Public hospital fees
Fees for services that public hospitals provide to TAC clients are agreed with the Victorian Department of Health and Human Services. Access the index for these fees on the department's website: Patient fees and charges for public health services.
For further information about TAC policies, contact us at 1300 654 329 or policy@tac.vic.gov.au
Changes to TAC funding in Victorian public health services
The Transport Accident Commission has introduced a new, simplified way of funding care for eligible TAC clients treated in Victorian public health services.
This shift means that instead of paying separately for medical, diagnostic and other services, the TAC provides a single bundled payment to health services through the Department of Health.
How the new funding model works
Under this new model, the TAC funds care using a single TAC price per National Weighted Activity Unit (NWAU). The TAC price is consistent across all Victorian public health services and reflects the cost of delivering care.
This activity‑based payment applies across all public health activity – emergency, admitted (including acute and mental health), sub‑acute and non‑admitted care.
Public health services are then responsible for payments to medical and diagnostic providers for care delivered on or after 1 July 2026, based on mutually agreed arrangements.
What the changes mean for providers
From 1 July 2026, medical practitioners and diagnostic providers no longer invoice the TAC directly for services delivered in public health settings . Any invoices for services submitted to the TAC on or after this date will be declined or recovered.
Providers should be in discussion with their employing or contracting health service to confirm remuneration arrangements due to the transition. If a provider uses a third‑party billing service, billing processes should be updated to reflect this change.
Note: Providers can still invoice the TAC for services delivered in public health settings on or before 30 June 2026. They have up to two years from the date of service to submit those invoices.
What’s not changing
Although the funding mechanism has changed, several aspects relating to care for TAC clients in public health settings are staying the same.
- TAC clients will continue to have access to all required services
- Overall level of TAC funding remains unchanged
- Pre‑approval requirements for services after the first 90 days post‑accident are still required
- Direct billing to the TAC for services delivered in private settings continues as usual.
Support and further information
Providers are encouraged to raise questions or concerns directly with their health service in the first instance.
You can check out the FAQs below for more detail on the transition and the new funding model.
For TAC‑specific questions, providers can contact tacwsvpublichospitalfunding@tac.vic.gov.au
Frequently Asked Questions
Health service funding and processes
How will this impact hospital funding?
The total level of funding we provide to support the care of Victorians injured in transport accidents will remain consistent with current arrangements, ensuring all services required will continue to be provided.
Funding for TAC clients will continue, but it will be paid directly to public health services (through the Department of Health). Health services will then be responsible for covering all associated costs of care, including medical and diagnostic services.
What costs are included?
From 1 July 2026, services for TAC clients in public health settings will be funded using a single price per National Weighted Activity Unit (NWAU). It will cover the full cost of care including attendance/admission, clinician and diagnostic services.
This approach will apply consistently across all public health services and all types of care, ensuring funding reflects the full cost of delivering services.
Public health services will receive this funding through activity-based payments using this standard price, across all activity types, including emergency care, admitted care (acute and mental health), sub-acute, and non-admitted services. An itemised list of in-scope service types has been provided by the Department of Health to public health services, to help them prepare for the change.
Note: the following services will continue to be billed directly to the TAC:
- Urgent care centres
- Aids and equipment
- Community mental health
- TAC-requested medical reports & FOI requests
- Discharge and non-admitted medicines (including high-cost, highly specialised S100 & S85 medicines)
- Diagnostics provided from an external referral.
A revised fee schedule for Victorian public hospital services will be in place from 1 July 2026. This will cover the services that remain out of scope under the new funding model.
What is the definition of ‘episode of care’?
An ‘episode of care’ is an umbrella term that captures services provided to a patient. This can include admitted patient separations, non-admitted occasions of service, or emergency department presentations. A health service will receive a separate payment each time a different service type is provided to a patient (consistent with the arrangement for public patients) but there will not be separate payments made for any single service type.
Under the current funding arrangements for an admitted patient separation (an ‘episode of care’), separate payments may be made for clinician fees, diagnostics and bed fees and other medical costs.
When the new funding arrangements take effect from 1 July, there will only be a single payment made to the health service for that separation that covers all of those elements. If a patient requires further non-admitted occasions of service as part of their treatment, each one will be considered a separate ‘episode of care’.
