Physiotherapist

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

We can pay the reasonable costs of your patient’s physiotherapy, without prior approval, when it is required as a result of a transport accident injury.

Patient consultations, travel, exercise programs and equipment are also covered, with some exceptions. For patients with a severe injury, the discussion, referral and approval of services may form part of the independence planning process.

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.

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

  • Complete certificates of capacity to assess and certify your patient’s capacity for work.
  • Provision of equipment under $1000. Our approval is required for equipment above $1000. Use the Equipment Prescription Form to submit written requests.
  • Refer patients to pain management programs and services.
  • Refer patients to gym/swim programs and exercise physiology services.
  • Conduct workplace assessments and reports, where requested by us.

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

Physiotherapist 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 physiotherapy services?

You can provide services if:

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

Who can provide Early Intervention Physiotherapy Framework (EIPF) services?

You can provide EIPF services if you are a physiotherapist who has:

  • Completed the required training.
  • Signed a declaration to provide services in line with the clinical framework.
  • Been approved by us to provide EIPF services.

For information on training and how to apply, see: [about the EIPF program]

What we can pay for

We can pay the reasonable costs of your patient’s physiotherapy, without prior approval, when it is required as a result of a transport accident injury.

Patient consultations

  • Physiotherapy consultations.
  • Group consultations involving two to six participants in the same treatment session.
  • Extended consultations, where the relevant criteria are met.
  • Meeting attendance, at the request of the TAC, where the TAC client is present.
  • Out of rooms consultations   – includes a travel fee for travel of less than 30 minutes.
  • Conduct workplace assessments and reports, where requested by us.

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 patient's residence. Where more than one patient is visited in a single travel period, total travel costs should be apportioned equally between patients.

Exercise programs

  • Supervised exercise programs.
  • Monitoring and evaluating gym/swim programs.

Equipment and orthoses

  • The assessment, recommendation and supply of external orthoses.
  • Provision of equipment under $1,000. Our approval is required for equipment above $1,000. Use the Equipment Prescription Form to submit written requests.

Other things to note

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

  • Complete certificates of capacity to assess and certify your patient’s capacity for work.
  • Advise on the use of botulinum toxin (Botox/Dysport).
  • Refer patients to pain management programs and services.
  • Refer patients to gym/swim programs and exercise physiology services.

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.

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 the patient's treating team and our TAC coordinator.
  • If your patient already has an individualised funding package, physiotherapy services may be included as part of that.

How much we can pay

We can pay for services in line with our fee schedule:

What we cannot pay for

We cannot pay for:

  • Services that are included as part of a hospital inpatient bed fee.
  • Pool charges, such as pool hire and entry included in the hydrotherapy fee, aqua aerobics and swimming attire.

Fee Schedules

Physiotherapy Services (Private)

