Dentists

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As dentists and dental technicians, you play an important role in helping our clients recover from their transport accident injuries.

We can pay the costs of dental treatment in line with our fee schedule, without prior approval, when it is required as a result of a transport accident injury.

Diagnostic services, prosthodontics, periodontics, endodontics and other dental treatments are covered. Dental technician services are also covered, with some needing prior approval.

Dentists can also complete certificates of capacity to assess and certify your patient’s capacity for work.  If your patient's accident was prior to 14th February 2018 they may need to meet the medical excess before you can invoice the TAC for treatment.

Click on the links below to see the full Dentist and Dental Technician guideline, to view the fee schedule and to find any documents and forms you may need.

Dentist & Dental Technician Guidelines

This guideline should be read in conjunction with the general provider guideline: What do I need to know about working with the TAC?

Who can provide dental services?

You can provide services if:

  • you are a dentist registered under the Health Practitioner Regulation National Law (e.g. AHPRA or the Dental Board of Australia) to practice in the dental profession (other than as a student).
  • You are a dental technician with the minimum qualification of a diploma of dental technology.

What we can pay for

We can pay the costs of your patient’s dental services in line with our fee schedule, without prior approval, when they are required as a result of a transport accident injury.

Please note that if your fees are greater than the TAC’s published rates we request you let the client know there will be an out of pocket expense.  Clients can contact us to discuss options if the out of pocket costs will prohibit treatment or services from going ahead.

General dental services:

  • diagnostic services
  • preventative services
  • adjunctive general services
  • restorative services
  • associated dental services to adjoining teeth

Specialist dental services:

  • prosthodontics
  • periodontics
  • endodontics
  • orthodontics
  • temporomandibular joint therapy

Bridges, crowns and restorative services:

  • dental implants
  • implant based bridge maintenance
  • crown and bridgework

Surgical procedures:

  • In-room oral surgery.
  • Surgical procedures, when performed in the hospital in the first three months from the date of accident. See: Medical Practitioner guideline.

Dental technician services:

  • A partial or full denture.
  • Relining of a full denture.
  • A mouth guard.
  • Repair to, or replacement of, a client’s denture that was damaged or lost in the transport accident.

Dental technician services needing prior approval:

  • Dental implants.
  • Oral and maxillofacial surgery that is not performed in the first three months following the accident. See the Medical Practitioner guideline.

Other things to note

Medical excess

For accidents that occurred prior to 14th February 2018 a medical excess may apply. Visit the medical excess page to see if it applies to your patient.  If the medical excess applies you will need to invoice the client directly.

Certificate of capacity

As part of your patient’s treatment, dentists can also complete a certificate of capacity to assess and certify your patient’s capacity for work.

Patients with a severe injury

  • If your patient has a severe injury, the discussion, referral and approval of services may form part of the independence planning process between your patient's treating team and our TAC coordinator.
  • If your patient already has an individualised funding package, dental services may be included as part of that.

How much we can pay

We can pay for services in line with our dental services fee schedule.

What we cannot pay for

We cannot pay for:

General dental treatment that your patient would have had regardless of their transport accident.