What will the pricing be?
We are working closely with Hospitals Victoria to determine the price per NWAU. There will be a new TAC price per NWAU that will apply to all public health services. This will be higher than the current price, taking into account the additional services to be included.
All TAC activity will remain uncapped. The change will not impact the level of care, or treatment and services provided to patients in public hospitals following a transport accident.
We are committed to ensuring a consistent level of funding for public health services and will be closely monitoring this change with a 12-month review process to ensure there is no financial impact to health services.
Will the TAC audit the payments hospitals make to clinicians?
No. Contractual and payment arrangements between individual health services and their clinicians are independent of the TAC. We cannot determine, influence, or monitor the individual fee and billing arrangements between health services and individual clinicians and diagnostic providers.
We may review patient episodes of care to ensure TAC activity and its associated costs are reasonable and appropriate. This is in line with our commitment to ensure payments are efficient, fair, and well-governed. The new funding model has been designed to include greater controls and checkpoints, to help reduce the risk of fraud and billing errors and strengthen the integrity and sustainability of the transport accident scheme.
We also run a billing review program to ensure service payments for TAC clients are appropriate and follow TAC policies and fee schedules. Find out more about the billing review program.
Health services will continue to be responsible for ensuring they adhere to standards, specifications, and data quality processes related to various health data collections to support accurate reporting and data integrity.
If unusual or inconsistent data is identified, we will work with the health service to review and address this. We may request clinical information for specific patient episodes to support a review process.
Does sub-acute care include both inpatient and outpatient services?
Yes. Sub-acute care includes both inpatient admissions and outpatient care.
Will TAC patients be considered ‘public patients’ from 1 July 2026?
No. TAC patients will continue to be classified as ‘compensable patients’, not ‘public patients’. However, the new TAC funding model will work in a similar way to how public patient episodes are funded. We will pay health services, via the Department of Health, and health services will then manage all costs of care, including medical and diagnostic services.
How will the funding model change affect cross-border health services?
The funding model change only applies to cross-border health services managed by the Victorian Department of Health. If a service is managed by an interstate health department, it must follow the funding rules set by its own state or territory, not Victoria.
What’s the impact of the funding model change to services provided to interstate TAC clients?
The funding model change only applies to Victorian public health services. It will not affect services provided to TAC clients, including those who are interstate. Further information on interstate funding can be found on the TAC website.
What if a TAC patient requires an ambulance transfer?
There will be no change to the way ambulance transfers are paid. This service will not be included in the NWAU single payment per episode of care. Health services or the ambulance provider can continue to invoice the TAC for this service.
Examples of current and future billing processes for health services, clinicians, and diagnostic providers?
The TAC has developed current state and future state scenarios that show existing billing arrangements and process and how these will change for health services, clinicians and diagnostic providers from 1 July 2026.
View TAC Payment Change Transition Scenarios for Health Services
How do health services make sure that TAC activity is funded?
While there is no change to reporting, health services should ensure that for TAC compensable patients, TAC is selected as the account class in VAED and VINAH reporting. If the account class does not reflect TAC, then TAC payment for the activity will not be received.
Scope and exclusions
Will gait analysis be NWAU-funded?
Gait analysis will be included as an in-scope service as part of the funding model changes for TAC patients from 1 July 2026. Gait analysis will be paid per NWAU using the new TAC-agreed price and combined into the standard DH data extract to TAC.
Are TAC-requested medical reports and Freedom of Information requests in-scope for the change?
TAC-requested medical reports and Freedom of Information requests will remain out of scope for the funding model change. Victorian public health services will continue to invoice us for these requests. Health services cannot bill the TAC for standard discharge reports.
Any care plans (nursing, allied health) that are required as part of the patient’s care are included in the NWAU funding – the TAC cannot be billed separately for these.
Further information on the invoicing requirements for medical and FOI reports can be found on the Department of Health website.
How will TAC fund our non‑metro health service’s GP clinic and private‑practice doctors from 1 July if the hospital keeps its fee?
This clinic operates like a private community GP and isn’t affected by the funding model change. Current processes remain the same. GP services for TAC clients will continue to be paid in line with the Medicare Benefits Schedule. For more information, check out the medical services reimbursement rates on our website.
