Orthotic and prosthetic

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 orthotic or prosthetic treatment

  1. Choose a provider. Your doctor can recommend one in your local area or you can search for an orthotist or prosthetist 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 an orthotist and prosthetist do?

An orthotist and prosthetist helps those who need artificial limbs or other supports like braces and callipers.

They look at the needs of people with physical or mobility issues caused by amputation or problems with their muscles, bones or nervous system.

Effective 1 July 2023

The TAC has extended the funding of temporary telehealth services previously scheduled to end on 30 September 2020 until further notice, giving clients the ongoing convenience and flexibility of accessing services from home.

For prosthetic and orthotic services provided on or after 1 July 2023
Service DescriptionTAC Item NumberMaximum Payment Rate
Initial Consultation PR600 $69.37
Initial Consultation (Telehealth)PR600T$69.37
Standard Consultation  PR602 $55.51
Standard Consultation (Telehealth)PR602T$55.51
Long Consultation  PR604 $82.96
Long Consultation (Telehealth)PR604T$82.96
Prolonged Consultation  PR606 $110.85
Prolonged Consultation (Telehealth)PR606T$110.85
Manufacture
Time to manufacture (per hour) (Greater than 1 hour should be charged pro-rata at hourly rate) PR608 $120.40
Purchase of Standard Products / Equipment
Standard products require the prior approval of the TAC and are payable at cost.
Details of the products must be included on the invoice for payment. PR610 As approved
Major Repair (Prosthesis) PR614 As approved
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)
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) PR612 As approved
Prosthetic Management Review Form - lower extremity or upper extremity. (Total cost for completion of Form) PR618* $61.21
Standard Consultation      - up to 30 minutes
Long Consultation             - >30 minutes < 45 minutes
Prolonged Consultation    - >45 minutes <60 minutes
For prosthetic and orthotic services provided between 1 July 2022 and 30 June 2023
Service DescriptionTAC Item NumberMaximum Payment Rate
Initial Consultation PR600 $64.24
Initial Consultation (Telehealth)PR600T$64.24
Standard Consultation  PR602 $51.40
Standard Consultation (Telehealth)PR602T$51.40
Long Consultation  PR604 $76.82
Long Consultation (Telehealth)PR604T$76.82
Prolonged Consultation  PR606 $102.65
Prolonged Consultation (Telehealth)PR606T$102.65
Manufacture
Time to manufacture (per hour) (Greater than 1 hour should be charged pro-rata at hourly rate) PR608 $111.49
Purchase of Standard Products / Equipment
Standard products require the prior approval of the TAC and are payable at cost.
Details of the products must be included on the invoice for payment. PR610 As approved
Major Repair (Prosthesis) PR614 As approved
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)
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) PR612 As approved
Prosthetic Management Review Form - lower extremity or upper extremity. (Total cost for completion of Form) PR618* $56.68
Standard Consultation      - up to 30 minutes
Long Consultation             - >30 minutes < 45 minutes
Prolonged Consultation    - >45 minutes <60 minutes
For prosthetic and orthotic services provided on or after 1 July 2023
Service DescriptionTAC Item NumberMaximum Payment Rate
Initial Consultation PR600 $69.37
Initial Consultation (Telehealth)PR600T$69.37
Standard Consultation  PR602 $55.51
Standard Consultation (Telehealth)PR602T$55.51
Long Consultation  PR604 $82.96
Long Consultation (Telehealth)PR604T$82.96
Prolonged Consultation  PR606 $110.85
Prolonged Consultation (Telehealth)PR606T$110.85
Manufacture
Time to manufacture (per hour) (Greater than 1 hour should be charged pro-rata at hourly rate) PR608 $120.40
Purchase of Standard Products / Equipment
Standard products require the prior approval of the TAC and are payable at cost.
Details of the products must be included on the invoice for payment. PR610 As approved
Major Repair (Prosthesis) PR614 As approved
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)
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) PR612 As approved
Prosthetic Management Review Form - lower extremity or upper extremity. (Total cost for completion of Form) PR618* $61.21
Standard Consultation      - up to 30 minutes
Long Consultation             - >30 minutes < 45 minutes
Prolonged Consultation    - >45 minutes <60 minutes
For prosthetic and orthotic services provided between 1 July 2022 and 30 June 2023
Service DescriptionTAC Item NumberMaximum Payment Rate
Initial Consultation PR600 $64.24
Initial Consultation (Telehealth)PR600T$64.24
Standard Consultation  PR602 $51.40
Standard Consultation (Telehealth)PR602T$51.40
Long Consultation  PR604 $76.82
Long Consultation (Telehealth)PR604T$76.82
Prolonged Consultation  PR606 $102.65
Prolonged Consultation (Telehealth)PR606T$102.65
Manufacture
Time to manufacture (per hour) (Greater than 1 hour should be charged pro-rata at hourly rate) PR608 $111.49
Purchase of Standard Products / Equipment
Standard products require the prior approval of the TAC and are payable at cost.
Details of the products must be included on the invoice for payment. PR610 As approved
Major Repair (Prosthesis) PR614 As approved
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)
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) PR612 As approved
Prosthetic Management Review Form - lower extremity or upper extremity. (Total cost for completion of Form) PR618* $56.68
Standard Consultation      - up to 30 minutes
Long Consultation             - >30 minutes < 45 minutes
Prolonged Consultation    - >45 minutes <60 minutes