Effective 1 July 2017

Registered for GST
Service DescriptionTAC Item Number2017/18 Maximum Payment Rate
In Rooms
Initial ConsultationPY600R$70.02
Standard ConsultationPY602R$53.35
Consultation, with Treatment Notification Plan (TNP)PY604R$70.02
Out of Rooms (the fees for these items include travel) 
Initial ConsultationPY600H$99.94
Standard ConsultationPY602H$79.96
Consultation, with Treatment Notification Plan (TNP)PY604H$99.94
Worksite / Home /Equipment Inspection and Report#PY620H*#$117.28
Physiotherapy Management Review (PMR)
Completion of PMR (on request of TAC Physiotherapy Consultant)PY630R*$58.74
#Billed as an hourly rate inclusive of travel
Group (e.g. Pilates)
Two or more patients treated in a class or group session and receive constant overall supervision and intermittent attention for up to 30 minutes at a timePY602G$32.38
Hydrotherapy (includes pool hire and entrance fees)
IndividualPH602R$53.35
Group (Two or more patients treated in a class or group session and receive constant overall supervision and intermittent attention for up to 30 minutes at a time)PH602G$32.38
Attendance at TAC Team Meeting (the fee for this item includes travel)
Attendance by treating physiotherapist at meeting where patient is present, where requested by TAC#PY625H*#$117.28
Extended Consultations
Specific Criteria apply and pre-approval by the TAC required.  Refer to the TAC Physiotherapy provider guideline regarding criteria for extended consultations. For Complex and Multi-site Orthopaedic (CMSO) Injuries, refer also to CMSO criteria
In Rooms
Between 31 and 40 minutes of direct patient contact timePY614R$66.74
Greater than 40 minutes of direct patient contact timePY616R$106.60
Out of Rooms (the fees for these items include travel)
Between 31 and 40 minutes of direct patient contact timePY614H$99.94
Greater than 40 minutes of direct patient contact timePY616H$159.67
Travel as a separate fee/item
Specific Criteria apply and pre-approval by the TAC required.  Refer to the TAC Physiotherapy policy:  "Can the TAC fund physiotherapists to travel as a separate fee/item?" 
For rural and regional travel of greater than 30 minutes (by prior approval from the TAC)^PY650#$106.43
Registered for GST
Service DescriptionTAC Item Number2016/17 Maximum Payment Rate
In Rooms
Initial ConsultationPY600R$68.99
Standard ConsultationPY602R$52.57
Consultation, with Treatment Notification Plan (TNP)PY604R$68.99
Out of Rooms (the fees for these items include travel) 
Initial ConsultationPY600H$98.48
Standard ConsultationPY602H$78.79
Consultation, with Treatment Notification Plan (TNP)PY604H$98.48
Worksite / Home /Equipment Inspection and Report#PY620H*#$115.57
Physiotherapy Management Review (PMR)
Completion of PMR (on request of TAC Physiotherapy Consultant)PY630R*$57.88
#Billed as an hourly rate inclusive of travel
Group (e.g. Pilates)
Two or more patients treated in a class or group session and receive constant overall supervision and intermittent attention for up to 30 minutes at a timePY602G$31.91
Hydrotherapy (includes pool hire and entrance fees)
IndividualPH602R$52.57
Group (Two or more patients treated in a class or group session and receive constant overall supervision and intermittent attention for up to 30 minutes at a time)PH602G$31.91
Attendance at TAC Team Meeting (the fee for this item includes travel)
Attendance by treating physiotherapist at meeting where patient is present, where requested by TAC#PY625H*#$115.57
Extended Consultations
Specific Criteria apply and pre-approval by the TAC required.  Refer to the TAC Physiotherapy provider guideline regarding criteria for extended consultations. For Complex and Multi-site Orthopaedic (CMSO) Injuries, refer also to CMSO criteria.
In Rooms
Between 31 and 40 minutes of direct patient contact timePY614R$65.77
Greater than 40 minutes of direct patient contact timePY616R$105.05
Out of Rooms (the fees for these items include travel)
Between 31 and 40 minutes of direct patient contact timePY614H$98.48
Greater than 40 minutes of direct patient contact timePY616H$157.34
Travel as a separate fee/item
Specific Criteria apply and pre-approval by the TAC required.  Refer to the TAC Physiotherapy policy:  "Can the TAC fund physiotherapists to travel as a separate fee/item?" 
For rural and regional travel of greater than 30 minutes (by prior approval from the TAC)^PY650#$104.88
Not Registered for GST
Service DescriptionTAC Item Number2017/18 Maximum Payment Rate2016/17 Maximum Payment Rate
Out of Rooms (the fees for these items include travel) 
Worksite / Home /Equipment Inspection and Report#PY620F^$106.63$105.07
Physiotherapy Management Review (PMR)
Completion of PMR (on request of TAC Physiotherapy Consultant)PY630F$53.38$52.60

# Billed as an hourly rate inclusive of travel

# Billed as an hourly rate inclusive of travel

Early Intervention Physiotherapy Framework Services

Effective 1 July 2017

Service DescriptionTAC Item Number2017/18 Maximum Payment Rate
Initial Consultation: History, examination and treatment of new patient
Initial Consultation: < 7 months from date of injuryEPA100$101.50
Initial Consultation: > 7 months from date of injuryEPB100$70.02

Standard Consultation
 
Standard Consultation: < 7 months from date of injuryEPA102$67.01
Standard Consultation: > 7 months from date of injuryEPB102$53.35
Post-operative consultation: Eligible surgical procedures only - see guidance material for details; can be billed for a maximum of 3 months from first treatment following eligible surgery; Can only be billed within 30 months of the date of injury.
Post-operative Consultation: max. 3 months of treatmentEIP001$67.01

Extended Consultation:
Prior approval required - refer to the policy for eligibility criteria
Extended Consultation (31-40 mins) : < 9 months from first community treatmentEPA107$89.33
Extended Consultation (31-40 mins) : > 9 months from first community treatmentEPB107$66.74
Extended Consultation (+40 mins) : < 9 months from first community treatmentEPA108$111.68
Extended Consultation (+40 mins) : > 9 months from first community treatmentEPB108$106.60

Travel:
Prior approval required - refer to the policy for eligibility criteria. Cannot be billed where the service rate includes travel
Melbourne MetropolitanEPA131$2.72 per km
Regional / RuralEPA132$1.84 per km

Hydrotherapy & Group Consultations:
Hydrotherapy rates include travel
Individual Hydrotherapy ConsultationPH602R$53.35
Group Hydrotherapy Consultation: Two or more patientsPH602G$32.38
Group Consultation: Maximum 6 patients receiving constant overall supervision and intermittent individual attention from a physiotherapistPY602G$32.38

Assessment & review:
Assessment and reviews include travel
Workplace Assessment and reportWPA101$155.05 per hour (max $465.15)
Home/Equipment Inspection & ReportPY620H$117.28
Completion of Physiotherapy Management Review ( at TAC request )PY630R$58.74
Attendance at TAC Team Meeting ( at TAC request)PY625H$117.28
Service DescriptionTAC Item Number2016/17 Maximum Payment Rate
Initial Consultation: History, examination and treatment of new patient
Initial Consultation: < 7 months from date of injuryEPA100 $100.02
Initial Consultation: > 7 months from date of injuryEPB100 $69.00

Standard Consultation
 
Standard Consultation: < 7 months from date of injuryEPA102 $66.03
Standard Consultation: > 7 months from date of injuryEPB102 $52.57
Post-operative consultation: Eligible surgical procedures only - see guidance material for details; can be billed for a maximum of 3 months from first treatment following eligible surgery; Can only be billed within 30 months of the date of injury.
Post-operative Consultation: max. 3 months of treatmentEIP001 $66.03

Extended Consultation:
Prior approval required - refer to the policy for eligibility criteria
Extended Consultation (31-40 mins) : < 9 months from first community treatmentEPA107 $88.03
Extended Consultation (31-40 mins) : > 9 months from first community treatmentEPB107 $65.77
Extended Consultation (+40 mins) : < 9 months from first community treatmentEPA108 $110.05
Extended Consultation (+40 mins) : > 9 months from first community treatmentEPB108 $105.05

Travel:
Prior approval required - refer to the policy for eligibility criteria. Cannot be billed where the service rate includes travel
Melbourne MetropolitanEPA131$2.72 per km
Regional / RuralEPA132$1.84 per km

Hydrotherapy & Group Consultations:
Hydrotherapy rates include travel
Individual Hydrotherapy ConsultationPH602R $52.57
Group Hydrotherapy Consultation: Two or more patientsPH602G $31.91
Group Consultation: Maximum 6 patients receiving constant overall supervision and intermittent individual attention from a physiotherapistPY602G $31.91

Assessment & review:
Assessment and reviews include travel
Workplace Assessment and reportWPA101 $152.79 per hour (max $458.37)
Home/Equipment Inspection & ReportPY620H $115.57
Completion of Physiotherapy Management Review ( at TAC request )PY630R $57.88
Attendance at TAC Team Meeting ( at TAC request)PY625H $115.57

Forms and brochures

View Physiotherapy: treatment notification plan (TNP) form

Physiotherapy: treatment notification plan (TNP) form

Summary:

A treatment notification plan (TNP) includes information relating to a TAC client's clinical diagnoses, proposed treatment plan, self-management strategies and outcome measures.  A TNP is required to be submitted to the TAC if there has been a gap in treatment of longer than six months. For most new clients you will not need to complete a TNP unless specifically asked to do so. Clients with a 'severe injury' or in receipt of an 'Immediate approval of services' letter do not need a TNP submitted to the TAC prior to treatment. The TAC may request a TNP at other times during your patient's treatment.

View Physiotherapy: management review (PMR) form

Physiotherapy: management review (PMR) form

Summary:

This form is to be completed by physiotherapists to report on the progress and/or effectiveness of a client's physiotherapy treatment and self-management plan. The separate 'notes' document in this section provides additional instructions and clarification to help complete the form.

View Billing Review Program - Information for Allied Health Providers

Billing Review Program - Information for Allied Health Providers

Summary:

The TAC and WorkSafe conduct periodic reviews of payments made to providers for medical and allied health services provided to TAC clients and injured workers through the Health Practitioner Billing Review Program.

The primary focus of the program is to ensure that payments made to medical and allied health providers are appropriate and comply with TAC and WorkSafe policies and fee schedules.

View Independence Plan - Information for providers

Independence Plan - Information for providers

Summary:

As medical and health providers, you play a critical role in helping your seriously injured client maximise their independence and achieve their goals. The Independence Plan documents the work done by you and other members of the treating team, and acts as a central reference point for everyone.

View CMSO (Complex and Multi-site Orthopaedic Injuries)

CMSO (Complex and Multi-site Orthopaedic Injuries)

Summary:


This document outlines to Physiotherapists the TAC's Complex and Multi-site Orthopaedic injuries criteria

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.

Early Intervention Physiotherapy Framework

The Early Intervention Physiotherapy Framework (EIPF) is a physiotherapy model that focuses on early intervention to maximise return to work and health outcomes. The EIPF supports physiotherapists in their clinical practice through training and increased fees in the early stages of treatment following an injury.

Click on the link below to find out how to register as a EIPF provider.

Early Intervention Physiotherapy Framework

How do I join the Early Intervention Physiotherapy Framework?

  1. Ensure you are registered to provide services to the TAC
  2. Read the fact sheets below to decide if joining the EIPF is right for you (including the service standards and sample declaration)
  3. Complete the online training (hyperlink: http://www.earlyinterventionphysiotherapyframework.com.au)

    To log in, you need to register (the 'Register' button is on the right of the screen). This allows you to resume the training later if you need to.

    Questions throughout the training are for learning purposes only. Your answers will not affect your ability to enrol in the EIPF program.

    If you experience any issues, please email the following addresses. Technical support will be available Monday - Friday (8am - 5pm). info@vide.co.nz or cameron.gosling@monash.edu.

  4. Sign and return the declaration to:
    Email: provider@tac.vic.gov.au
    or
    Fax: (03) 9656 9432

    Your enrolment will start from the date your declaration is received by the TAC and VWA. A confirmation letter will also be sent, for your records.

Change of address or new practice location

To ensure that the TAC & WorkSafe account systems are kept up to date, please notify the TAC of a change or addition to your practice locations by emailing us at provider@tac.vic.gov.au.

EIPF Enquiries

Send enquiries to provider@tac.vic.gov.au

Further information

Extended consultations

Extended consultations can be funded for physiotherapy services.  These sessions are for people injured in a transport accident who require treatment beyond that of a standard consultation.

Extended consultations

Extended consultations can be funded for physiotherapy services.  These sessions are for people injured in a transport accident who require treatment beyond that of a standard consultation.  These injuries may include:

  • A significant acquired brain injury
  • A spinal cord injury
  • Lymphoedema
  • Severe burns
  • Complex and multi-site orthopaedic injuries. See also the TAC Criteria for CSMO.

The TAC expects extended physiotherapy consultations are delivered in line with the principles of the Clinical Framework for the Delivery of Health Services PDF, 1.29MB.

If your patient has a severe injury that is not listed above, an application can be made for the injury to be assessed 'on merit'.

Prior approval is required for all extended consultations.

Training and webinars

The Personal Injury Education Foundation (PIEF) offer a free series of training presentations which have been designed to assist healthcare professionals, specifically physiotherapists, to learn more about the important role they play in helping patients to return to work after a work or motor vehicle related injury.

The training presentations are available on the PIEF website:

http://www.pief.com.au/healthprofessionalstraining/allied-health-vic

Other guidelines

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