Fee Schedules

Dental Services

Effective 1 July 2017

GeneralSpecialist
Service DescriptionADA Number2017/2018
Maximum
Payment
Rate
2017/2018
Maximum
Payment
Rate
Diagnostic services
Periodic oral examination 012 $47.92 $69.83
Initial examination and completion of TAC report form "DTF 1" 011, 018 $93.63 $115.71
Consultation arranged by the TAC for a second opinion, including a written report 014, 018 $158.44 $221.68
Single intraoral radiograph 022 $39.05 $39.05
Cephalometric radiograph 036 $103.79 $103.79
Panoramic radiograph (eg OPG) 037 $103.79  $103.79
Pulp vitality testing - per visit (maximum 3 visits per year) 061 $17.76 $17.76
Diagnostic model 071 $47.75 $47.75
Photographic records (for the TAC) 072 $26.41 $26.41
Preventive Services
(Prior approval from TAC required for these services)
Removal of plaque and stain 114 $84.86 $84.86
Non-vital bleaching (if separate appointments
are made)
117 $164.63$205.83 
Topical fluoride treatment 121 $51.01 $51.01
Oral hygiene instruction where appropriate
time is allocated
141 $30.49 $38.10
Adjunctive General Services
Desensitisation of dentine (per visit) 165 $32.74 $32.74
Odontoplasty for fractured teeth (per tooth) 171  $32.74 $32.74
Periodontics   
Root planing and subgingival curettage (per segment) 222 FBN* $261.88
Periodontal flap surgery (per segment) 232 FBN* $698.19
Osseous surgery (per segment) 233 FBN*  $314.90
Osseous graft    
    Small amount (eg alveolar bone) 234A   $287.43
    Large amount (eg rib graft) 234B   $476.43
Gingival connective tissue graft 235 FBN*$698.19
Guided tissue regeneration (per tooth or implant) 236/237 FBN*$698.19 
Expendable GTR material 236A   
Crown lengthening - including alveolar bone removal (per tooth).  NB: Multiple operation rule applies 238 FBN*  $537.16
Oral Surgery
Extraction of a single tooth 311 $121.75 $152.13
Sectional removal of tooth 314 $179.08 $188.49
Surgical extraction without bone removal 322 $179.08 $188.49
Surgical extraction requiring bone removal 323 $229.64 $281.06
Removal of soft tissue 377 $46.22 $46.22
Repositioning and splinting of displaced tooth 386 $190.01 $237.88
Replanting avulsed tooth and splinting 387, 772 $269.91 $382.00
Endodontics
Pulp capping 411 $32.49 $40.62
Cvek pulpotomy 414 $118.64 $173.47
Extirpation of pulp or debridement of root canal - 1 canal 415† $216.13 $316.29
Extirpation of pulp or debridement of root canal - each additional canal 416 $96.37 $129.98
Root canal obturation - 1 canal 417† $224.79 $323.60
Root canal obturation - each additional canal 418 $96.37 $129.98
Emergency endodontic procedure not exceeding 15 minutes 419 $121.75 $152.13
Apicectomy and apical seal 432, 434 $235.06 $312.50
Apexification - fee additional to routine endodontic treatment 458 $134.01  $210.62
Removal of root filling (per canal) 451 $88.96  $126.82
Additional visit for irrigation and/or dressing of the root canal system 455 $85.73 $103.79
† These fees include the cost of x-rays where required
Restorative Services   
Metallic restoration - 1 surface 511 $101.79 $128.39
Metallic restoration - 2 surfaces 512 $121.74 $166.33
Metallic restoration - 3 surfaces 513 $144.35$210.62
Adhesive resin restoration:  anterior tooth - 1 surface 521 $111.63 $141.20
Adhesive resin restoration:  anterior tooth - 2 surfaces 522 $131.85 $178.37
Adhesive resin restoration:  anterior tooth - 3 surfaces 523 $152.13  $216.13
Adhesive resin restoration:  anterior tooth - 4 surfaces 524 $183.85 $252.83
Adhesive resin restoration:  posterior tooth - 1 surface 531 $117.70 $147.03
Adhesive resin restoration:  posterior tooth - 2 surfaces 532 $141.95 $177.50
Adhesive resin restoration:  posterior tooth - 3 surfaces 533 $170.37 $223.97
Metallic inlay or onlay - 2 surface cavity 542 $612.85 $739.45
Metallic inlay or onlay - 3 surface cavity 543 $720.39 $889.67
In the administration of the TAC's dental service the term "gold" shall be restricted to alloys with a gold content of not less than 40% and with total precious metal content in excess of 60%. Any other dental alloy will be classified as "non precious metal".
