Occupational Therapist

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As occupational therapists, you play an important role in helping our clients recover from their transport accident injuries.

We can pay, and have approved, the reasonable costs of your client’s occupational therapy when it is required as a result of a transport accident injury.

Treatments, assessments, interventions and recommendations are covered, with some services needing prior approval. For clients with a severe injury, the discussion, referral and approval of services may form part of the independence planning process.

As part of your client’s treatment, you can also complete certificates of capacity to assess and certify your client’s capacity for work.

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

Occupational Therapy 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 occupational therapy services?

You can provide services if:

  • you are registered under the Health Practitioner Regulation National Law (e.g. AHPRA) to practice in the occupational therapy profession (other than as a student).

Who can provide Framework Occupational Therapy services?

You can provide Framework services if you are an occupational therapist who has:

  • Registered with the Occupational Therapy Board of Australia.
  • Met our eligibility requirements.
  • Signed a declaration committing to provide services in line with the Clinical Framework and the Framework Occupational Therapy model.
  • Undertaken the compulsory Framework Occupational Therapy training.
  • Received confirmation of approval from us.

For information on eligibility and how to apply, see: Framework Occupational Therapy

What we can pay for

We can pay the reasonable costs of occupational therapy services, without prior approval, when they are required as a result of a transport accident injury.  Please note that Framework OT services can be provided without prior approval by registered TAC Framework Occupational Therapists.

Treatment and services

  • Attending multidisciplinary consultation and team meetings.
  • Assisting a client to source and then transition into suitable supported accommodation.
  • Hand therapy – may include splint provision.

Assessments and recommendations relating to the following:

  • Home services.
  • Activities of daily living.
  • Vocational and return to work plans.
  • Transport and travel training.
  • Attendant care programs, including carer training, community access guidelines for a client and Functional Independence Reviews.
  • Support and monitoring for clients engaged in community group programs.
  • Disability support services.
  • Multiple and Complex Needs Model (MACNM)
  • Neurobehavioural rehabilitation services

Travel

  • Travel to conduct treatment in the community, where this is clinically justified.

Travel time can be paid for travel to and from your practice address and your client's residence. Where more than one client is visited in a single travel period, total travel costs should be apportioned equally between clients.

Equipment and orthoses

  • Provision of equipment under $1,000, including the supply of splints, supports and orthoses. Our approval is required for equipment above $1,000. Use the Equipment Prescription Form to submit written requests for higher cost items such as wheelchairs and bathroom equipment.

Driving assessments

  • A VicRoads authorised occupational therapist may perform driving assessments, in cases where the transport accident injury imposes physical, psychological or cognitive restrictions on driving.

Services needing prior approval

The following services require a written request and prior approval from us:

  • Attendant care.
  • Framework Occupational Therapy services.
  • Equipment above $1,000. See: Equipment Prescription Form.
  • Home modifications.
  • Vehicle modifications.

Other things to note

As part of your client’s treatment, you can:

Clients with a severe injury

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

How much we can pay

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

What we cannot pay for

We cannot pay for:

  • Services that are included as part of a hospital inpatient bed fee.