What is the impact of the funding model changes on billing for services provided to TAC patients in a community setting?
The funding model change covers services which are provided mainly in hospital environments. Community-based services, such as nursing and allied health, are often delivered by private providers in metropolitan or regional areas.
In smaller regional and rural settings, community-based services are often delivered by public health services. These community services typically sit outside the NWAU funding arrangements.
If equivalent services provided to public patients are not funded through NWAU, they should continue to be billed directly to the TAC.
Lodging and confirming claims
How can I confirm a TAC patient’s claim details?
Health services can use the TAC’s Provider Online Services (POS) platform to access a TAC patient’s claim number. Health services must be registered to access POS. You can register by completing this form and emailing it to hdsg_admin@tac.vic.gov.au.
Once registered, users can access POS via this link: https://portal.worksafe.vic.gov.au.
POS requires a patient’s name, date of accident and date of birth. It will then show accepted, denied, and pending claims for that patient. If no record is shown, it indicates a claim has not been lodged.
Health services can contact the TAC Lodgement team for queries on 5335 7600 or email lodgements@tac.vic.gov.au
Does TAC funding require a claim number from services, and how can services prompt patients to lodge claims without invoices?
The TAC can only pay for treatments and services where a claim has been lodged and accepted.
It is not a requirement for someone who has been injured in a transport accident to lodge a claim, noting they have up to one year to lodge a claim from the date of accident or from the date an accident-related injury first becomes evident.
Hospital staff can encourage the patient or their representative to lodge a TAC claim, and they have three options to do so:
- Hospital claim form – the hospital can complete and submit a claim form on behalf of a patient who has given consent
- Online claim form – individuals can choose to lodge a claim themselves using the online claim form
- Telephone – individuals can choose to contact the TAC by telephone to lodge their compensation claim.
Can a hospital lodge a TAC claim on behalf of the patient?
The hospital’s Patient Liaison Officers or nominated equivalent can lodge a claim on the patient’s behalf if the patient is admitted to hospital because of their transport accident, and they have given consent for the hospital to lodge a TAC claim for them.
Is a police report needed to validate a TAC claim?
A police report is required to make a TAC claim. Before processing the claim, the TAC will ask the patient for evidence that they have lodged or attempted to lodge a police report, such as:
- the event number
- station name
- police officer’s name and badge number.
Patients can submit a claim over the phone or via the TAC online claim lodgement form.
If a claim is lodged by the hospital’s Patient Liaison Officer and Ambulance Victoria (AV) attended the scene, then the following are accepted:
- AV reference number or AV case report
- A valid police report number or the police officer’s details e.g. name, number and police station.
Requests and approval process
Does this change affect TAC approval for patients, including non‑admitted people using public health services or equipment?
This is a funding model change only. There is no change to the TAC approval process for treatments, services and equipment.
Within the first 90 days of a patient’s accident, the TAC can help pay for some treatments and services without the need for health services or the patient to contact us for prior approval. The treatment or service must be:
- On the list of Approved treatments and services for new TAC clients, and
- Recommended by a health professional, related to the patient’s accident injuries, and delivered in line with the TAC Clinical Framework.
You will need TAC approval to help pay for treatments or services after the first 90 days of a patient’s accident.
Equipment and materials for patients are not part of the new funding model and will continue to require a TAC request and pre-approval in line with existing guidelines.
Find out more about what we can pay for on the TAC website.
How will health services know when TAC has approved treatment and services after the first 90 days following a transport accident?
There is no change to the TAC approval process for treatments and services or how the TAC communicates the decision. When the TAC approves a treatment or service, the decision will continue to be communicated directly to the requestor and the patient.
Health professionals will still need to seek TAC pre-approval for any treatment and/or services provided after the first 90 days following a patient’s accident.
We encourage health services to set up an internal process to make sure they have visibility of TAC pre-approvals for procedures requested by health professionals after the initial 90-day period, to ensure payment will be made for the approved service.
How will equipment for TAC patients be funded under the new arrangements?
There is no change to how equipment is provided and paid for under the new funding arrangements.
During the first 30 days post-discharge, Victorian public hospitals remain responsible for providing aids, equipment and domiciliary oxygen free of charge (no deposits or hire fees) to facilitate a safe and effective discharge after an acute, sub-acute or rehabilitation admission. If the patient needs equipment that are non-reusable, these should be purchased by the hospital rather than hired.
