32.25 $33.30
  Individual (30min) PUB08B $64.40 $66.45
  Individual (45min) PUB08C $96.60 $99.65
  Individual (60min) PUB08D $128.80 $132.90
  Group (15min) PUB07A $19.45 $20.10
  Group (30min) PUB07B $38.80 $40.05
  Group (45min) PUB07C $58.20 $60.05
  Group (60min) PUB07D $77.55 $80.00
Social Work Individual (15min) PUB40A $18.15 $18.75
  Individual (30min) PUB40B $36.25 $37.40
  Individual (45min) PUB40C $54.40 $56.15
  Individual (60min) PUB40D $72.50 $74.80
Speech Therapy Individual (15min) PUB29A $18.15 $18.75
  Individual (30min) PUB29B $36.25 $37.40
  Individual (45min) PUB29C $54.40 $56.15
  Individual (60min) PUB29D $72.50 $74.80
  Group (15min) PUB30A $11.00 $11.35
  Group (30min) PUB30B $22.00 $22.70
  Group (45min) PUB30C $33.00 $34.05
  Group (60min) PUB30D $44.00 $45.40
Chemist   PUB005 $17.75 $18.35
Facility Fee   PUB100 $65.35 $67.45
Interpreting First 2 hours PUB10 $98.70 $101.85
  per hour after initial 2 hours PUB11 $34.00 $35.10
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).
Outpatient nursing services ** Individual (15min) PUB09A $18.15 $18.75
  Individual (30min) PUB09B $36.25 $37.40
  Individual (45min) PUB09C $54.40 $56.15
  Individual (60min) PUB09D $72.50 $74.80

* 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 items PUB09A - PUB09D generally relate to the treatment of wound management. 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.

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 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, that 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

$65.35 per episode (effective from 1 November 2008)

The Facility Fee covers the material and administrative costs of providing the service in an Emergency/Casualty Department only. A facility fee is not payable when, on the same day, the claimant is subsequently admitted to hospital (including same day patient admissions). Multiple facility fees will only be paid where treatment of a time critical condition is provided. The account must be annotated with a statement of the circumstances necessitating the subsequent emergency treatment.

References: Circular 6/1996, 3 /1999 , 4/2000 and 23/2001

 

Last updated: 5 November, 2009

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