A future where every journey is a safe one

Occupational therapy guidelines

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

We can pay 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.

We will review our client’s treatment to ensure it’s reasonable, clinically justified, outcome focused and in line with the Clinical Framework. We'll ask you and our client for information during these reviews and may temporarily stop funding treatment if we don’t receive it. After a review we’ll let you and our client know the decision regarding further treatment.

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 tabs above for full details on our requirements and what we can and cannot pay for.

For more information on working with us, see: Occupational therapy page and General guidelines.

Functional Independence Reviews

These forms need to be completed when requested by us.  The forms aim to assist our clients transition from hospitals into their community and to assess their functional capacity.

Functional Independence Review form (for Provider use only)

Summary:

For occupational therapists – when requested by us, complete these forms to review the functional capacity of a client, such as the physical, cognitive and emotional functioning, as well as communication skills, and to evaluate their progress toward increased independence.

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


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

Summary:

For occupational therapists – when requested by us, complete this form to review the functional capacity, such as the physical, cognitive and emotional functioning, as well as communication skills, of a client living in supported accommodation, and to evaluate their progress toward increased independence.

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


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.


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.


Home Services

Complete these forms when requested by us to assess and report on our client’s capacity to undertake home tasks and recommend any assistance required.

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

Summary:

For medical and health providers – complete this form when requesting an occupational therapist assessment of the functional capacity and needs of clients who are unable to perform their usual household duties and responsibilities due to their transport accident injuries.


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

Summary:

For occupational therapists – complete this form when assessing the functional capacity and needs of clients who are applying to us for home services because they are unable to perform their usual household duties and responsibilities due to their transport accident injuries.


Home modifications

Complete this form when requested by us to assess and provide recommendations on the home modification needs of our clients.

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.

Important:
Approval from TAC/WorkSafe agent must be obtained prior to completing a home assessment.


Vehicle Needs

These forms need to be completed when requested by us to assess the transport needs of our clients and to assess and recommend vehicle and transport requirements and modification.

Vehicle needs and modifications assessment form (for Provider use only)

Summary:

For Occupational Therapists – This form should only be completed upon referral from the TAC post the completion of a Transport Needs Assessment Form. Complete this form to submit applications for TAC-funded vehicle modifications, to ensure the safety, accessibility and independence of our clients as drivers or passengers.

You will need to provide details about the person's transport needs, as well as whether their current or pre-accident vehicle is suitable for modification and, where relevant, if it has the capacity to fit a wheelchair.


Transport needs assessment form (for Provider use only)

Summary:

For providers – use this form to assess transport needs for our clients as a result of their accident injuries. You will need to consider transport requirements in relation to travelling to work, school, treatment/rehabilitation, recreational activities and day-to-day tasks such as shopping and banking, as well as provide recommendations as to how we can assist.


Holiday support

These forms need to be completed when requested by us to request attendant care services for clients going on holidays.

Australian Holiday Support Request form (for Provider use only)

Summary:

For occupational therapists – complete this form to request attendant care for holiday support and identify client support needs. This form can be completed by an Occupational Therapist in conjunction with a Community Access Planner.


Overseas Attendant Care Request form (for Provider use only)

Summary:

For occupational therapists – complete this form, in consultation with a community access planner and your client, to request support for your client while overseas on holiday.


Brochures

These brochures provide information for occupational therapists about working with the TAC.

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.


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

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) and registered with the Occupational Therapy Board of Australia.

The TAC is in partnership with the State-Wide Equipment Program (SWEP). We use this partnership to manage occupational therapist credentialing. This enables us to find suitably experienced and skilled occupational therapists to provide services for TAC clients in their local areas. You can read more about SWEP on the SWEP website.

What we can pay for

We can pay the reasonable costs of occupational therapy services, without prior approval, immediately after a transport accident when they are required as a result of a transport accident injury.

We will review our client’s treatment to ensure it’s reasonable, clinically justified, outcome focused and in line with the Clinical Framework. We'll ask you and our client for information during these reviews and may temporarily stop funding treatment if we don’t receive it.

Reviews help us understand our client’s injuries, treatment needs and goals and how to best support them to get their life back on track. After a review we’ll let you and our client know the decision regarding further treatment.

Where possible, the TAC will refer to providers who are registered and credentialed in line with the standards outlined in the SWEP registration and credentialing framework available on the SWEP website.

Immediately after a transport accident, a client may access occupational therapy services independently or following a referral from a medical practitioner or on discharge from hospital. The TAC can pay for the reasonable costs of an initial assessment and report required as a result of a transport accident injury.

Following an initial assessment and report, the TAC may pay for the reasonable costs of the following services after a review of the treatment plan:

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.
  • Home modifications.
  • Vehicle modifications.
  • Driving programs/lessons.
  • 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.
  • Travel should be a reasonable distance from your practice.
  • Travel should be invoiced in 15 minute increments.

Equipment and orthoses

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.

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 will form part of the independence planning process between your client's treating team and one of the TAC’s support coordinators.
  • If your client already has an individualised funding package, occupational therapy services may be included as part of that.

