Podiatry

The TAC Medical Excess may apply to these services 

 

 

Policy

The TAC can fund the reasonable cost of podiatry treatment for injuries sustained by a TAC client in a transport accident, where the treatment is clinically justified and the podiatrist is registered with the Podiatry Board of Australia.

Transport Accident Act 1986 reference: s.3 'medical service' and s.60

Guidelines

What does the TAC consider before approving podiatry services?

Before approving podiatry services, the following criteria must be met. The treatment:

  • is likely to be effective and achieve a measurable improvement
  • promotes progress toward functional independence and self-management that is consistent with the client's transport accident injuries.

Are there additional costs associated with podiatry treatment that the TAC can fund?

The TAC can fund the reasonable cost of:

  • adaptive equipment to assist a client's functional ability to perform podiatry tasks independently, eg. provision of orthoses. See also the Equipment policy.
  • adaptive or modified footwear. See also the Equipment policy.
  • x-rays, only of the lower extremity, foot, and ankle, in accordance with arrangements outlined in the Commonwealth Medicare Benefits Schedule Book
  • reports, only when requested in writing by the TAC.

Fees for treatment will be based on the TAC Podiatry Fee Schedule.

Can the TAC fund long or prolonged consultations?

The TAC can fund long and prolonged consultations where this is clinically justified and where prior approval has been obtained from the TAC. Refer to the TAC Podiatry Fee Schedule.

Can the TAC fund out of rooms rates for podiatry services?

The TAC can fund out of rooms podiatry visits where a client is medically unfit to attend the podiatrist's rooms for treatment and where prior approval has been obtained from the TAC.

Can the TAC fund podiatrist visits for in-patients at private hospitals?

The TAC can fund podiatry services to a client who is an in-patient in a private hospital where the following criteria have been met:

  • The visit is specifically requested by the client's treating medical practitioner.
  • The hospital has consented.
  • The cost of podiatry (including an initial consultation and treatment), is not included in the hospital bed fee, ie. the hospital is a TAC non-arrangement hospital.

What billing information does the TAC require?

The TAC requires that the actual provider of the service be identified on each account for payment. It is the responsibility of the registered provider to ensure accounts submitted to the TAC are correct, regardless of who has completed the account.

Can the TAC fund podiatry services performed by a member of a client's immediate family?

Refer to the Funding Treatment by a Member of a Client's Immediate Family policy.

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

The TAC will not fund:

  • treatment or services for a person other than the injured client
  • treatment or services for a condition that existed before a transport accident or that is not a direct result of a transport accident
  • treatment or services where there is no proper clinical justification
  • treatment, services or equipment where there is no published evidence in a recent peer-reviewed journal article that the treatment, service or equipment is safe and effective. Refer to the Non-Established, New or Emerging Treatments and Services policy
  • the cost of telephone calls and telephone consultations between providers and clients, and between other providers, including hospitals
  • treatment or services received by the injured person outside the Commonwealth of Australia
  • the cost of more than one initial consultation to the same podiatrist per course of treatment
  • treatment or services provided more than 2 years prior to the request for funding except where the request for payment is made within 3 years of the transport accident. Refer to the Time Limit to Apply for the Payment of Medical and Like Expenses policy.

 


Podiatry Services

Effective 1 July 2017

Service DescriptionTAC Item Number2017/2018
Maximum
Payment
Rate
2016/2017
Maximum
Payment
Rate
In Room Consultations
Initial consultation F002$58.15$57.30
Standard consultation – up to 30 minutesF012$46.53$45.85
Long consultation – 31 to 45 minutesF014$69.68$68.66
Prolonged consultation – 46 minutes and aboveF016$92.93$91.57
Out of Rooms Consultations
Initial consultation F023$81.35$80.16
Standard consultation – up to 30 minutesF033$69.68$68.66
Long consultation – 31 to 45 minutes F034$92.93$91.57
Prolonged consultationF035$116.01$114.32
Biomechanical Examination
Biomechanical Assessment (includes F111, F114, F117)F118$163.45$161.07
Items F101, F104, F111, F114, F115, F116, F117, F121, F141, F142, F145, F147, F148, F163, F361 to be charged as per consultations.
ORTHOMECHANICAL SERVICES & PROCEDURES (NB: Prior TAC approval required for these services)
Impressions and Models
Negative impression cast – footF301$69.31$68.30
Negative impression cast – foot & lower 1/3 of legF303$84.91$83.67
Prescription Orthoses
Ankle-foot orthosisF201$494.45$487.24
Orthodigital traction deviceF211$135.23$133.26
Custom moulded thermoplastic orthosis (including cast and posting)F221$251.19$247.53
Heel stabiliser, made to plaster modelF227$141.42$139.36
Cushioning orthosisF261$44.17$43.53
Pressure relief orthosisF263$108.46$106.88
Custom moulded thermoplastic orthosis (including cast and accommodating)F265$166.57$164.14
Moulded thermoplastic orthosis – non castF267$125.77$123.94
Heel liftF269$36.29$35.76
Interior shoe paddingF271$36.29$35.76
Protective deviceF341  
Prefabricated Orthoses
Heel stabiliserF229$77.08$75.96
Pre-moulded or pre-formed orthosisF240$125.77$123.94
Orthoses Modification and Repairs
Orthosis repair – not otherwise specified  F231*$52.06$51.30
Orthosis repair – plain          F381*$31.43$30.97
Orthosis cover – with soft tissue supplementF383$45.70$45.03
Orthosis post – forefoot or rear footF385$26.93$26.54
Prosthetic Devices
Simple digital or partial prosthesisF351$135.23$133.26
Splints
Dennis Browne splintF281 $160.13$157.79
Galley splintF282 $210.45$207.38
Counter Rotation systemF283 $607.28$598.42
Immobilisation splint, thermoplastic, plaster, or other; below kneeF311 $149.32$147.14
Immobilisation splint, thermoplastic, plaster, or other; ankle/footF312 $122.51$120.72
Immobilisation splint, thermoplastic, plaster, or other; above kneeF315 $183.90$181.22
Traction and training devices (eg. HAV splints)F331  
FOOTWEAR – F008, F025, F019 & F037 to be charged as consultations
PODIATRIC SURGERY (NB: Prior TAC approval required for these services)
Foreign body removal (subcutaneous)F429# $191.46$188.67
Foreign body removal (deep to deep fascia)F430 $406.43$400.50
Avulsion of toenailF440# $149.32$147.14
Excision, benign lesionF445# $309.52$305.01
Excision nail and/or nail matrix, partial, for permanent removalF474 $355.12$349.94
Excision nail and/or nail matrix, complete, for permanent removalF475 $493.56$486.36
Excision or plastic correction of peri-ungual tissueF476 $295.26$290.95
Linear repairF492 $158.56$156.25
Adjacent tissue transferF502 $528.00$520.30
Nail root and matrix resection with matrix sterilisation (single edge)F546# $180.30$177.67
Nail root and matrix resection with matrix sterilisation (total nail)F547# $323.50$318.78
Incision of soft tissue abscess (superficial)F561# $44.88$44.23
Incision of soft tissue abscess (deep or complicated)F562 $287.13$282.94
Percutaneous tenotomyF678 $277.20$273.16
Open tenotomyF687 $335.94$331.04
Capsulotomy or arthrotomy (exploration, drainage, or dislocation reduction) F689 $477.09$470.13
Ligament / capsular repair (digital)F692 $477.09$470.13
Ligament / capsular repair (mid foot / rear foot)F694 $853.42$840.97
Plantar fasciotomyF698 $787.72$776.23
Plantar fasciectomyF699 $787.72$776.23
Neurectomy of peripheral nerveF702 $632.14$622.92
Neurolysis of peripheral nerveF703 $577.37$568.95
Excision of cyst or small ganglionF704 $379.47$373.94
TenosynovectomyF705 $554.12$546.04
Tendon transfer or transplantation (forefoot insertion)F750 $671.58$661.79
Tendon transfer or transplantation (rear foot insertion)F752 $778.15$766.80
Tenoplasty (digital insertion)F755 $335.94$331.04
Tenoplasty (mid foot insertion)F757 $613.44$604.49
Tenoplasty (rear foot insertion)F759 $743.66$732.81
Excision or curettage of bone cyst or benign tumour (forefoot)F712 $692.69$682.59
Excision or curettage of bone cyst or benign tumour (rear foot)F713 $692.69$682.59
Primary metatarsal osteectomyF715 $692.69$682.59
Lesser metatarsal osteectomyF716 $692.69$682.59
Lesser tarsal osteectomyF720 $692.69$682.59
Tarsal osteectomyF721 $692.69$682.59
Phalangeal osteectomyF725 $539.80$531.93
Digital resection (supernumerary or other)F728 $420.75$414.61
Tarsal resectionF733 $692.69$682.59
Excision of accessory ossicle (partial or total)F736 $607.25$598.39
Digital arthroplastyF739 $336.06$331.16
Metatarsophalangeal arthroplastyF742 $909.11$895.85
Excision of tarsal coalitionF791 $961.30$947.28
Primary metatarsal osteotomy (distal)F782 $1,005.67$991.00
Primary metatarsal osteotomy (proximal)F783 $1,087.08$1,071.23
Lesser metatarsal osteotomy (distal)F784 $856.63$844.14
Lesser metatarsal osteotomy (proximal)F785 $856.63$844.14
Phalangeal osteotomyF786 $856.63$844.14
Tarsal osteotomyF787 $1,087.08$1,071.23
Insertion of internal fixationF793 $235.94$232.50
Removal of buried wire or screwF794 $271.59$267.63
Removal of buried plate or rodF795 $450.44$443.87
Metatarsophalangeal arthrodesisF852 $987.02$972.63
Tarso-metatarsal arthrodesisF854 $987.02$972.63
Interphalangeal arthrodesisF856 $433.09$426.77
Tarsal arthrodesisF857 $1,259.56$1,241.19
Ankle arthrodesisF858 $1,259.56$1,241.19
Subtalar arthroereisisF860 $1,410.16$1,389.59
Bone graft harvestF862 $510.91$503.46
Bone graft insertionF863 $738.92$728.14
External fixation device for distraction, rotation or angular correction osteotomyF872  
Open reduction internal fixation forefootF873 $510.91$503.46
Open reduction internal fixation rear footF874 $1,030.27$1,015.24
ArthroscopyF884 $891.06$878.06

Fees for podiatry 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.

# Procedures which can be performed by a Podiatrist or a Podiatric Surgeon. All other surgical procedures will only be considered when performed by a Fellow of the College of Podiatric Surgeons.

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.