Equipment guidelines (medical and rehabilitation)

These guidelines should be read in conjunction with our General provider guidelines.

Definitions

Medical equipment is required to treat or stabilise a medical condition, and includes things like optical devices, dentures, room temperature control, life support equipment.

Rehabilitation equipment is required to treat or stabilise any accident-related condition or injury and is recommended by a patient’s medical practitioner or health professional.

Supplier refers to a manufacturer or retailer providing equipment and related services to a patient.

The TAC Contracted Supplier Equipment Lists are guides to equipment available through our contracted suppliers. Available under Ordering equipment, these lists are a resource for treating health professionals to use when recommending equipment.

The TAC Equipment Purchasing Team sources specialised and/or custom made equipment for patients through non-contracted suppliers.

What we can pay for

We can consider paying the reasonable costs of supply (purchase or hire), delivery and installation of equipment where it is required as a result of a transport accident injury.

Hire of equipment should only be considered for short term use, usually 6-12 weeks.

Equipment should be reasonable, clinically justified, related to the transport accident injuries and in support of a specific recovery outcome.

We consider the reasonable cost of these items to be the recommended retail price.

Gap in treatment

If our client has not received a treatment or service in 6 months they will need to seek approval from us before we will pay for further equipment.  Ask our client for a copy of their approval if they have not had a treatment or service paid for by the TAC within 6 months.

Medical excess

For accidents that occurred prior to 14 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.

Who can request equipment?

We can pay the reasonable costs of equipment when requested by:

  • a registered medical practitioner, or
  • a health professional with relevant expertise (e.g. physiotherapist or occupational therapist)

Types of equipment

Basic equipment

If a client requires basic medical or rehabilitation equipment, you do not need our approval to prescribe this for their transport accident injuries. Medical practitioners and health professionals can order directly from a contracted equipment supplier, who will send the invoice to us.

Basic rehabilitation and medical items include:

  • bandages and braces (e.g. compression, Tubigrip, triangular slings)
  • cleaning equipment (adapted, non-electrical)
  • clothing and dressing aids (e.g. compression stockings, stocking aids, dressing sticks, button hooks)
  • continence equipment
  • eating and drinking aids (e.g. adapted cutlery, mugs, cups and plates)
  • hand strengthening items (e.g. hand putty / Theraputty, Digi-flex)
  • heat packs and ice packs (reusable, not single use)
  • household aids (e.g. reaching aids, tap turners, bottle and jar openers, adapted cleaning aids)
  • hygiene aids (e.g. shower stools, bath boards, bath transfer bench, basic commodes, toilet seat raisers, surround toilet frames)
  • orthosis
  • physio items (e.g. balance supports, exercise bands, exercise foam, exercise putty, fit balls, foam rollers, lumbar support rolls, hand weights, massage balls, support pillows)
  • silicone gel sheeting (one 10x13cm sheet only) or in equivalent liquid form
  • supports (e.g. braces, splints)
  • taping (e.g. zinc oxide, Fixomull, strapping)
  • thermal supports, pressure garments and gloves
  • walking and mobility aids (e.g. crutches, pick-up sticks, walking sticks, walking frames)

Basic recreational and therapy equipment (e.g. therapy bands, massage balls, foam rollers) may be prescribed as part of a self-management plan.

Specialised equipment

Where a client needs specialised medical or rehabilitation equipment, this requires our approval. Specialised medical and rehabilitation equipment includes:

  • beds
  • bikes
  • custom toilet / shower / commode chairs
  • hoists
  • large exercise equipment
  • lifting and standing items
  • lounge chairs / tilt recliners
  • mainstream multi-functional technology (e.g. tablets, smartphones, computers)
  • mattresses
  • minor home modification items
  • minor vehicle modifications
  • powered conversion kits
  • pressure cushions
  • ramps
  • recumbent trikes
  • scooters
  • shower trolleys
  • specialised medical items
  • standing frames
  • tilt tables
  • treatment couches
  • vocational aids
  • wheelchairs

Specialised equipment requires written clinical justification on the Equipment Prescription Form (EPF) from a patient’s treating medical practitioner or health professional. The request should include:

  • a summary of the patient’s injuries and equipment needs
  • relationship between the equipment and transport accident injury
  • details of the specific item, function and intended use
  • duration and expected use of the equipment (for hire)
  • costs of the equipment in an itemised quote

It is expected that wherever possible equipment items will be ordered from our Contracted Supplier Equipment Lists (see Ordering equipment). Further clinical justification is required if an equivalent item is being requested from an alternative non-contracted supplier.

Where possible, patients should always trial equipment before a request is submitted to us, to make sure that it is fit for purpose.

Other types of equipment

For an equipment item not listed as either basic or specialised above, please submit a request to us by letter or email, or contact the TAC claims manager to discuss.

