Medical services/doctor appointments

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.

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.

In response to COVID-19, the TAC can now pay for telehealth appointments for treatment related to your transport accident. Find out more about telehealth.

How to get doctor’s treatment

  1. You may already have a doctor that you see. If not, you can search for a doctor online.
  2. Call and make an appointment. Tell them you are a TAC client. 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
  3. 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.

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 ‘Claim reimbursement’ button 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 does a doctor do?

Your doctor or GP plays an important role in helping you recover.

Your doctor can:

  • Refer you to other health professionals and specialists.
  • Organise diagnostic tests, such as x-rays, blood tests, MRIs and CT scans.
  • Prescribe any medication you need.
  • Provide any certificates and reports you need.
  • Help you get back to work.

Information for health and service providers

If you are a doctor, please refer to our TAC Provider Guidelines.

The TAC has adopted the Medicare Benefits Schedule (MBS) items, explanations, definitions, rules and conditions for services provided by medical practitioners.  When invoicing for medical services, medical practitioners are expected to adhere to the MBS rules unless otherwise specified by the TAC on the Reimbursement Rates for Medical Services information page or its medical policies.

The Reimbursement Rates for Medical Services must be read in conjunction with:

Current rates 

Important: The Excel spreadsheet includes all the temporary MBS COVID19 telehealth items payable by the TAC.  It was last updated on 29 February 2024.

For further information about TAC funded telehealth, please refer to our telehealth information page.

Current rates 

Important: The Excel spreadsheet includes all the temporary MBS COVID19 telehealth items payable by the TAC.  It was last updated on 29 February 2024.

For further information about TAC funded telehealth, please refer to our telehealth information page.

At the time of production this publication contained up to date information as released by Medicare Australia (Medicare).  The relevant publication will be updated to reflect any further changes that are implemented by Medicare each year.  Please check our website for the latest version.

If you have any questions about these publications or the reimbursement rates, please contact the TAC on 1300 654 329. Alternatively, e-mail info@tac.vic.gov.au.

Effective 1 July 2023

For Return to work case conferences held on or after 1 July 2023
Service DescriptionTAC Item NumberMaximum
Payment
Rate
GP Participation in a RTW Case Conference✝
< 20 minutes RTWCC1 $130.18
20 - 40 minutes RTWCC2 $208.20
> 40 minutes RTWCC3 $286.11
 
GP organise and coordinate a RTW Case Conference✝ RTWCC4 $273.37
GP RTW Worksite Visit (employer agreement required) RTWWV $519.98
RTW Phone call between GP & Employer RTWPC $35.06
For Return to work case conferences held between 1 July 2022 and 30 June 2023
Service DescriptionTAC Item NumberMaximum
Payment
Rate
GP Participation in a RTW Case Conference✝
< 20 minutes RTWCC1 $125.33
20 - 40 minutes RTWCC2 $200.44
> 40 minutes RTWCC3 $275.45
 
GP organise and coordinate a RTW Case Conference✝ RTWCC4 $263.18
GP RTW Worksite Visit (employer agreement required) RTWWV $500.61
RTW Phone call between GP & Employer RTWPC $33.75
For Return to work case conferences held on or after 1 July 2023
Service DescriptionTAC Item NumberMaximum
Payment
Rate
GP Participation in a RTW Case Conference✝
< 20 minutes RTWCC1 $130.18
20 - 40 minutes RTWCC2 $208.20
> 40 minutes RTWCC3 $286.11
 
GP organise and coordinate a RTW Case Conference✝ RTWCC4 $273.37
GP RTW Worksite Visit (employer agreement required) RTWWV $519.98
RTW Phone call between GP & Employer RTWPC $35.06
For Return to work case conferences held between 1 July 2022 and 30 June 2023
Service DescriptionTAC Item NumberMaximum
Payment
Rate
GP Participation in a RTW Case Conference✝
< 20 minutes RTWCC1 $125.33
20 - 40 minutes RTWCC2 $200.44
> 40 minutes RTWCC3 $275.45
 
GP organise and coordinate a RTW Case Conference✝ RTWCC4 $263.18
GP RTW Worksite Visit (employer agreement required) RTWWV $500.61
RTW Phone call between GP & Employer RTWPC $33.75

Note : These items are restricted for use by General Practitioners only and should be read in conjunction with the Medical Practitioner policy and the General Practitioner Participation in RTW Activities information sheet.

The General Practitioner can either organise and coordinate or participate in a case conference, the practitioner cannot bill both items at the same case conference.

Better Health Channel has a useful guide to seeing a doctor, specialist or health professional.

Asking questions at your appointments helps to get all the information you need to stay informed about your treatment.

healthdirect has some suggested questions which you might consider asking.

PainHEALTH has clinically supported information, tips, support and personal stories to help manage musculoskeletal pain.

Head to Health websitehttps://headtohealth.gov.au/

Head to Health (H2H) can help you find the information, resources, and services that most suit your needs. Whether you want to improve your overall sense of wellbeing, or you need help with something that is concerning you, or you are helping someone you care about—Head to Health can point you to great  online mental health resources.

