Acupuncture

The TAC Medical Excess may apply to these services 

 

 

Policy

The TAC can pay the reasonable costs of acupuncture services when required as a result of a transport accident injury under section 60 of the Transport Accident Act 1986 (the Act).

The TAC will periodically review a client's entitlement to acupuncture services to ensure that the treatment and services remain reasonable for the transport accident injury and are payable under the Act.

Background


The TAC has developed the Clinical Framework for the Delivery of Health Services (Clinical Framework) to set out key principles for delivery of services to clients.

The Clinical Framework is based on the following principles:

  • Measurement and demonstration of the effectiveness of treatment
  • Adoption of a biopsychosocial approach
  • Empowering the client to manage their injury
  • Implementing goals focused on optimising function, participation and/or return to work/health
  • Base treatment on best available research evidence.

The TAC expects that all health professionals providing services to clients integrate the principles of the Clinical Framework into their daily practice.

Further information about the Clinical Framework can be found at www.tac.vic.gov.au.

Definitions

In this policy acupuncture includes the use of:

  • fine sterile needles that are inserted into the skin at specific points in the body
  • lasers on the same points on the body in place of sterile needles, without puncturing the skin and
  • dry needling techniques to treat trigger points in muscles.

Guidelines

What can the TAC pay for in relation to acupuncture services?

The TAC can pay the reasonable costs of acupuncture services:

  • required as a result of the transport accident injury
  • that are reasonable, necessary or appropriate in the circumstances
  • that are clinically justified, safe and effective
  • that have a clear rehabilitative purpose and are not for non-transport accident injury rehabilitative purposes
  • that are likely to achieve or maintain a measurable functional improvement
  • that promote progress towards functional independence, participation and self-management.

Please note that the TAC will not pay for more than one initial consultation by the same provider or clinic unless there are exceptional circumstances, for example where a significant period of time has elapsed since the client last received acupuncture treatment 

Who can provide acupuncture services?

Acupuncture services can be provided by a person:

  • who is registered as a Chinese medicine practitioner in the Division of Acupuncturists under the Health Practitioner Regulation National Law, or
  • whose registration is endorsed under section 97 of the Health Practitioner Regulation National Law as being qualified to practice as an acupuncturist (for example by the Chiropractic, Osteopathy or Physiotherapy Boards of Australia).

What information does the TAC need?

For clients with a 'severe injury' treatment will be approved as part of the independence planning process. The acupuncturist will be required to submit initial baseline measures within 10 working days of approval of treatment from the TAC. Outcome measures are to be maintained and recorded throughout the treatment and provided to the TAC upon request.

For all other clients the TAC does not require any information from an acupuncturist before commencement of initial treatment for a client's transport accident injury. After initial treatment has commenced, the acupuncturist will be required to submit information to the TAC where the acupuncturist expects to provide more than five sessions of treatment. This also applies to clients who have previously:
  • been treated at another acupuncture clinic, or
  • received acupuncture treatment and it is more than 12 months since the last treatment session.

In these circumstances, the acupuncturist must submit information to the TAC about the:

  • client's transport accident injury and clinical diagnosis
  • client's reported symptoms and findings from physical assessment
  • current objective and measurable functional limitations and goals of treatment with expected time frames for achievement 
  • proposed treatment plan including commencement and anticipated end dates
  • functional outcome measures to be used including baseline measures
  • these measures need to be recorded regularly but only require submission to the TAC on request, and
  • previous acupuncture treatment (if any) received by the client prior to the transport accident, including details of the condition treated, when it was treated and for what period of time.

For all clients the TAC may contact the client or health professional for further information if required. In some circumstances an Acupuncture Treatment Questionnaire may be requested by the TAC. Acupuncturists should not submit a TAC Acupuncture Treatment Questionnaire or written reports unless specifically requested by the TAC.

In relation to acupuncture services what will the TAC not fund?

The TAC will not pay for:

  • any form of treatment from a Chinese medicine practitioner other than acupuncture, such as alternative therapy, Chinese herbs and medicines, etc.
  • the cost of disposable acupuncture needles or dressings
  • treatment or services that are not in line with the Clinical Framework
  • concurrent treatment by acupuncturists, physiotherapists, chiropractors and osteopaths
  • treatment provided more than once on the same day to the same client
  • pharmacy items such as creams and gels supplied by health professionals - see also the Pharmacy (Chemist Medications) policy
  • treatment or services for a person other than the client
  • treatment or services subcontracted to, or provided by a non-registered provider
  • fees associated with cancellation or non attendance
  • treatment or services provided outside the Commonwealth of Australia
  • treatment or services provided by telephone or other non face to face mediums 
  • telephone calls and telephone consultations between providers and clients, and between other providers, including hospitals
  • treatment or services provided more than two years prior to the request for funding except where the request for payment is made within three years of the transport accident.  Refer to the Time Limit to Apply for the Payment of Medical and Like Expenses policy.

 


Chinese Medicine Practitioners (Acupuncture)

Effective 1 July 2017

Registered for GSTNot Registered for GST
Service DescriptionTAC Item Number 2017/18
Maximum Payment Rate
2016/17
Maximum Payment Rate
TAC Item Number2017/18
Maximum Payment Rate
2016/17
Maximum Payment Rate
Initial ConsultationA600$55.57$54.76   
Standard ConsultationA602$45.41$44.75   
Completion of Acupuncture Treatment Questionnaire (when requested by the TAC)A650*$49.85$49.12AGF650$45.31$44.65

GST

*The TAC maximum fee includes a 10% allowance for GST for items which TAC believes are taxable supplies.  If you are a provider not registered for GST:

  • You are not legally permitted to charge GST
  • You should indicate on all invoices submitted your status as 'not registered for GST purposes'
  • The TAC will only reimburse you an amount which excludes the GST component for items billed where the maximum fee includes a 10% allowance for GST

If you are not registered for GST please state on all invoices the TAC item number listed for providers not registered.


View Information for people with soft tissue injuries

Information for people with soft tissue injuries

Summary:

This booklet provides information about soft tissue injuries (e.g. painful strains, sprains and bruises) and how health care professionals can help you recover faster by getting moving. As well as explaining the types of treatment and services the TAC can fund, there are handy tips about working with your therapy providers, staying motivated and measuring progress.

View Acupuncture treatment questionnaire (Provider use only)

Acupuncture treatment questionnaire (Provider use only)

Summary:

This form is for acupuncture practitioners to provide an overview of the client's health and work/functional status, treatment plan, progress, limitations and advice for self-management of their condition. The separate 'notes' document in this section provides additional instructions and clarification to help practitioners to complete the questionnaire.

View Independence Plan - Information for providers

Independence Plan - Information for providers

Summary:

Our attendant care providers support clients to achieve their independence goals in daily living activities, therapy support, personal and domestic skills retraining and community access skills.