Social Work - Information for clients

This page is about social work provided outside of hospital. 

If you have claimed social work before and would like more information, please see the Social Work policy.

Will the TAC pay for social work?

The TAC will pay for social work when: 

  • You have an accepted TAC claim
  • You have a referral to see a social worker from your General Practitioner
  • The TAC approves the social work before you receive it
  • The social work is for your accident related injuries
  • The social work is helping you to make progress in your recovery. 

The TAC will make decisions about paying for social work for you in the time-frames set out in the TAC's Service Charter.

Who can provide social work?

The TAC can pay for social work provided by a social worker who is eligible for full membership with the Australian Association of Social Workers (AASW).

Can I choose my own social worker, or will the TAC choose one for me?

  • You must choose your own social worker, the TAC can't choose one for you
  • You need to send the TAC a copy of your referral to the social worker, we will then let you know if your treatment is approved
  • When you call to make your first appointment, let the social worker know you are a TAC client and that you have an accepted TAC claim. You should talk to them about the TAC's payment limits
  • You do not need to fill out a form.

How long will the TAC pay for my social work?

  • There is no maximum number of social work services the TAC can pay for?

How the bills are paid

  • In most cases your social worker will bill the TAC directly for your treatment
  • If you have paid a bill yourself, keep the receipt and send the original to the TAC for reimbursement. You should make a copy of the receipt for your own records
  • There is a limit to how much the TAC can pay for each social work service. If your social worker charges more than the TAC maximum, you will need to pay the difference. This is known as paying 'the gap'.

Policy

The TAC can pay the reasonable costs of social work services required as a result of transport accident injuries.

Transport Accident Act 1986 reference: s.3 'rehabilitation service', s.23 and s.60

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

Guidelines

Who is eligible?

A client is eligible if he/she is assessed by a medical practitioner as requiring social work services as a result of a transport accident injury.

Who can provide social work services to a TAC client?

Social work services can be paid for by the TAC when provided by a qualified social worker who is eligible for full membership with the Australian Association of Social Workers (AASW). All social work services require referral from a medical practitioner and prior written approval from the TAC.

What does the TAC consider before paying for social work services?

The TAC can pay the reasonable cost of social work services where:

  • The service is for a transport accident injury and is clinically justified
  • The service is likely to be effective and achieve or maintain a measurable improvement
  • The service promotes progress towards independence, participation and self-management
  • A medical practitioner has provided the referral for treatment and the medical practitioner reviews the need for ongoing services on a regular basis.

Can the TAC pay for counselling if a family member or friend is required to participate in the client's counselling session?

The TAC can pay for counselling where a friend or family member attends with a client to facilitate the rehabilitation of the client.

Can the TAC pay for family counselling services provided by a social worker to family members of eligible clients?

The TAC can pay for family counselling services provided by a social worker. Refer to the Family Counselling policy.

Can the TAC pay for a social worker to visit a client in a private hospital?

The TAC can pay for a social worker to visit a private hospital in-patient if this has been requested by the client's medical practitioner, the hospital has consented and the hospital is not a TAC arrangement hospital. Refer to Hospitals - Private policy.

Can more than one social work consultation be paid for on the same day?

The TAC can pay for more than one social work consultation on the same day under special circumstances, eg. a social worker arranges to treat a client at his/her practice and is required to attend a Guardianship and/or Administration hearing on the same day or an extended family meeting.

Can the TAC pay for case management services provided by a social worker?

The TAC can pay for case management services provided by a social worker. Refer to the 'Who can provide case management services?' section of the Case Management policy.

Can the TAC pay for a social worker to attend meetings?

The TAC can pay for a social worker to attend meetings where written prior approval from the TAC is obtained.

Can the TAC pay for concurrent psychology and social work treatment?

The TAC can only pay for concurrent psychology and social work intervention, where there is collaboration between the providers, there is no overlap in treatment and it can be shown that the client will have an improved mental health outcome.

What fees are payable?

Fees for social work services performed within a private practice will be based on the TAC fee schedule for Social Work.

Fees for social work 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.

What are the reporting requirements?

For clients with a 'severe injury' treatment will be approved as part of the independence planning process. The social worker 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, once their treatment has been approved, the TAC may request a written report from the social worker at the conclusion of their approved treatment. The report should include the following information:

  • client's progress (measured against the goals in the treatment plan)
  • recommendations and future management.