Summary

This information sheet explains what to expect at TAC medical examinations that clients claiming support services are required to attend. You will also find details of what you need to bring and reimbursements (e.g. for travel or work absence related to your examination appointment) that you may be eligible to claim.

Summary

This information describes different ways to manage and learn about pain. It can help you develop strategies to return to work, reduce dependence on medication and improve mental health.

A Pain Education Program is an effective way to help treat persistent pain. These programs are discreet, accessible at any time and often self-directed. Most are free or low-cost.

A Pain Management Program is a more tailored, intensive program under the direction of a pain management provider.

A Network Pain Management Program is a Pain Management Program delivered within the TAC’s approved network of pain management providers.

Summary

Digital mental health services provide information, support and resources. They can provide an easy, effective alternative to seeing a health professional in person.

We’re here to help you get your life back on track after your transport accident. To help you recover we will pay for medical services provided by a doctor within 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 doctors and diagnostics

In the first 90 days after your accident, you can see your doctor for treatment and care for your injuries without the need for you to contact us first.

After the first 90 days, you will need TAC approval to see your doctor.

We will also pay for your doctor to meet with your employer, once you both feel it’s time to talk about returning to work. Your doctor can visit your workplace to see if you will be able to manage or if you will need some help. If this is more than 90 days after your accident, you will need TAC approval first.

Other services you can access

Your doctor may recommend other services for you, such as pathology and imaging services. This will help them decide on the best treatment for your injuries. We will pay for these services.

When needed, we will work with your treating team to help them manage the medical services and supports you need.

We may contact your doctor to discuss your progress or request an assessment to make sure that:

  • 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.

See Clinical notes and treatment reports for more information.

We will also pay for your doctor to meet with your employer, once you both feel it’s time to talk about returning to work. Your doctor can visit your workplace to see if you will be able to manage or if you will need some help.

Treatments 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 is the role of my doctor?

Your doctor (also known as a General Practitioner or GP) plays an important part in your recovery. They will:

  • Manage and coordinate your care and recovery.
  • Prescribe the medication you need.
  • Send you to see other health professionals or specialists.
  • Give you health information and education.
  • Help you get back to work.
  • Give you any certificates and reports you need.

For more information, see:

How treatments and services are paid for

We pay for your medical treatment:

  • Directly to your doctor, 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 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 Febuary 2018, we can only pay for these services once any required medical excess has been reached. Find out if the medical excess applies to you.

For providers

If you are a doctor, please refer to our TAC Provider Guidelines.

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.

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.

In response to COVID-19, the TAC can now pay for telehealth appointments for treatment related to your transport accident. Find out more about telehealth.

How to get doctor’s treatment

  1. You may already have a doctor that you see. If not, you can search for a doctor online.
  2. Call and make an appointment. Tell them you are a TAC client. 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
  3. 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.

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 ‘Claim reimbursement’ button 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 does a doctor do?

Your doctor or GP plays an important role in helping you recover.

Your doctor can:

  • Refer you to other health professionals and specialists.
  • Organise diagnostic tests, such as x-rays, blood tests, MRIs and CT scans.
  • Prescribe any medication you need.
  • Provide any certificates and reports you need.
  • Help you get back to work.

Information for health and service providers

If you are a doctor, please refer to our TAC Provider Guidelines.

The TAC has adopted the Medicare Benefits Schedule (MBS) items, explanations, definitions, rules and conditions for services provided by medical practitioners.  When invoicing for medical services, medical practitioners are expected to adhere to the MBS rules unless otherwise specified by the TAC on the Reimbursement Rates for Medical Services information page or its medical policies.

The Reimbursement Rates for Medical Services must be read in conjunction with:

Current rates 

Important: The Excel spreadsheet includes all the temporary MBS COVID19 telehealth items payable by the TAC.  It was last updated on 29 February 2024.

For further information about TAC funded telehealth, please refer to our telehealth information page.

Current rates 

Important: The Excel spreadsheet includes all the temporary MBS COVID19 telehealth items payable by the TAC.  It was last updated on 29 February 2024.

For further information about TAC funded telehealth, please refer to our telehealth information page.

At the time of production this publication contained up to date information as released by Medicare Australia (Medicare).  The relevant publication will be updated to reflect any further changes that are implemented by Medicare each year.  Please check our website for the latest version.

If you have any questions about these publications or the reimbursement rates, please contact the TAC on 1300 654 329. Alternatively, e-mail info@tac.vic.gov.au.

Effective 1 July 2023

For Return to work case conferences held on or after 1 July 2023
Service DescriptionTAC Item NumberMaximum
Payment
Rate
GP Participation in a RTW Case Conference✝
< 20 minutes RTWCC1 $130.18
20 - 40 minutes RTWCC2 $208.20
> 40 minutes RTWCC3 $286.11
 
GP organise and coordinate a RTW Case Conference✝ RTWCC4 $273.37
GP RTW Worksite Visit (employer agreement required) RTWWV $519.98
RTW Phone call between GP & Employer RTWPC $35.06
For Return to work case conferences held between 1 July 2022 and 30 June 2023
Service DescriptionTAC Item NumberMaximum
Payment
Rate
GP Participation in a RTW Case Conference✝
< 20 minutes RTWCC1 $125.33
20 - 40 minutes RTWCC2 $200.44
> 40 minutes RTWCC3 $275.45
 
GP organise and coordinate a RTW Case Conference✝ RTWCC4 $263.18
GP RTW Worksite Visit (employer agreement required) RTWWV $500.61
RTW Phone call between GP & Employer RTWPC $33.75
For Return to work case conferences held on or after 1 July 2023
Service DescriptionTAC Item NumberMaximum
Payment
Rate
GP Participation in a RTW Case Conference✝
< 20 minutes RTWCC1 $130.18
20 - 40 minutes RTWCC2 $208.20
> 40 minutes RTWCC3 $286.11
 
GP organise and coordinate a RTW Case Conference✝ RTWCC4 $273.37
GP RTW Worksite Visit (employer agreement required) RTWWV $519.98
RTW Phone call between GP & Employer RTWPC $35.06
For Return to work case conferences held between 1 July 2022 and 30 June 2023
Service DescriptionTAC Item NumberMaximum
Payment
Rate
GP Participation in a RTW Case Conference✝
< 20 minutes RTWCC1 $125.33
20 - 40 minutes RTWCC2 $200.44
> 40 minutes RTWCC3 $275.45
 
GP organise and coordinate a RTW Case Conference✝ RTWCC4 $263.18
GP RTW Worksite Visit (employer agreement required) RTWWV $500.61
RTW Phone call between GP & Employer RTWPC $33.75

Note : These items are restricted for use by General Practitioners only and should be read in conjunction with the Medical Practitioner policy and the General Practitioner Participation in RTW Activities information sheet.

The General Practitioner can either organise and coordinate or participate in a case conference, the practitioner cannot bill both items at the same case conference.

Better Health Channel has a useful guide to seeing a doctor, specialist or health professional.

Asking questions at your appointments helps to get all the information you need to stay informed about your treatment.

healthdirect has some suggested questions which you might consider asking.

PainHEALTH has clinically supported information, tips, support and personal stories to help manage musculoskeletal pain.

Head to Health websitehttps://headtohealth.gov.au/

Head to Health (H2H) can help you find the information, resources, and services that most suit your needs. Whether you want to improve your overall sense of wellbeing, or you need help with something that is concerning you, or you are helping someone you care about—Head to Health can point you to great  online mental health resources.

Summary

This information sheet explains what to expect at TAC medical examinations that clients claiming support services are required to attend. You will also find details of what you need to bring and reimbursements (e.g. for travel or work absence related to your examination appointment) that you may be eligible to claim.

Summary

This information describes different ways to manage and learn about pain. It can help you develop strategies to return to work, reduce dependence on medication and improve mental health.

A Pain Education Program is an effective way to help treat persistent pain. These programs are discreet, accessible at any time and often self-directed. Most are free or low-cost.

A Pain Management Program is a more tailored, intensive program under the direction of a pain management provider.

A Network Pain Management Program is a Pain Management Program delivered within the TAC’s approved network of pain management providers.

Summary

Digital mental health services provide information, support and resources. They can provide an easy, effective alternative to seeing a health professional in person.

We’re here to help you get your life back on track after your transport accident. To help you recover we will pay for medical services provided by a doctor within 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 doctors and diagnostics

In the first 90 days after your accident, you can see your doctor for treatment and care for your injuries without the need for you to contact us first.

After the first 90 days, you will need TAC approval to see your doctor.

We will also pay for your doctor to meet with your employer, once you both feel it’s time to talk about returning to work. Your doctor can visit your workplace to see if you will be able to manage or if you will need some help. If this is more than 90 days after your accident, you will need TAC approval first.

Other services you can access

Your doctor may recommend other services for you, such as pathology and imaging services. This will help them decide on the best treatment for your injuries. We will pay for these services.

When needed, we will work with your treating team to help them manage the medical services and supports you need.

We may contact your doctor to discuss your progress or request an assessment to make sure that:

  • 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.

See Clinical notes and treatment reports for more information.

We will also pay for your doctor to meet with your employer, once you both feel it’s time to talk about returning to work. Your doctor can visit your workplace to see if you will be able to manage or if you will need some help.

Treatments 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 is the role of my doctor?

Your doctor (also known as a General Practitioner or GP) plays an important part in your recovery. They will:

  • Manage and coordinate your care and recovery.
  • Prescribe the medication you need.
  • Send you to see other health professionals or specialists.
  • Give you health information and education.
  • Help you get back to work.
  • Give you any certificates and reports you need.

For more information, see:

How treatments and services are paid for

We pay for your medical treatment:

  • Directly to your doctor, 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 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 Febuary 2018, we can only pay for these services once any required medical excess has been reached. Find out if the medical excess applies to you.

For providers

If you are a doctor, please refer to our TAC Provider Guidelines.

See what else we can pay for