Complex coronal metallic reconstruction in amalgam 515 $189.30 $265.34
Complex coronal reconstruction in tooth coloured adhesive resin - direct 525/535 $281.06 $360.08
Temporary restoration emergency or interim treatment only 572 $95.15 $118.87
Pin retention (per unit pin) 575 $27.99 $27.99
Enamel bonded adhesive resin facing 582 $253.53 $316.83
Indirect bonded facing  583 $840.45  $1,065.86
Post - direct preformed 597 $95.15 $118.87
Temporary composite bridge when not part of definitive treatment (per pontic) 632 $198.01 $243.00
Crown and Bridgework
Bridges should be described in terms of the Australian Dental Association's Schedule of Dental Services.  However, in addition to the number of units, the number of abutment teeth and pontics should be stated [eg 3 units (2+1). The fee which the TAC will consider reasonable may be calculated by adding the fees listed for the restoration of the abutment teeth to the fees listed for the pontic or pontics as hereunder specified.
Indirect non-metallic full crown 613 $1,226.00 $1,602.57
Indirect veneered full crown 615 $1,314.72 $1,686.44
Full crown - metallic 618 $1,226.00 $1,602.57
Cast core for crown including post 625 $307.07 $537.16
Preliminary restoration for crown 627 $189.30 $265.33
Pontics - direct  642 $230.44 $307.05
Pontics - indirect 643 $1,016.53 $1,270.54
Bridge - indirect bonded (Maryland)    
          1 pontic 643/ 649 $1,314.72 $1,583.58
          2 pontics 643/ 649 $1,891.87 $2,358.85
Implant based veneered - full crown 661, 672 $2,000.18 $2,440.38
Surgical Procedures For Implant Prostheses
Hardware for implant procedures 661A   
Prosthesis with metal frame for bridgework (per implant) 666   $1,559.77
Removal and reattachment of implant prosthesis for repair or cleaning 669  $158.44 
Surgical implant guide 679 $216.13 $216.13
Osseo-integration procedure - intraoral implantation of titanium fixture 684 FBN* $960.55
Osseo-integration procedure - one-stage 688 FBN*  $1,074.23
Osseo-integration procedure - fixation of transcutaneous abutment 691 FBN*  $363.46
If these procedures are to be carried out in a hospital under general anaesthesia, prior approval must be obtained from TAC.
For the second and subsequent fixtures inserted at the same appointment, the multiple operation rule applies.
In addition, the surgeon is entitled to reimbursement for the retail cost of any expendable implant hardware supplied directly.
Prosthodontics - Full Dentures
Full upper or full lower dentures 711, 712 $861.95 $1,283.98
Full upper and full lower dentures 719 $1,520.64 $2,391.48
Prosthodontics - Partial Dentures
Partial denture - acrylic base:    
     One tooth 721A/722A $380.24 $475.27
     Two teeth 721B/722B $424.60 $530.68
     Three teeth 721C/722C $468.91 $587.67
     Four teeth 721D/722D $557.62$697.01 
     Five to nine teeth 721E/722E $646.35 $807.89
     Ten teeth or more 721F/722F $823.72 $1,029.69
Partial denture - chrome cobalt including cost of casting:    
     One or two teeth 727A/728A $1,317.89 $1,647.35
     Three or four teeth 727B/728B $1,406.61 $1,758.20
     Five to nine teeth 727C/728C $1,520.64$1,900.75
     Ten teeth or more 727D/728D $1,609.34 $2,011.64
Additional items for Acrylic Dentures only
Each retainer 731 $44.42 $44.42
Occlusal rest (not part of retainer) 732 $15.30 $15.30
Immediate tooth replacement 736 $10.29 $10.29
Full denture relining 743 $301.10 $376.45
Partial denture relining 744 $264.63 $329.57
Denture base modification 754 $153.58 $153.58
Adding tooth to partial denture to replace extracted tooth 768 $148.92 $148.92
Orthodontics
Active removable appliance therapy - one arch 821 $711.75 $1,028.35
Full arch banding - one arch 831 N/A $3,722.40
Full course of fixed appliance orthodontic treatment 881 N/A $5,805.32
Orthodontic extrusion of tooth 846 N/A$844.54
Temporomandibular Joint Therapy
Full clinical assessment of case including joint and muscle palpation, occlusal analysis with study models and report to the TAC. 963, 964 $227.11 $278.60
Occlusal splint including initial programming 965 $515.42 $607.60
Routine adjustment of splint - per visit (maximum of 6 visits) 966 $85.68 $108.01
Travel - Treatment outside of rooms   FBN*
GeneralSpecialist
Service DescriptionADA Number2016/2017
Maximum
Payment
Rate
2016/17
Maximum
Payment
Rate
Diagnostic services
Periodic oral examination 012 $47.22$68.81
Initial examination and completion of TAC report form "DTF 1" 011, 018 $92.26$114.02
Consultation arranged by the TAC for a second opinion, including a written report 014, 018 $156.13$218.45
Single intraoral radiograph 022 $38.48$38.48
Cephalometric radiograph 036 $102.28$102.28
Panoramic radiograph (eg OPG) 037 $102.28$102.28
Pulp vitality testing - per visit (maximum 3 visits per year) 061 $17.50$17.50
Diagnostic model 071 $47.05$47.05
Photographic records (for the TAC) 072 $26.02$26.02
Preventive Services
(Prior approval from TAC required for these services)
Removal of plaque and stain 114 $83.62$83.62
Non-vital bleaching (if separate appointments
are made)
117 $162.23$202.83
Topical fluoride treatment 121 $50.27$50.27
Oral hygiene instruction where appropriate
time is allocated
141 $30.05$37.54
Adjunctive General Services
Desensitisation of dentine (per visit) 165 $32.26$32.26
Odontoplasty for fractured teeth (per tooth) 171 $32.26$32.26
Periodontics   
Root planing and subgingival curettage (per segment) 222 FBN*$258.06
Periodontal flap surgery (per segment) 232 FBN*$688.01
Osseous surgery (per segment) 233 FBN*$310.31
Osseous graft    
    Small amount (eg alveolar bone) 234A  $283.24
    Large amount (eg rib graft) 234B  $469.48
Gingival connective tissue graft 235 FBN*$688.01
Guided tissue regeneration (per tooth or implant) 236/237 FBN*$688.01
Expendable GTR material 236A   
Crown lengthening - including alveolar bone removal (per tooth).  NB: Multiple operation rule applies 238 FBN*$529.33
Oral Surgery
Extraction of a single tooth 311 $119.97$149.91
Sectional removal of tooth 314 $176.47$185.74
Surgical extraction without bone removal 322 $176.47$185.74
Surgical extraction requiring bone removal 323 $226.29$276.96
Removal of soft tissue 377 $45.55$45.55
Repositioning and splinting of displaced tooth 386 $187.24$234.41
Replanting avulsed tooth and splinting 387, 772 $265.97$376.43
Endodontics
Pulp capping 411 $32.02$40.03
Cvek pulpotomy 414 $116.91$170.94
Extirpation of pulp or debridement of root canal - 1 canal 415† $212.98$311.68
Extirpation of pulp or debridement of root canal - each additional canal 416 $94.96$128.08
Root canal obturation - 1 canal 417† $221.51$318.88
Root canal obturation - each additional canal 418 $94.96$128.08
Emergency endodontic procedure not exceeding 15 minutes 419 $119.97$149.91
Apicectomy and apical seal 432, 434 $231.63$307.94
Apexification - fee additional to routine endodontic treatment 458 $132.06$207.55
Removal of root filling (per canal) 451 $87.66$124.97
Additional visit for irrigation and/or dressing of the root canal system 455 $84.48$102.28
† These fees include the cost of x-rays where required
Restorative Services   
Metallic restoration - 1 surface 511 $100.31$126.52
Metallic restoration - 2 surfaces 512 $119.96$163.90
Metallic restoration - 3 surfaces 513 $142.24$207.55
Adhesive resin restoration:  anterior tooth - 1 surface 521 $110.00$139.14
Adhesive resin restoration:  anterior tooth - 2 surfaces 522 $129.93$175.77
Adhesive resin restoration:  anterior tooth - 3 surfaces 523 $149.91$212.98
Adhesive resin restoration:  anterior tooth - 4 surfaces 524 $181.17$249.14
Adhesive resin restoration:  posterior tooth - 1 surface 531 $115.98$144.89
Adhesive resin restoration:  posterior tooth - 2 surfaces 532 $139.88$174.91
Adhesive resin restoration:  posterior tooth - 3 surfaces 533 $167.89$220.70
Metallic inlay or onlay - 2 surface cavity 542 $603.91$728.67
Metallic inlay or onlay - 3 surface cavity 543 $709.88$876.69
In the administration of the TAC's dental service the term "gold" shall be restricted to alloys with a gold content of not less than 40% and with total precious metal content in excess of 60%. Any other dental alloy will be classified as "non precious metal".
Complex coronal metallic reconstruction in amalgam 515 $186.54$261.47
Complex coronal reconstruction in tooth coloured adhesive resin - direct 525/535 $276.96$354.83
Temporary restoration emergency or interim treatment only 572 $93.76$117.14
Pin retention (per unit pin) 575 $27.58$27.58
Enamel bonded adhesive resin facing 582 $249.83$312.21
Indirect bonded facing  583 $828.19$1,050.32
Post - direct preformed 597 $93.76$117.14
Temporary composite bridge when not part of definitive treatment (per pontic) 632 $195.12$239.46
Crown and Bridgework
Bridges should be described in terms of the Australian Dental Association's Schedule of Dental Services.  However, in addition to the number of units, the number of abutment teeth and pontics should be stated [eg 3 units (2+1). The fee which the TAC will consider reasonable may be calculated by adding the fees listed for the restoration of the abutment teeth to the fees listed for the pontic or pontics as hereunder specified.
Indirect non-metallic full crown 613 $1,208.12$1,579.20
Indirect veneered full crown 615 $1,295.55$1,661.84
Full crown - metallic 618 $1,208.12$1,579.20
Cast core for crown including post 625 $302.59$529.33
Preliminary restoration for crown 627 $186.54$261.46
Pontics - direct  642 $227.08$302.57
Pontics - indirect 643 $1,001.70$1,252.01
Bridge - indirect bonded (Maryland)    
          1 pontic 643/ 649 $1,295.55$1,560.48
          2 pontics 643/ 649 $1,864.28$2,324.45
Implant based veneered - full crown 661, 672 $1,971.01$2,404.79
Surgical Procedures For Implant Prostheses
Hardware for implant procedures 661A   
Prosthesis with metal frame for bridgework (per implant) 666  $1,537.02
Removal and reattachment of implant prosthesis for repair or cleaning 669  $156.13
Surgical implant guide 679 $212.98$212.98
Osseo-integration procedure - intraoral implantation of titanium fixture 684 FBN*$946.54
Osseo-integration procedure - one-stage 688 FBN*$1,058.56
Osseo-integration procedure - fixation of transcutaneous abutment 691 FBN*$358.16
If these procedures are to be carried out in a hospital under general anaesthesia, prior approval must be obtained from TAC.
For the second and subsequent fixtures inserted at the same appointment, the multiple operation rule applies.
In addition, the surgeon is entitled to reimbursement for the retail cost of any expendable implant hardware supplied directly.
Prosthodontics - Full Dentures
Full upper or full lower dentures 711, 712 $849.38$1,265.25
Full upper and full lower dentures 719 $1,498.46$2,356.60
Prosthodontics - Partial Dentures
Partial denture - acrylic base:    
     One tooth 721A/722A $374.69$468.34
     Two teeth 721B/722B $418.41$522.94
     Three teeth 721C/722C $462.07$579.10
     Four teeth 721D/722D $549.49$686.84
     Five to nine teeth 721E/722E $636.92$796.11
     Ten teeth or more 721F/722F $811.71$1,014.67
Partial denture - chrome cobalt including cost of casting:    
     One or two teeth 727A/728A $1,298.67$1,623.32
     Three or four teeth 727B/728B $1,386.10$1,732.56
     Five to nine teeth 727C/728C $1,498.46$1,873.03
     Ten teeth or more 727D/728D $1,585.87$1,982.30
Additional items for Acrylic Dentures only
Each retainer 731 $43.77$43.77
Occlusal rest (not part of retainer) 732 $15.08$15.08
Immediate tooth replacement 736 $10.14$10.14
Full denture relining 743 $296.71$370.96
Partial denture relining 744 $260.77$324.76
Denture base modification 754 $151.34$151.34
Adding tooth to partial denture to replace extracted tooth 768 $146.75$146.75
Orthodontics
Active removable appliance therapy - one arch 821 $701.37$1,013.35
Full arch banding - one arch 831 N/A$3,668.11
Full course of fixed appliance orthodontic treatment 881 N/A$5,720.65
Orthodontic extrusion of tooth 846 N/A$832.22
Temporomandibular Joint Therapy
Full clinical assessment of case including joint and muscle palpation, occlusal analysis with study models and report to the TAC. 963, 964 $223.80$274.54
Occlusal splint including initial programming 965 $507.90$598.74
Routine adjustment of splint - per visit (maximum of 6 visits) 966 $84.43$106.43
Travel - Treatment outside of rooms  FBN*