After 30 days from discharge, the TAC takes responsibility for providing aids and equipment. Victorian public hospitals must contact us to confirm whether alternative equipment is needed or whether existing hire arrangements, if any, should continue.
Billing and payments
How will invoicing be different from 1 July 2026?
Medical practitioners and diagnostic providers will no longer be able to invoice the TAC directly for services provided in Victorian public health services from 1 July 2026. Payment will be provided directly by health services.
This means that if we receive an invoice from a medical practitioner or diagnostic provider for treatment and services delivered to a TAC patient in a public hospital from 1 July 2026, it will be rejected.
Health services must have new payment arrangements in place with impacted clinicians to ensure they can pay all eligible invoices for medical practitioners and diagnostic providers.
Can medical practitioners who provided services on or before 30 June 2026 send their invoices to the TAC after 1 July?
Yes. Medical practitioners can send their invoices to the TAC after 1 July 2026, as long as it is for services provided to TAC patients on or before 30 June 2026. Providers have up to two years from the date of service to submit their invoice(s) to the TAC.
Some items I billed before are now being rejected. I thought this change wasn’t meant to take effect until 1 July 2026?
We are continually reviewing and refining our payment system controls to ensure we are only paying for eligible treatments and services. Invoice items that cannot be paid will specify a reason for the rejection on the remittance advice. This may relate to adherence to MBS co-billing rules which the TAC adopts and is not related to the funding model change.
If you have specific questions about your current invoicing items or remittance advice, please contact a member of the TAC Customer Service Team on 1300 654 329 or email payments_enquiries@tac.vic.gov.au.
Medical, diagnostic and third-party billing providers
Will TAC practitioners need private practice roles, or can services be provided within their public health service engagement?
From 1 July 2026, individual medical practitioners (including surgeons, anaesthetists, specialist physicians and other medical specialists) and diagnostic companies will no longer be able to invoice the TAC directly for services provided in Victorian public health services. Instead, public health services will manage these payments.
Health services will need to work with their medical practitioners and diagnostic providers to establish new agreed payment and contractual arrangements for the care of TAC clients from 1 July 2026. The TAC has no influence on what these arrangements are. Queries relating to these arrangements should be directed to the relevant health service.
Our health service uses a third-party diagnostic provider. Do they continue to invoice the TAC directly?
All diagnostic services required for TAC patients admitted in Victorian public health services or referred from non-admitted activity are within the in-scope service types and covered by the new TAC price per NWAU.
This means third-party diagnostic providers cannot invoice the TAC directly for these patients. Health services and third-party diagnostic providers will need to establish new agreed payment arrangements for TAC patients.
If a TAC patient attends a public health service from an external referral (e.g. GP, Specialist) for diagnostic services only, then this activity can be invoiced directly to the TAC.
How will this change affect medical practitioners who work in both public and private hospitals?
Medical practitioners may continue to bill the TAC directly for services provided in public hospitals until 30 June 2026.
From 1 July 2026, the new funding model will apply to services delivered for TAC clients in Victorian public health services, meaning direct billing by practitioners to the TAC will no longer occur in those settings.
Direct billing to the TAC for services provided in private settings will not change
Will the upcoming change apply to allied health outpatient services delivered by public health services?
The funding model change will apply to all outpatient services delivered by public health services in Victoria. This may include (but is not limited to) outpatient fracture clinic review, outpatient surgery clinic review or outpatient allied health review or treatment.
Under the new funding arrangements, an outpatient attendance is considered as an episode of care and will be reported by public health services through VINAH.
It is important to remember that the new funding arrangements do not change the TAC approval process for treatments and services. Clinicians must still submit the appropriate treatment requests to the TAC approval for any for care required beyond 90 days after the patient’s accident.
How will including outpatient and ED attendances in the new model affect remuneration arrangements for medical specialists?
Medical practitioners’ remuneration arrangements for outpatient and emergency presentations will be determined by individual health services in consultation with their medical practitioners. The TAC does not set or influence payment rates and arrangements for medical providers. Health services are best placed to provide advice on engagement models or clinician remuneration.