Fee Schedules

Occupational Therapy Services

Effective 1 July 2017

Registered for GST
Service DescriptionTAC Item Number2017/18 Maximum Payment Rate
Occupational Therapy Treatment
Individual Treatment   
Initial Consultation OT0005 $58.15
Standard Consultation: 
     Up to 30 minutes
OT0006 $46.53
Long Consultation:
     > 30 minutes - 45 minutes
OT0007 $69.54
Prolonged Consultation:
     > 45 minutes - 60 minutes
OT0008 $92.93
Occupational Therapy Service Plan
OTSP (flat rate) OT0050* $76.62
Group Treatment
Group Consultation (per person) OT0001 $27.99
Travel (with prior approval): Travel time from practitioner's prior consultation to the client's residence and from the client's residence to the practitioner's next appointment OT0010 $92.93
Other Occupational Therapy Services
Home Inspection, Education, Equipment Prescription Note:  An initial home inspection may include both evaluation of the home for modifications and assessment of service requirements.
Undertake inspection, education and complete report (per hour) OT0020* $102.11
Co-ordinate modifications and organise equipment (per hour) OT0021* $102.11
Travel time from previous appointment to claimant's residence and from claimant's residence to next appointment (per hour) OT0022* $102.11
Driving Assessment. Funding request must specify the amount of time allocated for each of the different driving assessment components including the on-road assessment, off-road assessment and report writing (per hour) OT0030* $102.11
Home Services Needs Assessment (Home Help, Domestic Services, Attendant Care)
Undertake review of services and complete report (per hour) OT0040* $102.11
Travel time from the practitioner's prior consultation to the claimant's residence and from the claimant's residence to the practitioner's next appointment (per hour) OT0041* $102.11
Functional Independence Review
FIR Report (flat rate) OT0100* $255.10
FIR Assessment/Liaison (per hour)  OT0105* $102.11
FIR Travel (per hour) OT0110* $102.11
Single Discipline Vocational Services
Worksite Assessment/Job Analysis VOC005* $102.11
An assessment and report evaluating the suitability of the worksite and job specifications for a claimant (per hour).
A full report will contain an analysis of the worksite and recommendations regarding critical work demands; the ability of the claimant to perform particular duties; suitable alternative duties; modifications to the workplace and other relevant issues.
This may include recommendations for the grading of hours and duties and other requirements for the establishment of a TAC return to work program. Time allocated is to include liaison with all relevant parties.
Post Placement Support VOC010* $102.11
This service involves the monitoring of a TAC return-to-work program to ensure progress is occurring and, in consultation with the TAC Rehabilitation Officer, address any problems which arise (per hour).
The service is an adjunct to the establishment of a TAC return-to-work program which may form part of the Worksite Assessment and could apply to claimants returning to their pre-accident employment or commencement in new employment.
Travel  VOC015* $102.11
Travel time from practitioners prior appointment to the relevant location (place of employment, residence, etc) and from this location to the practitioner's next appointment (per hour).
Note:  Single Discipline Vocational Services are only payable when undertaken by an appropriately qualified practitioner as follows:
>  Worksite Assessment/Job Analysis
    -  Ergonomist, Occupational Therapist
>  Post Placement Support
    -  Occupational Therapist, Rehabilitation Counsellor, Vocational Counsellor, Ergonomist
Registered for GST
Service DescriptionTAC Item Number 2016/17 Maximum Payment Rate
Occupational Therapy Treatment
Individual Treatment   
Initial Consultation OT0005 $57.30
Standard Consultation: 
     Up to 30 minutes
OT0006 $45.85
Long Consultation:
     > 30 minutes - 45 minutes
OT0007 $68.53
Prolonged Consultation:
     > 45 minutes - 60 minutes
OT0008 $91.57
Occupational Therapy Service Plan
OTSP (flat rate) OT0050* $75.50
Group Treatment
Group Consultation (per person) OT0001 $27.58
Travel (with prior approval): Travel time from practitioner's prior consultation to the client's residence and from the client's residence to the practitioner's next appointment OT0010 $91.57
Other Occupational Therapy Services
Home Inspection, Education, Equipment Prescription Note:  An initial home inspection may include both evaluation of the home for modifications and assessment of service requirements.
Undertake inspection, education and complete report (per hour) OT0020* $100.62
Co-ordinate modifications and organise equipment (per hour) OT0021* $100.62
Travel time from previous appointment to claimant's residence and from claimant's residence to next appointment (per hour) OT0022* $100.62
Driving Assessment. Funding request must specify the amount of time allocated for each of the different driving assessment components including the on-road assessment, off-road assessment and report writing (per hour) OT0030* $100.62
Home Services Needs Assessment (Home Help, Domestic Services, Attendant Care)
Undertake review of services and complete report (per hour) OT0040* $100.62
Travel time from the practitioner's prior consultation to the claimant's residence and from the claimant's residence to the practitioner's next appointment (per hour) OT0041* $100.62
Functional Independence Review
FIR Report (flat rate) OT0100* $251.38
FIR Assessment/Liaison (per hour)  OT0105* $100.62
FIR Travel (per hour) OT0110* $100.62
Single Discipline Vocational Services
Worksite Assessment/Job Analysis VOC005* $100.62
An assessment and report evaluating the suitability of the worksite and job specifications for a claimant (per hour).
A full report will contain an analysis of the worksite and recommendations regarding critical work demands; the ability of the claimant to perform particular duties; suitable alternative duties; modifications to the workplace and other relevant issues.
This may include recommendations for the grading of hours and duties and other requirements for the establishment of a TAC return to work program. Time allocated is to include liaison with all relevant parties.
Post Placement Support VOC010* $100.62
This service involves the monitoring of a TAC return-to-work program to ensure progress is occurring and, in consultation with the TAC Rehabilitation Officer, address any problems which arise (per hour).
The service is an adjunct to the establishment of a TAC return-to-work program which may form part of the Worksite Assessment and could apply to claimants returning to their pre-accident employment or commencement in new employment.
Travel  VOC015* $100.62
Travel time from practitioners prior appointment to the relevant location (place of employment, residence, etc) and from this location to the practitioner's next appointment (per hour).
Note:  Single Discipline Vocational Services are only payable when undertaken by an appropriately qualified practitioner as follows:
>  Worksite Assessment/Job Analysis
    -  Ergonomist, Occupational Therapist
>  Post Placement Support
    -  Occupational Therapist, Rehabilitation Counsellor, Vocational Counsellor, Ergonomist
Not Registered for GST
Service DescriptionTAC Item Number 2017/18 Maximum Payment Rate 2016/17 Maximum Payment Rate
Other Occupational Therapy Services
Home Inspection, Education, Equipment Prescription Note:  An initial home inspection may include both evaluation of the home for modifications and assessment of service requirements.
Undertake inspection, education and complete report (per hour) OTGF20 $92.82 $91.47
Co-ordinate modifications and organise equipment (per hour) OTGF21 $92.82 $91.47
Travel time from previous appointment to claimant's residence and from claimant's residence to next appointment (per hour) OTGF22 $92.82 $91.47
Driving Assessment. Funding request must specify the amount of time allocated for each of the different driving assessment components including the on-road assessment, off-road assessment and report writing (per hour) OTGF30 $92.82 $91.47
Home Services Needs Assessment (Home Help, Domestic Services, Attendant Care)
Undertake review of services and complete report (per hour) OTGF40 $92.82 $91.47
Travel time from the practitioner's prior consultation to the claimant's residence and from the claimant's residence to the practitioner's next appointment (per hour) OTGF41 $92.82 $91.47
Functional Independence Review
FIR Report (flat rate) OTG100 $231.92 $228.54
FIR Assessment/Liaison (per hour)  OTG105 $92.82 $91.47
FIR Travel (per hour) OTG110 $92.82 $91.47
Single Discipline Vocational Services

