Speech Pathology

Policy

The TAC can fund the reasonable cost of speech pathology services for a client who has sustained communication or swallowing disorder(s) as a result of injuries suffered in a transport accident, where the service is provided by a qualified speech pathologist.

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

What speech pathology services can the TAC fund?

The TAC can fund the reasonable cost of speech pathology services where:

  • there is clinical justification for treatment
  • the treatment is likely to be effective and achieve or maintain a measurable functional improvement
  • the treatment promotes progress towards functional independence, participation and self-management.

All speech pathology services require prior approval in writing from the TAC.

Fees for speech pathology services performed in a private practice will be based on the TAC fee schedule for Speech Pathology services.

Fees for speech pathology services performed in a public hospital setting will be based on the Department of Human Services schedule of fees and charges for acute health services in Victoria.

What documentation does the TAC require to consider initial funding of speech pathology services?

For clients who do not have a 'severe injury', a Speech Pathology Treatment Notification Plan (SPTNP) form is required where treatment is requested beyond an initial 5 sessions.

See also the Speech Pathology Treatment Notification Plan notes document for assistance in completing this form.

If there is a gap in treatment of greater than 6 months or if the TAC client attends a different speech pathology clinic, the TAC expects that a new SPTNP will be completed by the speech pathologist and submitted to the TAC for approval. All fields on the Speech Pathology Treatment Notification Plan must be completed to be accepted by the TAC.

For clients with a 'severe injury' a request for speech pathology will be approved as part of the independence planning process. The speech pathologist 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 The TAC may contact the treating speech pathologist and request the information outlined above.

Payment for the Speech Pathology Treatment Notification Plan is made in accordance with the TAC fee schedule for Speech Pathology services.

What documentation does the TAC require to consider ongoing funding of speech pathology services?

The treating speech pathologist must contact the TAC Coordinator by phone towards the completion of the approved treatment plan to discuss the client's progress and request further services if required. In some circumstances, a Speech Pathology: Management Review (SPMR) form may be requested. These forms provide additional information on the treatment being given to a client and also may be requested when a client is discharged to another service provider. See also the Speech Pathology Treatment Management Review notes document for assistance on completing this form.

The TAC will only fund speech pathology Management Reviews when they have been requested by the TAC.

All fields on the Speech Pathology Treatment Notification Plan must be completed to be accepted by the TAC.

Payment for the Speech Pathology Treatment Notification Plan is made in accordance with the TAC fee schedule for Speech Pathology services.

Can the TAC fund group consultations by a Speech Pathologist?

The TAC can fund group consultations by speech pathologists.

Group consultations are defined as 2 or more clients being treated in the same treatment area, receiving continual overall supervision and intermittent attention.

Can the TAC fund a speech pathologist to 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 the treating therapist clinically justifies that the treatment should be delivered in a community setting, e.g. home, school or a client's place of work
  • the speech pathologist providing the treatment is the most appropriate according to geographic location of the client and the therapy specialty required
  • travel time is separately billed and is reimbursed on a time only basis at a pro rata rate.

Travel time can be claimed only for travel to and from the practitioner's practice address and the community setting, e.g. home or school.  Where more than 1 client is visited in a single travel period, total travel costs should be apportioned equally to those clients 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 Speech Pathology fee schedule.

Can the TAC fund a speech pathologist to attend meetings?

The TAC can fund a speech pathologist to attend meetings where:

  • attendance at the meeting has been requested by the TAC as part of the independence planning process, or
  • prior written approval has been provided by TAC, and
  • the need for attendance is clinically justified.

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

The TAC can fund speech pathology visits to a client who is an in-patient in a private hospital where each of the following criteria has been met:

  • the visit is specifically requested by the client's treating medical practitioner
  • the hospital has consented
  • the cost of speech pathology (including an initial consultation and treatment), is not included in the hospital bed fee, i.e. the hospital is a TAC Hospital - Private (Non-Arrangement).

Can the TAC fund speech pathology services where a significant gap in a client's treatment exists?

For the purpose of this policy, a gap in treatment is when no speech pathology services have been sought for more than 6 months and treatment commences or resumes after this period.

The TAC can fund speech pathology services after a gap in treatment, however, the TAC may telephone or write to a client and/or the service provider in order to:

  • determine if the treatment is related to the transport accident injury
  • determine the reason for the gap in treatment
  • obtain details of the proposed treatment plan.

Once this information is received the TAC will consider the request for funding of treatment.

Can the TAC fund speech pathology 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 speech pathology what will the TAC not fund?

The TAC will not fund:

  • services for a person other than the injured client
  • treatment where there is no proper clinical justification
  • treatment for a condition that existed before a transport accident or that is not a direct result of a transport accident
  • more than 1 initial consultation by the same speech pathologist or speech pathology clinic per course of treatment
  • more than 1 non-hospital consultation per day
  • speech pathology services where the cost is included in the hospital bed fee including speech pathology visits to public hospitals
  • fees associated with non-attendance
  • the cost of telephone calls and telephone consultations between providers and clients, and between other providers, including hospitals
  • treatment received by the injured person outside the Commonwealth or Australia
  • treatment 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.

Speech Pathology 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
Rate
TAC Item Number 2017/18 Maximum Payment Rate2016/17 Maximum Payment
Rate
Individual Treatment
Completion and submission of Treatment Notification Plan (SPTNP) ST600 $51.25$50.50   
Hourly Rate ST604 $92.93$91.57   
Group Treatment
Group Consultation (per person, per hour) ST601 $55.80$54.99   
Travel (with prior approval)
Travel ST630 $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.
^All travel is to be separately billed in blocks of 15 minutes.
Speech Pathology Management Review (SPMR)
Completion and submission of the SPMR form (only on request by TAC) ST640* $51.25$50.50ST640F $46.60$45.92

Fees for speech pathology 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.


View Speech pathology: treatment notification plan (SPTNP) form

Speech pathology: treatment notification plan (SPTNP) form

Summary:

The TAC requires speech pathologists to prepare and submit a treatment notification plan (TNP) when seeing TAC clients. The plan requires a clinical diagnoses, proposed treatment plan, self-management strategies and outcome measures.

View Speech pathology: management review plan (SPMR) form

Speech pathology: management review plan (SPMR) form

Summary:

This  form is to be completed by speech pathologists to report on the progress and/or effectiveness of a TAC client's speech pathology treatment and management plan. It looks at how much improvement the client has made and propose revisions to the treatment plan, goals and strategies.

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.