* Note: Where the terminology FBN appears in this schedule, the fee must be negotiated with the TAC before any dental treatment is commenced.

Medical Services Reimbursement Rates

The TAC has adopted the Medicare Benefits Schedule (MBS) items, explanations, definitions, rules and conditions for services provided by medical practitioners.  When invoicing for medical services, medical practitioners are expected to adhere to the MBS rules unless otherwise specified by the TAC in the Reimbursement Rates for Medical Services booklet or its medical policies.

The Reimbursement Rates for Medical Services booklet below must be read in conjunction with:

At the time of production this publication contained up to date information as released by Medicare Australia (Medicare).  The relevant publication will be updated to reflect any further changes that are implemented by Medicare each year.  Please check our website for the latest version.

If you have any questions about these publications or the reimbursement rates, please contact the TAC on 1300 654 329. Alternatively, e-mail info@tac.vic.gov.au.

Forms and brochures

View Dental: dental report form

Dental: dental report form

Summary:

For dental providers – use this form, when requested by us, to report damage caused to a patient's teeth and mouth as a result of their transport accident, and to propose a treatment plan.

View Dental: maxillo facial report form

Dental: maxillo facial report form

Summary:

For dental or maxillofacial providers – use this form, when requested by us, to report damage caused to a patient's jaw or face as a result of their transport accident, and to outline the treatment given.

Working with the TAC

Below you will find information relevant to all providers about working with TAC clients, including:

  • How to register
  • Approvals process
  • Travel
  • Compliance requirements
  • Medical excess (for accidents before 14th February 2018)
  • Requests for further information
  • Subsequent, pre-existing and non-accident related injuries
  • Treatment by a family member
  • How to get paid
  • What we cannot pay for

Click on the General Provider guideline below to find out more.

General Provider Guidelines

If you are a registered TAC provider, you can provide treatment and services to our clients when they:

  • Are required as a result of a transport accident injury.
  • Are safe and effective.
  • Promote recovery, functional independence or self-management.

How to register as a provider

To register, you may:

During the registration process you may be asked to provide evidence of your qualification or other documentation requested by us.

What we can pay for

Approved services

The following services are approved for all our clients:

  • ambulance
  • hospital (including surgery for the first three months from the date of accident)
  • medical  (including medical imaging)
  • pharmacy
  • allied health
  • mental health
  • domestic services and gardening
  • interpreting services
  • equipment under $1,000

We do not require requests, clinical notes or reports before we will pay for the above services.

Other services

We must approve in writing any services not listed above.

Requests for approval must be in writing from an appropriately qualified health professional and include the following information:

  • claim number
  • transport accident injury being treated
  • type of treatment or service being requested
  • rationale as to why it is required
  • proposed date of the service/treatment
  • number of services proposed or expected duration
  • date treatment will be reviewed
  • functional goals/outcome measure that will be used to evaluate the treatment
  • self-management strategies in place

We will consider the principles of the Clinical Framework when considering whether a treatment or service request is reasonable and appropriate. We will then respond to written treatment and service requests as set out in our TAC Service Charter.

Travel

We can pay the reasonable cost of travel without prior approval where:

  • It is clinically justified for you to conduct treatment in the community, or you are the most appropriate option in that locality, and
  • The treatment has an associated scheduled fee/item number.

The following requirements apply:

  • Travel time will only be paid for travel to and from your practice address and the patient’s residence or place of appointment.
  • Where you visit more than one TAC client in a single travel period, total travel costs should be split equally for each.
  • If you book multiple appointments on the same day, please organise them efficiently, as we cannot pay for down time between appointments.
  • When invoicing for travel, keep a record of travel details – points of origin, destination and duration of travel – in case we need it.

Other things to note

As providers, you are expected to:

Health professionals should also follow the principles of the Clinical Framework for the Delivery of Health Services (Clinical Framework) into their clinical practice. This 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.

Medical excess (applies to accidents before 14th February 2018)

Client's whose accidents occurred prior to 14th February 2018 are required to pay the first $629 of treatment costs for medical services (excluding hospital and ambulance) before the TAC can fund their ongoing treatment unless:

  • the client or an immediate family member were admitted to hospital as an inpatient; or
  • an immediate family member dies as a result of the transport accident.

If a TAC client hasn't reached the medical excess, you need to invoice them directly for any medical treatment and services they receive. Bulk billed services can be used to reach the medical excess amount.

Once the client has provided a declaration to the TAC that they have reached their medical excess, you can begin invoicing the TAC directly.