The cost of the report is in accordance with the TAC fee schedule for Social Work.

For all clients Social workers must not submit written reports, unless specifically requested to do so by the TAC. If further treatment is required past the approved treatment plan, the social worker must contact the TAC officer by phone to discuss the client's future management. The TAC may contact the client or social worker if further information is required.

Can a social worker claim for travel?

The TAC can pay the reasonable cost of travel time where:

  • prior written approval has been provided by the TAC
  • a medical practitioner has confirmed that the client is medically unfit to travel, or clinical justification is provided by the treating therapist that the treatment should be delivered in the a community saetting, ie. in the home, school or at the client's place of work, in order to acheive the rehabilitation goals
  • a social worker with the required speciality can not be sourced locally and the social worker must travel to treat the client
  • travel time is separately billed and is reimbursed on a time basis at a pro rata rate.

Refer to the Social Work Fee Schedule for information about how to invoice travel.

How are travel costs calculated?

Travel is separately billed and is reimbursed on a time only basis at a pro rata rate. A social worker may claim his/her travel time to and from the practice address and the community setting, eg. home, school or a client's place of work.

Where more than 1 client is visited in a single travel period, total travel costs should be apportioned equally to those clients to whom services have been provided.
For example: Practice rooms are in A, patient 1 in B, patient 2 in C, patient 3 in D, travelling time is as below:

PatientFromToTime
1AB45 minutes
2BC50 minutes
3CD40 minutes
Return to RoomsDA1 hour 30 minutes
  Total travelling 3 hours 45 minutes 

3 hours 45 minutes @ $92.93 (fee as of 1 July 2017) per hour = $348.49, therefore travel per patient, $348.49/3 = $116.16 and the travel time of 3 hours 45 minutes will average to 1 hour 15 minutes each. The average travel time and the amount charged must be clearly stated on the invoice. For the current fee, refer to the TAC fee schedule for Social Work.

Can the TAC pay for social work services provided 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 social work what will the TAC not pay for?

The TAC will not pay for:

  • services for a person other than the injured client
  • treatment or services where there is no objective evidence that a treatment or service is safe and effective
  • more than 1 initial consultation by the same social worker per course of treatment
  • concurrent treatment unless it is clinically justified
  • social work where the cost is included in the hospital bed fee
  • services for a condition that existed before a transport accident or that is not a direct result of a transport accident
  • fees associated with non-attendance
  • the cost of telephone calls and telephone consultations between providers and clients, and between other providers, including hospitals
  • more than 1 social work consultation on the same day, unless the circumstances requires this, eg. for a social worker to attend a Guardianship and/or Administration hearing or an extended family meeting
  • services received by the injured person outside the Commonwealth of Australia
  • 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.

Social Work Services

Effective 1 July 2017

Registered for GST Not Registered for GST
Service Description TAC Item Number 2017/18 Maximum Payment Rate2016/17 Maximum Payment RateTAC Item Number 2017/18 Maximum Payment Rate2016/17 Maximum Payment Rate
Individual Treatment
Initial Consultation SW600 $58.15$57.30   
Standard Consultation: 
up to 30 minutes
SW602 $46.53$45.85   
Long Consultation: 
> 30 minutes < 45 minutes
SW604 $69.54$68.53   
Prolonged Consultation: 
> 45 minutes < 60 minutes
SW606 $92.93$91.57   
Group Consultation: 
up to 30 minutes 
      
Group Treatment
Group Consultation
(per person)
SW602G $27.99$27.58   
Travel (with prior approval) SW630 $92.93$91.57   
All travel is to be separately billed in blocks of 15 minutes.    
Reports
Report
When submitting an account for payment, details of the time taken to complete the report must be recorded on the account.
SW640* $102.22$100.73SW640F $92.93$91.57
Travel claimed in relation
to providing a report for management-type services such as reviews undertaken at the TAC's specific request, will incur a GST on the applicable TAC maximum fee. 
SW641* $102.22$100.73SW641F $92.93$91.57
Travel time can be claimed only for travel to and from the practitioner's practice address and the TAC client's residence.  Where more than one client is visited in a single travel period, total travel costs should be apportioned equally between those clients to whom services have been provided.

Fees for social work 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.

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.