How is equipment supplied?

Equipment can be obtained from a range of suppliers, depending on the type of equipment required and the patient’s circumstances. These include contracted and non-contracted equipment suppliers and, in certain circumstances, public and private hospitals.

Contracted Equipment Suppliers

Our contracted equipment suppliers provide the standard items included in our Contracted Supplier Equipment Lists (see Ordering equipment).

Contracted equipment suppliers offer an equipment ordering portal that treating health professionals and TAC clients can use to order the rehabilitation and medical equipment they need.

Contracted equipment suppliers can also provide customised or specialised equipment items, including customised wheelchairs, beds, ceiling hoists and communication devices.

For more information on our contracted equipment suppliers and to access the equipment ordering portals please visit:

Non-Contracted Equipment Suppliers

Where specialised equipment items are to be provided by non-contracted suppliers, this must be organised via our Equipment Purchasing Team.

Public hospitals

Bed fees paid in Victorian public hospitals cover the cost of aids and equipment, including surgical supplies, provided to a patient whilst an inpatient.

  • The first 30 days post-discharge: Victorian public hospitals are responsible for providing aids, equipment and domiciliary oxygen free of charge (no deposits or hire fees) to facilitate a safe and effective discharge for a period of 30 after an acute, sub-acute or rehabilitation admission. If the patient needs equipment of a non-reusable nature, these items should be purchased by the hospital and not provided on a hire basis.
  • After 30 days post-discharge: After 30 days from discharge, we are responsible for providing aids and equipment. Victorian public hospitals must contact us to determine alternative equipment arrangements are needed or whether the current hire arrangements will continue.

Private hospitals: Bed fees paid in private hospitals cover the cost of aids and equipment provided to inpatients. Theatre fees cover the costs of surgical supplies provided during operating room procedures. See our Private hospital guidelines.

For basic equipment for discharge, private hospitals can order directly from our contracted equipment suppliers, who will send the invoice to us. Prior approval is required for specialised equipment.

What else can we pay for?

Maintenance

We can pay the reasonable costs of maintenance for specialised equipment items paid for by us, such as:

  • electric hoist or standing hoist
  • electric adjustable medical beds
  • alternating air pressure mattresses
  • wheelchairs (powered, manual and tilt in space)
  • electric scooters
  • room temperature control units
  • electric ceiling hoists
  • commodes (shower or transporter varieties)
  • feed pumps
  • suction machine
  • air-conditioner
  • ventilators
  • home modifications including wheelchair lifts and automatic doors

Repairs and Replacement

We can pay the reasonable costs of repairs and replacement arising from normal wear and tear to equipment we have paid for. We can also pay for modifications where the equipment is adaptive or disability-specific, such as wheelchairs, commodes, and electric scooters.

It is expected that equipment we partially or entirely pay for is used in a responsible manner consistent with its intended use. Equipment should be maintained appropriately, stored responsibly and in no way wilfully damaged.

Your patient should also take out an appropriate level of insurance at their own cost.

Equipment damaged in the transport accident

We can pay the reasonable costs of repair, adjustment or equivalent replacement of medical or rehabilitation equipment that was broken, damaged or lost in a transport accident. Equipment will be restored to your patient’s pre-accident prescription. Examples include medical equipment such as dentures, orthotics, mobility aids and/or optical equipment that was required prior to the accident.

Patient contribution

Your patient will be required to contribute to the cost of equipment where:

  • they select equipment that is more expensive than a suitable standard model
  • the equipment would be required regardless of the transport accident injury, such as household items
  • the equipment is only partially related to your patient’s transport accident injury

What we cannot pay for

We cannot pay for:

  • Equipment items provided to an in-patient as part of a hospital bed fee.
  • Equipment items for the first 30 days post discharge from a public hospital.
  • Insurance to cover equipment we have paid for.
  • Vitamins and supplements prescribed by an allied health provider. We can only pay for these when recommended by a medical practitioner and purchased at a pharmacy.

Please do not invoice us for consumables used as a part of in-rooms treatment (e.g. isopropyl alcohol wipes, needles, cotton balls, rubber gloves), as we undertake periodic reviews of invoicing patterns and conduct audits from time to time to ensure supply of these items is clinically justified. There may be some exceptions for the excessive cost of consumables related to hand and burn specific dressings.

Provision of multiple same or similar items will generate a review of treatment.

Equipment requirements

Medical beds

We can pay the reasonable costs of medical beds and related items, such as:

  • adjustable beds
  • specialist or pressure care mattresses
  • pressure care overlays
  • moving or positioning supports

Requests for medical beds should be submitted by the treating medical practitioner or health professional on the EPF.

Standard beds

There is currently no conclusive National Health and Medical Research Council level 1 or 2 evidence to show that sleeping on a particular type of bed or mattress can help back pain compared to other mattress types.

See our Non-Established, New or Emerging Treatment and Services policy.

Clothing, including compression garments

We can pay the reasonable costs for clothing only where required for:

  • body temperature control, or thermoregulation, such as thermal undergarments, thermal gloves, mittens or mitts
  • reducing the risk of re-injury or deterioration, such as wheelchair gloves
  • minimising hypertrophic scarring, oedema or other similar conditions, such as compression garments prescribed by a treating health professional for the management of wounds or burns

We can pay the reasonable costs of modifications/alterations to standard retail clothing and/or clothing paid for by us where this is required to facilitate independence, safety or return to work.

In relation to clothing, we cannot pay for:

  • off the shelf clothing
  • activewear or swimwear
  • custom-made clothing for a pre-existing condition
  • clothing normally issued by an employer
  • replacement of clothing that was damaged at the time of the transport accident injury

Continence

Continence equipment must be prescribed by a qualified continence nurse, and must be prescribed from our Contracted Supplier Equipment Lists (see Ordering equipment) using the Continence Prescription (Hospital discharge) Form or the Continence Prescription (Community) Form.

Prescriptions are considered valid for up to two years.

Footwear

Footwear or modifications will only be considered where a patient is unable to wear their pre-injury footwear because of their transport accident injury. This is because footwear is an expense incurred regardless of a transport accident injury.

We can pay the reasonable costs of:

  • Custom-made or orthopaedic footwear that is required because standard off the shelf footwear or pre-injury footwear cannot be worn due to the transport accident injury, or it does not support your patient’s rehabilitation needs.
  • Modifications to a patient’s pre-injury footwear or off the shelf footwear.
  • Footwear that is required to accommodate an orthosis, where a therapist has demonstrated that every attempt has been made to accommodate the orthosis in the patient’s own footwear.

For these types of footwear, we will only accept written requests from:

  • an appropriately qualified medical specialist, such as an orthopaedic surgeon
  • an orthotist
  • a podiatrist

In relation to footwear, we will not pay for:

  • Footwear normally issued by an employer.
  • Non-orthopaedic or standard off the shelf footwear that is not required to fit custom modifications or orthotics as a result of the patient’s transport accident injuries. Examples include day-to-day sneakers, runners or work-related footwear.

For further information about orthotics, please refer to our Prosthetist and orthotist guidelines.

Life support equipment

We can pay the reasonable costs of life support equipment, including artificial respirators and ventilators, humidifiers and enteral feed pumps.

Mainstream Multifunctional Technology (MMT)

Standard MMT devices, such as personal computers, tablets and smartphones, are considered to be a normal personal item and will not usually be paid for.

Please note:

  • Mainstream multifunctional technology (MMT) means a device or service which is commercially available for everyday use by anyone, can perform multiple functions, and has not been especially designed for rehabilitative use or for disability purposes, but under this policy is being used for a rehabilitative or disability purpose.
  • Devices refers to the hardware aspect of MMT, for example, touch screen tablet computers, smartphones, desktop or laptop computer hardware and related items.
  • Software means programs or applications (apps) that are used on MMT devices and may require download from the internet to obtain and update.
  • Internet services means an internet connection that allows the device to access software downloads and updates, as well as interact with online programs, websites, and other devices. An internet service is essential for downloading programs and updating the programs and applications, but is not necessarily essential for running software on the device

We can consider paying the reasonable costs of MMT for patients who:

  • Require the MMT as part of a goal-oriented rehabilitation program in which the recommendation is that the MMT will:
    • measurably increase independence, for example, via a reduction in need for support workers, and/or
    • measurably improve a deficit in communication.
  • Can demonstrate the ability to effectively use MMT (both device and prescribed software) for the reasons it has been recommended.
  • Do not own or have reasonable access to the requested MMT or other equipment that meets the identified needs.
  • Require a MMT device due to an injury that means your patient cannot communicate in a usual way, such as:
    • acquired brain injury
    • quadriplegia
    • significantly reduced arm function
    • upper limb/hand amputation
    • brachial plexus palsy

We can pay for the reasonable costs of:

  • Standard model MMT devices with the minimum requirements to run the prescribed program or software.
  • Software or apps that are prescribed to meet your patient’s specific transport accident injury needs.
  • Additional internet services only where required to access prescribed programs/apps.

We consider the reasonable costs for MMT devices to be the recommended retail price, and will not pay more than this amount.

Where your patient requires the MMT equipment for a resolving condition, we will not purchase the item, and will only consider paying the reasonable costs of hiring the item for the period until the condition has resolved.

We will only accept requests for MMT equipment from a qualified speech pathologist or occupational therapist. These consultations can be paid in line with our fee schedules for speech pathology and occupational therapy.

We will not pay for:

  • MMT that is not part of a goal-oriented rehabilitation plan
  • costs associated with accessing the internet if a patient has sufficient existing internet services that will enable them to access and use the prescribed software.
  • insurance or warranty costs
  • redeemable products, such as iTunes vouchers/cards
  • consumables such as printer ink, paper, blank USBs and CD/DVDs
  • telephone lines for the purpose of an internet installation
  • costs of mobile telephone plans, telephone calls, or telephone services

Personal alarms and monitoring services (safety items)

Personal alarms and monitoring services can be useful for patients who would like greater independence but require daily monitoring and support for medical reasons. The type of service or device will depend on your patient's needs and circumstances.

Personal alarms and monitoring services may include:

  • A personal alarm which can be worn as a necklace pendant, watch or belt clip. Otherwise, a special sensitive button or 'blow switch' can be used where your patient has limited or ataxic movements.
  • A receiver unit and the required components that are plugged into your patient's telephone line. This allows the signal to be received from the personal alarm and automatically dials the monitoring centre.
  • The monitoring station, which provides the 24-hour monitoring by a third party. If your patient needs assistance or if a regular 'check in' is missed, the nominated emergency contact/s will be notified.
  • Bolton Clarke Response Service. This service only applies to patients who have no nominated emergency contacts.
  • Medical alert devices (such as a medical alert bracelet, pendant, vial of life and/or wallet card) are worn by a patient, with details of their medical, supervision, and emergency instructions.
  • Keysafes, which comprise the safe and mounting hardware. This could be the spin-dial or push-button version and mounted to a wall or located on a fence, railing or pipe. A keysafe can hold several keys and is accessed by entering a pin or combination.
  • On-call attendant care, which is a remote service for patients who require a low level of care during the day and/or overnight, but do not require an attendant carer to be constantly present and/or sleep over in their home. See our Attendant care provider guidelines.

We cannot pay for personal alarms that are not monitored by a monitoring station.

Room temperature control

We can pay the reasonable costs of room temperature control equipment when required to address difficulty regulating body temperature as a result of a transport accident injury. In most cases this would be a spinal cord lesion at or above the level of T6. In other exceptional cases, it must be medically confirmed that the transport accident injury has resulted in a permanent inability to regulate temperature.

We can pay the reasonable costs of provision of equipment, installation, maintenance and increased consumption of gas or electricity associated with the running of an air conditioner, evaporative cooling unit or heater.

We will only accept requests for room temperature control equipment from a consultant physician or specialist, as recognised by the Health Insurance Act (1973), who is able to confirm that your patient’s injuries meet the medical criteria outlined above.

In relation to room temperature control equipment, we require the following information:

  • Documentation of a spinal cord injury at or above the level of T6 or other exceptional cases where the transport accident injury has resulted in a permanent inability to regulate temperature.
  • Eligibility for energy concessions, such as the life support machine electricity concession.
  • Electricity consumption prior to the installation of the equipment, such as supplying a copy of the electricity or gas account to demonstrate pre injury usage. This can be compared to electricity consumption after the installation of the room temperature control equipment to identify any increased usage.
  • The proportion of the electricity account related to your patient prior to their transport accident injury.

We will not pay for equipment for areas of the home that the patient cannot access or does not access for activities of daily living

Sport and recreation

We can consider paying the reasonable costs of modified or adapted equipment to enable participation in a sporting or leisure activity. Your patient’s individual circumstances will be taken into account in determining eligibility and reasonable costs. Patient contributions may be required in some circumstances.

For a patient who is able to return to their pre-injury activity, we can pay the reasonable costs of adaptions to their own equipment.

For a patient who is unable to return to their pre-injury activity, we can pay the reasonable costs of:

  • Hire of sporting or recreational equipment for three months.
  • Purchase of entry level equipment for one sporting or leisure activity where your patient can demonstrate commitment to continued participation.
  • Purchase of equipment for subsequent sporting or recreational pursuits. If your patient has discontinued the previous activity in favour of another, it would be reasonable for the patient to contribute the trade-in value of TAC-paid equipment toward the new equipment.
  • Making a contribution towards elite or advanced equipment where required.

In relation to sporting and recreational equipment, we require the following information:

  • Demonstrated commitment to the sport or recreational activity such as club membership, regular attendance and/or evidence of participation.
  • Reasons why basic entry level equipment will not be sufficient, when requesting elite or advanced equipment.

In relation to sporting and recreational equipment, we will not pay for:

  • Vehicles used for sport or recreational use. See our Vehicle Modifications policy.
  • Optional features, such as metallic paint or tool kits.
  • Maintenance and repairs, except for sporting wheelchairs.
  • Replacement of sporting or recreational equipment that was damaged in the transport accident.
  • Sport or recreational clothing.
  • Participation costs, such as court hire, entry fees or coaching.

For information about sporting and recreational prostheses, see our Prosthetist and orthotist guidelines.