For information about our invoicing requirements, please see How to invoice the TAC.

Forms and brochures

View Certificate of Capacity form

Certificate of Capacity form

Summary:

The Certificate of Capacity form is for authorised providers to provide information about their TAC patient's transport accident conditions and to assess and certify their capacity for work as a result of these injuries.

IMPORTANT NOTICE:
It is an offence under the legislation to provide false or misleading information. A person who provides a false or misleading certificate of capacity could be liable to prosecution.

Please provide feedback about the Certificate of Capacity to medicalcertificatefeedback@tac.vic.gov.au

View Occupational Therapy: Functional Independence Review form (for Provider use only)

Occupational Therapy: Functional Independence Review form (for Provider use only)

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.

View Occupational Therapy: Home services needs assessment report form (for Provider use only)

Occupational Therapy: Home services needs assessment report form (for Provider use only)

Summary:

This form is to be completed by occupational therapists assessing the functional capacity and needs of clients seeking TAC-funded homes services because they're unable to perform their usual household responsibilities due to their accident injuries.

View Occupational Therapy: Home services needs assessment referral form (for Provider use only)

Occupational Therapy: Home services needs assessment referral form (for Provider use only)

Summary:

This form is to be used when requesting an assessment by an occupational therapist regarding the home services support needs of TAC clients who are unable to perform their usual duties around the household due to their accident injuries.

View Occupational Therapy: Supported Accommodation Functional Independence Review form (for Provider use only)

Occupational Therapy: Supported Accommodation Functional Independence Review form (for Provider use only)

Summary:

This form is to be completed by occupational therapists when requested by the TAC to review the functional capacity (i.e. physical, cognitive and emotional functions as well as communication skills) of clients living in supported accommodation and evaluating their progress towards increased independence.

View Functional Independence Assessment: Accommodation and Allied Health Service Recommended form (for Provider use only)

Functional Independence Assessment: Accommodation and Allied Health Service Recommended form (for Provider use only)

Summary:

For occupational therapists – in consultation with other treating therapists and the Early Support Coordinator, complete this form in preparation for a client’s discharge from hospital.  To ensure the client makes a smooth transition from hospital to the community, the assessment considers the most suitable accommodation, as well as the allied health and therapy services they will need.

For help completing this form, see the separate notes document.

View Functional Independence Assessment: Attendant Care and Allied Health Service Recommendations form (for Provider use only)

Functional Independence Assessment: Attendant Care and Allied Health Service Recommendations form (for Provider use only)

Summary:

For occupational therapists – in consultation with other treating therapists and the Early Support Coordinator, complete this form in preparation for a client’s discharge from hospital.  To ensure the client makes a smooth transition from hospital to the community, the assessment considers the attendant care and other allied health and therapy services they will need.

For help completing this form, see the separate notes document.

View Home modifications assessment form (for Provider use only)

Home modifications assessment form (for Provider use only)

Summary:

For occupational therapists – complete this comprehensive form when providing assessment services for our clients when they are applying to us for home modifications to ensure safety and accessibility.

Note: there are separate forms for Hospital based OTs and for Community based OTs.

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.

Framework Occupational Therapists

Framework Occupational Therapy is a service model that recognises the importance of a client’s participation and independence in the everyday activities at home, at work, at school or within the community. Framework Occupational Therapy providers have specific experience in treating clients who have received an acquired brain injury or spinal cord injury as a result of a transport accident.

To become a Framework OT, applicants are required to meet the criteria of one of the following categories:

  1. Three years experience as an OT, including 2 years experience providing services to people with an Acquired Brain Injury (ABI) and/or Spinal Cord Injury (SCI); OR
  2. Three years experience as an OT without experience providing services to people with an ABI and/or SCI, To be eligible for this category the applicant is required to declare that they will complete 50% of the required OT Continuing Professional Development (CPD) over the next two years on providing services to people with ABI/SCI. Each CPD must include clinical supervision specific to this client cohort;OR
  3. Two years experience as an OT including experience providing services to people with an ABI and/or SCI, In this case the applicant will be required to declare that they have arrangements in place for clinical supervision specific to this client group for the first year of practice as a Framework OT, and the applicant will be required to declare that they will complete 50% of the required CPD over the next two years on providing services to people with an ABI/SCI.

Read more about the Framework OT application process or download an application form.

Other guidelines and policies that may be relevant for Occupational Therapists include: