Optometry and Orthoptic Services

We can help pay for this treatment in the first 90 days after your accident. You do not need to contact us for approval first if:

  • you have a TAC claim number
  • your doctor or other health professional recommends it, and
  • it is for your accident injuries.

To get this treatment, you will need a referral from your doctor.

We may contact you or your provider to check your progress and see if you are getting the support you need. This will help us make sure your treatment is helping your recovery. It will allow us to make decisions about what treatment we can pay for and how long we can pay for it.

How to get treatment from an eye specialist

  1. Go to your doctor for a referral to see an eye specialist.
  2. Choose a eye specialist. Your doctor can recommend one in your local area or you can search for one online.
  3. Call and make an appointment. Tell them you are a TAC client, you have a referral and who the referral is from. Ask if they charge at TAC rates. If the provider charges more, they may ask you for a 'gap payment' to make up the difference
  4. Go to your appointment and give the provider your TAC claim number.

When you need to ask for TAC approval:

Please contact us for approval if it is:

  • close to or more than 90 days since your accident and we haven’t already approved more treatment, or
  • more than 6 months since you’ve had any treatment or service paid for by the TAC.

Specialist doctors called ‘optometrists’, ‘orthoptists’ or ‘ophthalmologists’ provide eye care.

How we pay for treatment

There are two ways we can pay for your approved treatments and services:

  • we pay your provider at the TAC rate
  • you pay your provider, and we repay you at the TAC rate.

To ask for a reimbursement, scan or take a photo of your receipt. Send it to us with the ‘Reimbursement form’ button under 'Upload documents' on myTAC, or by email to info@tac.vic.gov.au and we will repay you.

We will pay for your treatment at the TAC rate . If your provider charges more than the TAC rate, you may need to pay the difference. This is known as a 'gap payment'.

If your provider charges you a gap payment, you may be able to seek reimbursement for some of this through:

  • Medicare or your private health insurance
  • The TAC.

Please note, in most cases, we are unable to reimburse you for a gap payment. This is because we have paid for your treatment or service at a rate we have determined is reasonable. You may still ask for a reimbursement from the TAC and we will let you know our decision.

What do eye specialists do?

These health professionals check and treat problems with your eyes and your vision.

  • Optometrists are trained to examine the eyes to detect vision defects, signs of injury, ocular diseases or abnormalities and general eye health.
  • Orthoptics specialises in the diagnosis and non-surgical management of eye disorders, particularly eye movement disorders.
  • Ophthalmology deals with the anatomy, physiology and diseases of the eye.

Optometry fees

Effective 1 July 2020

For Optometry services provided on or after 1 July 2020
Service DescriptionTAC Item NumberMaximum Payment Rate
Optometric Consultations
Comprehensive Initial Consultation10910$82.83
Referred Comprehensive Initial Consultation10905$82.83
Comprehensive initial consultation by another practitioner within 24 months of a previous comprehensive consultation.10907$41.46
Other comprehensive consultations10912$82.83
Professional attendance of more than 15 minutes duration, where patient has new signs or symptoms, unrelated to earlier course of attention, requiring comprehensive reassessment within 24 months of initial consultation.10913$82.83
Professional attendance of more than 15 minutes duration being the first in a course of attention where the patient has a progressive disorder (excluding presbyopia) requiring comprehensive reassessment within 24 months of initial consultation.10914$82.83
Professional attendance of more than 15 minutes duration, being the first in a course of attention involving the examination of the eyes, with the instillation of a mydriatic, of a patient with diabetes mellitus requiring comprehensive reassessment.10915$82.83
Brief initial consultation10916$41.46
Subsequent consultation10918$41.46
Contact lenses for specified classes of patients: patients with myopia of 5.0 dioptres or greater (spherical equivalent) in 1 eye.10921$205.47
Contact lenses for specified classes of patients: patients with manifest hyperopia of 5.0 dioptres or greater (spherical equivalent) in 1 eye.10922$205.47
Contact lenses for specified classes of patients: patients with astigmatism of 3.0 manifest hyperopia of 3.0 dioptres or greater in 1 eye.10923$205.47
Contact lenses for specified classes of patients: patients with irregular astigmatism in either eye.10924$259.33
Contact lenses for specified classes of patients: patients with anisometropia of 3.0 dioptres or greater.10925$205.47
Contact lenses for specified classes of patients: patients with corrected visual acuity of 0.7 logMAR (6/30) or worse in both eyes.10926$205.47
Contact lenses for specified classes of patients: patients for whom a wholly or segmentally opaque contact lens is prescribed for the alleviation of dazzle, distortion or diplopia caused by: pathological mydriasis; aniridia; coloboma of the iris; or pupillary malformation or distortion; or significant ocular deformity or corneal opacity.10927$259.33
Contact lenses for specified classes of patients by reason of physical deformity cannot wear glasses.10928$205.47
Contact lenses for specified classes of patients who have  medical or optical condition.10929$259.33
Professional attendance involving the prescription & fitting of contact lenses.10930$205.47
Domiciliary Visits10931$28.86
Domiciliary Visits10932$14.39
Domiciliary Visits10933$9.55
Computerised Perimetry10940$79.02
Computerised Perimetry10941$47.65
Low Vision Assessment10942$41.46
Children's Vision Assessment10943$41.46
For Optometry services provided between 1 July 2019 and 30 June 2020
Service DescriptionTAC Item NumberMaximum Payment Rate
Optometric Consultations
Comprehensive Initial Consultation 10910 $81.07
Referred Comprehensive Initial Consultation 10905 $81.07
Comprehensive initial consultation by another practitioner within 24 months of a previous comprehensive consultation. 10907 $40.58
Other comprehensive consultations 10912 $81.07
Professional attendance of more than 15 minutes duration, where patient has new signs or symptoms, unrelated to earlier course of attention, requiring comprehensive reassessment within 24 months of initial consultation. 10913 $81.07
Professional attendance of more than 15 minutes duration being the first in a course of attention where the patient has a progressive disorder (excluding presbyopia) requiring comprehensive reassessment within 24 months of initial consultation. 10914 $81.07
Professional attendance of more than 15 minutes duration, being the first in a course of attention involving the examination of the eyes, with the instillation of a mydriatic, of a patient with diabetes mellitus requiring comprehensive reassessment. 10915 $81.07
Brief initial consultation 10916 $40.58
Subsequent consultation 10918 $40.58
Contact lenses for specified classes of patients: patients with myopia of 5.0 dioptres or greater (spherical equivalent) in 1 eye. 10921 $201.11
Contact lenses for specified classes of patients: patients with manifest hyperopia of 5.0 dioptres or greater (spherical equivalent) in 1 eye. 10922 $201.11
Contact lenses for specified classes of patients: patients with astigmatism of 3.0 manifest hyperopia of 3.0 dioptres or greater in 1 eye. 10923 $201.11
Contact lenses for specified classes of patients: patients with irregular astigmatism in either eye. 10924 $253.82
Contact lenses for specified classes of patients: patients with anisometropia of 3.0 dioptres or greater. 10925 $201.11
Contact lenses for specified classes of patients: patients with corrected visual acuity of 0.7 logMAR (6/30) or worse in both eyes. 10926 $201.11
Contact lenses for specified classes of patients: patients for whom a wholly or segmentally opaque contact lens is prescribed for the alleviation of dazzle, distortion or diplopia caused by: pathological mydriasis; aniridia; coloboma of the iris; or pupillary malformation or distortion; or significant ocular deformity or corneal opacity. 10927 $253.82
Contact lenses for specified classes of patients by reason of physical deformity cannot wear glasses. 10928 $201.11
Contact lenses for specified classes of patients who have  medical or optical condition. 10929 $253.82
Professional attendance involving the prescription & fitting of contact lenses. 10930 $201.11
Domiciliary Visits 10931 $28.25
Domiciliary Visits 10932 $14.09
Domiciliary Visits 10933 $9.35
Computerised Perimetry 10940 $77.34
Computerised Perimetry 10941 $46.63
Low Vision Assessment 10942 $40.58
Children's Vision Assessment 10943 $40.58

Orthoptic services fees

Effective 1 July 2020

Orthoptic services can be invoiced online via LanternPay for next business day payments.

For Orthoptic services provided on or after 1 July 2020
Service DescriptionTAC Item NumberMaximum Payment Rate
In Rooms
Initial Consultation TH0040 $60.53
Standard Consultation TH0042 $48.49
Out of Rooms
Initial Consultation TH0041 $84.49
Standard Consultation TH0043 $72.55
For Orthoptic services provided between 1 July 2019 and 30 June 2020
Service DescriptionTAC Item NumberMaximum Payment Rate
In Rooms
Initial Consultation TH0040 $59.34
Standard Consultation TH0042 $47.53
Out of Rooms
Initial Consultation TH0041 $82.83
Standard Consultation TH0043 $71.12

Fees for orthoptic services performed within a public hospital will be based on the Department of Human Services schedule of fees and charges for acute health services in Victoria.
Refer to www.health.vic.gov.au/feesman

Coronavirus update

The TAC is unable to send or receive hard copy documents at this time. We have some different options for you to send us forms, documents or receipts for reimbursement.

Reimbursements

  • myTAC
    Please use our app or web portal, myTAC to ask for reimbursements. Go to upload documents > reimbursement form and send us a photo of your receipt or proof of payment and a description of what you've paid for.
  • Email
    If you can't use myTAC to send your receipts, please take a photo and email it to us at info@tac.vic.gov.au. Include your claim number in the subject line of your email so we can process your request.

Forms and documents

  • myTAC
    Please use our app or web portal, myTAC to send forms or documents. Go to upload documents > submit documents and send us a photo of your form or document.
  • Email
    If you can't use myTAC to send your forms or documents, please take a photo and email it to us at info@tac.vic.gov.au. Include your claim number in the subject line of your email so we can process your request.

General reimbursement form

Summary:

You can use this form to claim general reimbursements from the TAC.

Coronavirus update

The TAC is unable to send or receive hard copy documents at this time. We have some different options for you to send us forms, documents or receipts for reimbursement.

Reimbursements

  • myTAC
    Please use our app or web portal, myTAC to ask for reimbursements. Go to upload documents > reimbursement form and send us a photo of your receipt or proof of payment and a description of what you've paid for.
  • Email
    If you can't use myTAC to send your receipts, please take a photo and email it to us at info@tac.vic.gov.au. Include your claim number in the subject line of your email so we can process your request.

Forms and documents

  • myTAC
    Please use our app or web portal, myTAC to send forms or documents. Go to upload documents > submit documents and send us a photo of your form or document.
  • Email
    If you can't use myTAC to send your forms or documents, please take a photo and email it to us at info@tac.vic.gov.au. Include your claim number in the subject line of your email so we can process your request.

Travel expense declaration form

Summary:

This form is to be used when claiming reimbursement for travel (i.e. private vehicle, public transport and/or taxi) expenses to attend: medical treatment for accident injuries; medical examinations arranged by the TAC; approved rehabilitation or disability services; or work, if you are participating in a formal Return to Work program.

Coronavirus update

The TAC is unable to send or receive hard copy documents at this time. We have some different options for you to send us forms, documents or receipts for reimbursement.

Reimbursements

  • myTAC
    Please use our app or web portal, myTAC to ask for reimbursements. Go to upload documents > reimbursement form and send us a photo of your receipt or proof of payment and a description of what you've paid for.
  • Email
    If you can't use myTAC to send your receipts, please take a photo and email it to us at info@tac.vic.gov.au. Include your claim number in the subject line of your email so we can process your request.

Forms and documents

  • myTAC
    Please use our app or web portal, myTAC to send forms or documents. Go to upload documents > submit documents and send us a photo of your form or document.
  • Email
    If you can't use myTAC to send your forms or documents, please take a photo and email it to us at info@tac.vic.gov.au. Include your claim number in the subject line of your email so we can process your request.

Optical, orthoptic and optometry 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 orthoptic, ophthalmology and optometry consultations provided in Australia.

In the first 90 days after your accident, the TAC can help pay for this treatment 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 this treatment 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 optical, orthoptic and optometry services

In the first 90 days after your accident, if your doctor recommends that you need optical, orthoptic or optometry services because of your injuries, there's no need to contact us for approval first.

After the first 90 days, you will need TAC approval for more optical, orthoptic and optometry services.

We will pay you to visit your doctor so you can discuss your needs with them. As part of that visit, they can refer you to an orthoptist, ophthalmologist or optometrist.

When needed, we will work with your treating team to help them organise the eye treatments and support you need.

We may contact your eye specialist to discuss your progress or ask for an assessment to make sure that:

  • You have access to the most 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.

Treatment and services we can’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.

What do these services do?

Optometrists are primary health care specialists trained to examine the eyes to detect defects in the vision, signs of injury, ocular diseases or abnormality and problems with general optical health.

Orthoptics is a primary health care discipline that specialises in the diagnosis and non-surgical management of eye disorders, particularly eye movement disorders.

Ophthalmology is a medical service that deals with the anatomy, physiology and diseases of the eye. An ophthalmologist is a specialist in medical and surgical eye problems.

For more information please refer to the following resources:

How treatments and services are paid for

We pay for your treatments:

  • Directly to your health provider when you have given them your TAC claim number, or
  • If you have to pay, use myTAC to send a copy of your receipt to us and we will repay you.

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 service provider charges more than the TAC rate, you may need to pay the difference.

For a list of TAC rates, see:

For accidents that happened before 14 February 2018, we can only pay for optometry and ophthalmology services once any required medical excess has been reached. Find out if the medical excess applies to you.

For providers

If you are a provider of eye services, please refer to our: