Evidence-based treatment

What is evidence-based treatment?

To get the best possible health outcome for you, we want to make sure that you get the best possible treatment and services.

Evidence-based, best practice treatments have strong clinical evidence and are supported by our chief medical bodies.

Can I get approval for a new or non-established treatment?

If your treating health professional recommends a new or non-established procedure or treatment, they will need to contact us and provide us with strong clinical evidence.

For more information, see: Evidence-based treatment policy.

Will the TAC pay for my new or non-established treatment?

If the treatment is approved, we will pay for your treatment.

We will pay your health professional directly when you give them your TAC claim number.

Evidence-based treatment

At the TAC we’re here to help you get your life back on track following your transport accident. To support your recovery, we pay for treatment and services in Australia that are evidence-based and best practice.

What does best practice and evidence-based mean?

To get the best possible health outcome for you, we want to make sure that you get the best possible treatment and services. This means we will only pay for treatments that have strong clinical evidence and are supported by our chief medical bodies.

To determine which treatments and services are approved, we are guided by the Medical Services Advisory Committee, the Medicare Benefit Schedule, the Prostheses List Advisory Committee, the Department of Human Services Prostheses List, the Pharmaceutical Benefit Schedule, the Australian Register of Therapeutic Goods and other evidence-based medical bodies.

Once these bodies have made a decision on the clinical effectiveness and safety of a treatment, we will follow that decision.

Getting approval for a new, non-established treatment

Your treating health professional may recommend that you undergo a procedure or treatment that is considered new, non-established or potentially a clinical trial. We will consider this if they provide us with strong clinical evidence. We consider strong evidence to be National Health and Medical Research Council Level 1 or 2 evidence that demonstrates the safety and efficacy of the treatment.

We may request an evidence review to better understand the safety and efficacy of treatment and services. An evidence review involves analysing the highest quality research evidence to find out if a treatment or service is proven to be beneficial. When there is minimal clinical evidence to support a treatment or service, we may not pay for the treatment.

During this process we will ask for more information from your health professional. We’ll let you know our decision once we have had the opportunity to look at all the details and make a decision about the safety and effectiveness of the treatment.

Paying for these services

If we approve the treatment, we will pay your service provider directly when you have given them your TAC claim number.

We pay for your services in line with our responsibilities under the Transport Accident Act 1986.

How much we will pay

Where approved, we pay the cost of a new treatment, clinical trial or non-established, evidenced-based treatment in line with the fees charged by the provider.

What we won’t pay for

We can’t pay for services that:

  • Do not treat your transport accident injuries.
  • Are not reasonable, necessary or appropriate.
  • Are not clinically justified, safe and effective.

We also can’t pay for:

  • Off-label use of medication where there is insufficient evidence.
  • Any materials, including prosthetics, not listed on the Australian Register of Therapeutic Goods.