Summary

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

How to send documents to the TAC

myTAC

myTAC is the quickest way to:

  • Submit receipts and claim reimbursements
  • Send documents and forms
  • Update your personal and banking details
  • Find out about treatments and services the TAC may pay for

Email

If you can't use myTAC to send your receipts 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.

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.

How to send documents to the TAC

myTAC

myTAC is the quickest way to:

  • Submit receipts and claim reimbursements
  • Send documents and forms
  • Update your personal and banking details
  • Find out about treatments and services the TAC may pay for

Email

If you can't use myTAC to send your receipts 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.

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:

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:

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

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
  • orthoses

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:

  • Directly to your orthotist and prosthetist, when you have provided them with 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 payment rates, see:

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

For providers

If you are a prosthetist or orthotist, see 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 orthotic or prosthetic treatment

  1. Choose a provider. Your doctor can recommend one in your local area or you can search for an orthotist or prosthetist 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 an orthotist and prosthetist do?

An orthotist and prosthetist helps those who need artificial limbs or other supports like braces and callipers.

They look at the needs of people with physical or mobility issues caused by amputation or problems with their muscles, bones or nervous system.

Effective 1 July 2023

The TAC has extended the funding of temporary telehealth services previously scheduled to end on 30 September 2020 until further notice, giving clients the ongoing convenience and flexibility of accessing services from home.