How much we can pay

Occupational therapists who are credentialed at Red level (as defined by the SWEP Framework) are eligible to invoice in line with the Occupational Therapy fee schedule for red level providers.

All other occupational therapists will be paid in line with our Occupational therapy fees.

What we cannot pay for

We cannot pay for services that are included as part of a hospital inpatient bed fee.

This Guideline relates to the following client policies


Occupational therapy fees

Effective 1 November 2019

TAC has entered into a partnership with the Victorian State-Wide Equipment Program (SWEP). TAC uses this partnership to manage Occupational Therapist (OT) credentialing. OTs can bill the TAC at rates based on your SWEP credentials for the service type.

OTs not credentialed with SWEP can bill at the General OT / SWEP (Green/Amber) rate.

For previous fees, please refer to the Occupational Therapy fee schedule for services performed before 1 November 2019.

For Occupational therapy services provided on or after 1 November 2019 by general OTs or with SWEP Green or Amber level
Service DescriptionTAC Item NumberMaximum Payment Rate - Non Registered for GSTMaximum Payment Rate - Registered for GST
Occupational Therapy Treatment
Initial Consultation OTSG01 $60.64 $60.64
Standard Consultation: 
     Up to 30 minutes
OTSG02 $48.52 $48.52
Long Consultation:
     > 30 minutes - 45 minutes
OTSG03 $72.51 $72.51
Prolonged Consultation:
     > 45 minutes - 60 minutes
OTSG04 $96.90 $96.90
Group Consultation (per person) OTSG05 $29.19 $29.19
Occupational Therapy Service Plan (OTSP) flat rate OTSG06 $79.90 $79.90
Travel (with prior approval) : Travel time from practitioner's prior consultation to the clients residence and from the clients residence to the practitioners next appointment (rate per 15 minutes) OTSG07 $24.23 $24.23
Home Modifications
Undertake inspection, education and complete report (per hour) OTSG08 $106.47 $106.47
Co-ordinate modifications and organise equipment (per hour) OTSG09 $106.47 $106.47
Travel time from practitioner's prior consultation to the client's residence and from the client's residence to the practitioners next appointment (rate per 15 minutes) OTSG10 $26.62 $26.62
Driving Assessment
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) OTSG11         $106.47 $106.47
Home Services Needs Assessment
Undertake review of services and complete report (per hour) OTSG12 $106.47 $106.47
Travel time from practitioner's prior consultation to the client's residence and from the client's residence to the practitioners next appointment (rate per 15 minutes) OTSG13 $26.62$26.62
Functional Independence Review
FIR Report (flat rate) OTSG14 $266.00 $266.00
FIR Assessment/Liaison (per hour)  OTSG15 $106.47 $106.47
FIR Travel (rate per 15 minutes) OTSG16 $26.62$26.62
For Occupational therapy services provided on or after 1 November 2019 by OTs with SWEP Red level credentials
Service DescriptionTAC Item Number Maximum Payment Rate - Non Registered for GST Maximum Payment Rate - Registered for GST
Occupational Therapy Treatment - SWEP Red
OT Service Session as approved by the TAC. Rate per hour, billed in 15 minute increments OTSR01         $135.44 $135.44
Travel - Travel directly related to the provision of Framework OT services with the approval of the TAC (rate per 15 minutes). This fee includes all costs associated with the travel. OTSR02        $33.86 $33.86
Occupational Therapy Treatment Plan (OTSP) - At request of TAC only (Flat rate/Per Report) OTSR03        $135.44 $148.99
Initial Assessment Services - Home Services - SWEP Red
Assessment and Assessment Report - Completion of the Assessment and the provision of a Report(per hour) TAC approval required for > 5 hours OTSR04 $135.44 $148.99
Follow-up Services - Completion of the specific actions required to facilitate achievement of the goals identified in the Assessment Report in accordance with the approval given by the TAC (per hour). Maximum 6 hours OTSR05         $135.44 $135.44
Travel - Assessment - Travel directly related to the provision of the Assessment - Includes all costs associated with travel (rate per 15 minutes). TAC approval required for > 1 hour OTSR06        $33.86 $37.25
Travel - Follow Up Services - Travel directly related to the provision of the Assessment - Includes all costs associated with travel (rate per 15 minutes). TAC approval required for > 1 hour OTSR07 $33.86 $37.25
Follow Up/Review Services - Home Services - SWEP Red
Assessment and Assessment Report - Completion of the Assessment and the provision of a Report (per hour) TAC approval required for > 4 hours OTSR08 $135.44 $148.99
Follow-up Services - Completion of the specific actions required to facilitate achievement of the goals identified in the Assessment Report in accordance with the approval given by the TAC (per hour). Maximum 6 hours OTSR09 $135.44 $135.44
Travel - Assessment - Travel directly related to the provision of the Assessment - Includes all costs associated with travel (rate per 15 minutes). TAC approval required for > 1 hour OTSR10 $33.86 $37.25
Travel - Follow-up Services - Travel directly related to the provision of the Follow-up Services - Includes all costs associated with travel (rate per 15 minutes). TAC approval required for > 1 hour OTSR11 $33.86 $33.86
Functional Independence Review - SWEP Red
Assessment and Assessment Report - Completion of the Assessment and the provision of a Report(per hour) TAC approval required for > 6 hours OTSR12     $135.44 $148.99
Follow-up Services - Completion of the specific actions required to facilitate achievement of the goals identified in the Assessment Report in accordance with the approval given by the TAC (per hour). Maximum 6 hours OTSR13      $135.44 $135.44
Travel - Assessment - Travel directly related to the provision of the Assessment - Includes all costs associated with travel (rate per 15 minutes). TAC approval required for > 1 hour OTSR14 $33.86 $37.25
Travel - Follow-up Services - Travel directly related to the provision of the Follow-up Services - Includes all costs associated with travel (rate per 15 minutes). TAC approval required for > 1 hour OTSR15        $33.86 $33.86
Equipment - SWEP Red
Assessment and Assessment Report - Completion of the Assessment and the provision of a Report (per hour) TAC approval required for > 5 hours OTSR16 $135.44 $148.99
Follow-up Services - Completion of the specific actions required to facilitate achievement of the goals identified in the Assessment Report in accordance with the approval given by the TAC (per hour). Maximum 6 hours OTSR17 $135.44 $135.44
Travel - Assessment - Travel directly related to the provision of the Assessment - Includes all costs associated with travel (rate per 15 minutes). TAC approval required for > 1 hour OTSR18 $33.86 $37.25
Travel - Follow-up Services - Travel directly related to the provision of the Follow-up Services - Includes all costs associated with travel (rate per 15 minutes).TAC approval required for > 1 hour OTSR19 $33.86 $33.86
Home Modifications - SWEP Red
Assessment and Assessment Report - Completion of the Assessment and the provision of a Report (per hour) TAC approval required for > 8 hours OTSR20 $135.44 $148.99
Follow-up Services - Completion of the specific actions required to facilitate achievement of the goals identified in the Assessment Report in accordance with the approval given by the TAC (per hour). OTSR21 $135.44 $135.44
Travel - Assessment - Travel directly related to the provision of the Assessment - Includes all costs associated with travel (rate per 15 minutes). TAC approval required for > 1 hour OTSR22 $33.86 $37.25
Travel - Follow-up Services - Travel directly related to the provision of the Follow-up Services - Includes all costs associated with travel (rate per 15 minutes). TAC approval required for > 1 hour OTSR23 $33.86 $33.86
Transport Assessment - SWEP Red
Assessment and Assessment Report - Completion of the Assessment and the provision of a Report (per hour) TAC approval required for > 4 hours OTSR24 $135.44 $148.99
Follow-up Services - Completion of the specific actions required to facilitate achievement of the goals identified in the Assessment Report in accordance with the approval given by the TAC (per hour). Maximum 6 hours OTSR25 $135.44 $135.44
Travel - Assessment - Travel directly related to the provision of the Assessment - Includes all costs associated with travel (rate per 15 minutes). TAC approval required for > 1 hour OTSR26 $33.86 $37.25
Travel - Follow-up Services - Travel directly related to the provision of the Follow-up Services - Includes all costs associated with travel (rate per 15 minutes). TAC approval required for > 1 hour OTSR27 $33.86 $33.86
Vehicle Modifications Assessment - SWEP Red
Assessment and Assessment Report - Completion of the Assessment and the provision of a Report (per hour) TAC approval required for > 6 hours OTSR28 $135.44 $148.99
Follow-up Services - Completion of the specific actions required to facilitate achievement of the goals identified in the Assessment Report in accordance with the approval given by the TAC (per hour). OTSR29 $135.44 $135.44
Final Vehicle Inspection Report - Completion of the Report (Flat rate - Per Report) OTSR30 $135.44 $148.99
Travel - Assessment - Travel directly related to the provision of the Assessment - Includes all costs associated with travel  (rate per 15 minutes). TAC approval required for > 1 hour OTSR31 $33.86 $37.25
Travel - Follow-up Services - Travel directly related to the provision of the Follow-up Services - Includes all costs associated with travel (rate per 15 minutes). TAC approval required for > 1 hour OTSR32 $33.86 $33.86
Occupational Therapy Vocational Services
Worksite Assessment/Job Analysis

An assessment and report evaluating the suitability of the worksite and job specifications for a client (per hour). A full report will contain an analysis of the worksite and recommendations regarding critical work demands, the ability of the client 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.
VOC005 $106.47 $106.47
Post Placement Support

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 adjuct to the establishment of a TAC return-to-work program which may form part of the Worksite Assessment and could apply to clients returning to their pre-accident employment or commencement in new employment.
VOC010 $106.47 $106.47
Travel (rate per 15 minutes)

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 (rate per 15 minutes).
VOC015 $26.62 $26.62
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

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