Physiotherapist guidelines

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

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.

Please note that the EIPF program is no longer taking new registrations.  We are in the process of reviewing the physiotherapy fee schedule and service model. Current registered EIPF physiotherapists can continue to bill at the EIPF rates. In the meantime, please contact Pippa Kirby if you have any queries about the EIPF program.

What we can pay for

We can pay the reasonable costs of your patient’s physiotherapy, without prior approval, immediately after a transport accident when it is 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. When requested, you must complete the Allied health treatment and recovery plan and return it to us. We may temporarily cease funding our client’s treatment until the plan is received.

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.

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 basic equipment. Our approval is required for specialised equipment.

Equipment should be reasonable, clinically justified, related to the transport accident injuries and in support of a specific recovery outcome. Please read our Medical and Rehabilitation Equipment Guidelines and 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 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.

Gap in treatment

If our client has not received treatment in 6 months they will need to seek approval from us before we will pay for further treatment.  Ask our client for a copy of their approval if you haven’t seen them in 6 months.

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.
  • 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.