For prosthetic and orthotic services provided on or after 1 July 2023
Service DescriptionTAC Item NumberMaximum Payment Rate
Initial Consultation PR600 $69.37
Initial Consultation (Telehealth)PR600T$69.37
Standard Consultation  PR602 $55.51
Standard Consultation (Telehealth)PR602T$55.51
Long Consultation  PR604 $82.96
Long Consultation (Telehealth)PR604T$82.96
Prolonged Consultation  PR606 $110.85
Prolonged Consultation (Telehealth)PR606T$110.85
Manufacture
Time to manufacture (per hour) (Greater than 1 hour should be charged pro-rata at hourly rate) PR608 $120.40
Purchase of Standard Products / Equipment
Standard products require the prior approval of the TAC and are payable at cost.
Details of the products must be included on the invoice for payment. PR610 As approved
Major Repair (Prosthesis) PR614 As approved
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)
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) PR612 As approved
Prosthetic Management Review Form - lower extremity or upper extremity. (Total cost for completion of Form) PR618* $61.21
Standard Consultation      - up to 30 minutes
Long Consultation             - >30 minutes < 45 minutes
Prolonged Consultation    - >45 minutes <60 minutes
For prosthetic and orthotic services provided between 1 July 2022 and 30 June 2023
Service DescriptionTAC Item NumberMaximum Payment Rate
Initial Consultation PR600 $64.24
Initial Consultation (Telehealth)PR600T$64.24
Standard Consultation  PR602 $51.40
Standard Consultation (Telehealth)PR602T$51.40
Long Consultation  PR604 $76.82
Long Consultation (Telehealth)PR604T$76.82
Prolonged Consultation  PR606 $102.65
Prolonged Consultation (Telehealth)PR606T$102.65
Manufacture
Time to manufacture (per hour) (Greater than 1 hour should be charged pro-rata at hourly rate) PR608 $111.49
Purchase of Standard Products / Equipment
Standard products require the prior approval of the TAC and are payable at cost.
Details of the products must be included on the invoice for payment. PR610 As approved
Major Repair (Prosthesis) PR614 As approved
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)
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) PR612 As approved
Prosthetic Management Review Form - lower extremity or upper extremity. (Total cost for completion of Form) PR618* $56.68
Standard Consultation      - up to 30 minutes
Long Consultation             - >30 minutes < 45 minutes
Prolonged Consultation    - >45 minutes <60 minutes
For prosthetic and orthotic services provided on or after 1 July 2023
Service DescriptionTAC Item NumberMaximum Payment Rate
Initial Consultation PR600 $69.37
Initial Consultation (Telehealth)PR600T$69.37
Standard Consultation  PR602 $55.51
Standard Consultation (Telehealth)PR602T$55.51
Long Consultation  PR604 $82.96
Long Consultation (Telehealth)PR604T$82.96
Prolonged Consultation  PR606 $110.85
Prolonged Consultation (Telehealth)PR606T$110.85
Manufacture
Time to manufacture (per hour) (Greater than 1 hour should be charged pro-rata at hourly rate) PR608 $120.40
Purchase of Standard Products / Equipment
Standard products require the prior approval of the TAC and are payable at cost.
Details of the products must be included on the invoice for payment. PR610 As approved
Major Repair (Prosthesis) PR614 As approved
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)
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) PR612 As approved
Prosthetic Management Review Form - lower extremity or upper extremity. (Total cost for completion of Form) PR618* $61.21
Standard Consultation      - up to 30 minutes
Long Consultation             - >30 minutes < 45 minutes
Prolonged Consultation    - >45 minutes <60 minutes
For prosthetic and orthotic services provided between 1 July 2022 and 30 June 2023
Service DescriptionTAC Item NumberMaximum Payment Rate
Initial Consultation PR600 $64.24
Initial Consultation (Telehealth)PR600T$64.24
Standard Consultation  PR602 $51.40
Standard Consultation (Telehealth)PR602T$51.40
Long Consultation  PR604 $76.82
Long Consultation (Telehealth)PR604T$76.82
Prolonged Consultation  PR606 $102.65
Prolonged Consultation (Telehealth)PR606T$102.65
Manufacture
Time to manufacture (per hour) (Greater than 1 hour should be charged pro-rata at hourly rate) PR608 $111.49
Purchase of Standard Products / Equipment
Standard products require the prior approval of the TAC and are payable at cost.
Details of the products must be included on the invoice for payment. PR610 As approved
Major Repair (Prosthesis) PR614 As approved
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)
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) PR612 As approved
Prosthetic Management Review Form - lower extremity or upper extremity. (Total cost for completion of Form) PR618* $56.68
Standard Consultation      - up to 30 minutes
Long Consultation             - >30 minutes < 45 minutes
Prolonged Consultation    - >45 minutes <60 minutes

Summary

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

How to send documents to the TAC

myTAC

myTAC is the quickest way to:

  • Submit receipts and claim reimbursements
  • Send documents and forms
  • Update your personal and banking details
  • Find out about treatments and services the TAC may pay for

Email

If you can't use myTAC to send your receipts 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.

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.

How to send documents to the TAC

myTAC

myTAC is the quickest way to:

  • Submit receipts and claim reimbursements
  • Send documents and forms
  • Update your personal and banking details
  • Find out about treatments and services the TAC may pay for

Email

If you can't use myTAC to send your receipts 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.

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:

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:

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

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
  • orthoses

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:

  • Directly to your orthotist and prosthetist, when you have provided them with 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 payment rates, see:

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

For providers

If you are a prosthetist or orthotist, see our TAC provider guidelines.

See what else we can pay for