Orthotic and prosthetic services
We’re here to help you get your life back on track after your transport accident. To help you with your injuries we will pay for any orthosis/prosthesis services provided in Australia.
In the first 90 days after your accident, the TAC can help pay for these services without the need for you to contact us for approval first.
When you need to contact us for approval
You or your provider need to contact the TAC for approval of these services if:
- It is approaching or more than 90 days since your accident and we have not approved further treatment or services, or
- It has been more than 6 months since you’ve had any treatment or service paid for by the TAC.
When we can pay for orthotic and prosthetic services
In the first 90 days after your accident, if your doctor recommends that you see an orthotist and prosthetist after your transport accident there’s no need to contact us for approval first.
After the first 90 days, you will need TAC approval before you see an orthotist and prosthetist.
Your orthotist and prosthetist may recommend prescription, manufacture, supply and fitting of an orthosis or prosthesis to help you. We can also help with the repair of orthosis or prosthesis when your orthotist and prosthetist asks us.
When needed, we will work with your treating team to help them organise the orthotic and prosthetic treatment and support you need.
If you require surgically implanted prosthesis as a result of your injuries, we will pay for the cost of the surgery, in line with our policy Surgery and medical specialists.
We may contact your orthotist and prosthetist to discuss your progress or request an assessment, to make sure that:
- You have access to appropriate treatment and support.
- You are getting proven, evidence-based treatment and not receiving treatment that isn't helping you recover.
- You are moving towards getting your life back on track or being able to live independently.
Treatments and services we can’t pay for
We cannot pay for any prosthetic:
- That is not listed on the Prostheses List.
- That has received a negative determination, as determined by the Australian Government’s Prostheses List Advisory Committee.
Where a prosthetic or orthotic item is under warranty, any repair, modification or replacement will be replaced under that warranty.
We can’t pay for services that:
What does an orthotist and prosthetist do?
An orthotist and prosthetist helps people who need artificial limbs or other supportive devices such as back or ankle braces and callipers. They look at the physical needs of people with mobility issues caused by amputation or problems with their muscles, bones or nervous system.
An orthotist and prosthetist can make and fit devices such as:
- external prostheses
- osseo-integration for prostheses
An orthotist and prosthetist can also work with medical specialists and surgeons to help with the prescription and modification for surgically implanted prostheses.
For more information, see:
How treatments and services are paid for
We pay for your treatments:
We pay for your services in line with our responsibilities under the Transport Accident Act 1986.
How much we will pay
We will pay for your treatment and services according to our fee schedule. If your provider charges more than the TAC rate, you may need to pay the difference.
For a list of TAC payment rates, see:
- Department of Health Schedule of Fees and Charges for Acute Health Services in Victoria
- Prostheses List Advisory Committee
If you are a prosthetist or orthotist, see our TAC provider guidelines.