You can find out if a client is subject to medical excess by:

  • using the medical excess tool
  • checking if they are available to invoice using Lantern Pay
  • checking client correspondence via the client’s letter or myTAC app

When further information is needed

In some cases we may contact your patient or yourself to seek further information about the treatment or service. We will send in writing any requests for reports or information.

We can release a treatment report to the client, another health practitioner or the client's legal representative upon receipt of a verbal or written request from a client or their legal representative.

If you are a health practitioner, clinical notes will be paid for in accordance with Schedule 2 of the Health Records Regulations 2012 and under the guidelines set out in the Health Records Act 2001.

See the relevant provider guideline or policy for information relevant to these services.

Subsequent, pre-existing and non-accident related injuries

Notify us if your patient has sustained a subsequent or exacerbation of an existing injury.

  • Where a pre-existing injury has become aggravated as a result of a transport accident, we will fund treatment for the exacerbation of that injury.
  • When a patient is being treated for non-accident related injuries at the same time as accident related injuries, you may only invoice us for the treatment relating to the patient’s accident related injury.
  • We will only accept liability for an injury sustained after the transport accident if it is established that a patient’s subsequent injury is a direct result of the injury or injuries originally sustained in the transport accident.

Treatment by an immediate family member

We cannot pay for treatment or services provided by a member of a client’s immediate family, unless exceptional circumstances exist such as:

  • Treatment was provided in an emergency situation.
  • A client resides in a remote area and the distance to access an alternative health care professional is excessive.

When the TAC client has been treated by a family member, care should be transferred to another suitably qualified healthcare professional as soon as practicable.

How to get paid

Use LanternPay

If you’re an eligible provider, LanternPay lets you:

  • check if your patient or client has a TAC approved claim.
  • submit invoices online.
  • view payment decisions immediately.
  • receive payment the next business day.

To find out more about LanternPay and to register, watch our short video or visit www.lanternpay.com/TAC.

Mail your invoice

You may also invoice us by mail. Services subject to GST must be submitted on a GST compliant invoice. Your invoice must include:

payee details

  • group/company/agency
  • ABN
  • TAC payee number (if you have one)
  • billing address and practice/clinic address

client details

  • given and family names
  • TAC claim number

service details

  • name of service provider and Medicare number (if applicable)
  • date of service and time of service (if applicable)
  • TAC item number as per the TAC fee schedule
  • duration of service
  • itemised fee
  • service location (if different to practice address)
  • total charge for invoiced items

If multiple providers are required on one invoice, you must clearly identify the service listed under each service provider. Duplicate accounts, such as statements, photocopies or facsimiles will not be processed for payment.

Send your invoice to:

Transport Accident Commission (TAC)
GPO Box 2751
MELBOURNE   VIC   3001

Payment dates

We process invoices each week. Payment will be made to your bank account.

Is this your first TAC invoice?

In order to receive payment in your bank account, please complete an EFT/Direct Deposit Authority form.

Note:

Invoices you submit to us should accurately reflect the goods and/or services that have been provided. Inaccurate, inappropriate or fraudulent invoicing may result in requests for supporting documentation, prosecution, recovery of inappropriately paid funds or other actions.

If you become aware of an error in your invoicing for services provided to our clients, or where there is a concern over the accuracy of the payments that we have made, contact us on 1300 654 329 to rectify the situation.

What we cannot pay for

Services

We cannot pay for:

  • Services for a person other than the client (except for family counselling where applicable).
  • Services subcontracted to, or provided by, a non-registered provider.
  • Services provided outside the Commonwealth of Australia.
  • Services where there is no National Health and Medical Research Council level 1 or 2 evidence that they are safe and effective. See: Non-established, new or emerging treatments and services policy.

Expenses and travel

We cannot pay for:

  • The cost of telephone calls and telephone consultations between providers and clients, and between other providers, including hospitals. The exception is GPs coordinating return to work programs approved by us.
  • Downtime between appointments or travel expenses unrelated to a consultation.

Invoices

We cannot pay for:

Reports

We cannot pay for:

  • The same medical report provided more than once – for example, a re-issue of a previous report or multiple copies.
  • A consultation used for the purposes of preparing a medical report. When we request a report, please complete it using your existing clinical notes.

Other guidelines that may be relevant for you include: