Acupuncture

Acupuncture involves inserting fine needles into specific points on the skin or applying various other techniques to the acupuncture points to encourage the body to heal itself.

The TAC can pay the reasonable cost of acupuncture provided to TAC clients which is required as a result of transport accident injuries.

Where a pre-existing condition has become aggravated as a result of a transport accident, the TAC will consider funding treatment for that condition. The level of treatment that the TAC can consider funding will depend on the extent to which the transport accident has exacerbated the pre-existing condition.

For accidents that occurred prior to 14 February 2018 a medical excess may apply.

The TAC will pay the reasonable cost of acupuncture services. This includes:

• acupuncture consultations, which may involve:
  • assessing injuries
  • providing manual therapy
  • developing treatment plans and reviewing progress
• completion an Allied Health Treatment and Recovery Plan when requested by the TAC.

The TAC will pay for treatment and services according to the Acupuncture fee schedule. If a provider’s fee is higher than the TAC rate, the client may need to pay a gap fee to cover the difference. Information about how the TAC pays for services can be found on the Paying for treatment and services page.

The TAC won't pay for:

• services that are not required for the treatment of transport accident-related injuries.
• services provided by individuals who do not meet the provider guideline requirements or comply with the Allied Health Policy
• services that are not evidence based, reasonable, clinically justified and outcome focused.

This includes:

• Acupuncture provided by students or by practitioners who are not registered with AHPRA.
• Chinese herbal medicine.
• Acupuncture when the client is receiving concurrent treatment from another allied health or medical professional, except in exceptional circumstances. See the Allied Health Policy for further information.

Further information can be found at What we cannot pay for.

Within the first 90 days of a client’s accident, the TAC can help pay for acupuncture services without the need for prior TAC approval. The TAC may contact clients or their service providers to discuss client progress and ensure that treatment is clinically justified and outcome focused.

If a client needs acupuncture beyond 90 days after their transport accident, the TAC must provide approval before TAC-funded treatment can be delivered. Prior approval is also needed if it has been more than 6 months since the client last received TAC-funded treatment.

To request further treatment, acupuncturists must complete an Allied Health Treatment and Recovery Plan. The TAC will use this information to consider if the client is receiving treatment that aligns with the Clinical Framework and continues to be reasonable, clinically justified and outcome focused. Based on this assessment, the TAC will inform the provider and client about what the TAC will help pay for and for how long.

To provide TAC-funded acupuncture, a practitioner must:

• Be registered:
  • As a Chinese medicine practitioner in the Division of Acupuncturists under the Health Practitioner Regulation National Law (AHPRA)
  • To practice as an acupuncturist under Section 97 of the Health Practitioner Regulation National Law. For example, allied health professionals who are endorsed by the Osteopathy or Physiotherapy Boards of Australia to practice as acupuncturists.
• Comply with the TAC Allied Health policy.
• Adhere to the principles of the Clinical Framework for the Delivery of Health Services.

Promoting independence and avoiding treatment dependence

In line with Principle 3 of the Clinical Framework, the TAC expects that providers of acupuncture promote independence from treatment through early education, setting clear treatment expectations and encouraging active participation in daily activities. Strategies to empower the injured person to manage their injury and discourage overreliance on treatment should be incorporated in all phases of recovery. Further guidance on promoting injury self-management is available in the Clinical Framework.

The TAC uses the following principles to make socially and economically responsible decisions in line with the Transport Accident Act 1986:

1. Entitled

A TAC client is entitled to a treatment or service if the TAC has accepted liability for the accident-related injury that relates to the treatment or service.

2. Reasonable

When deciding if a treatment or service is reasonable, the TAC considers whether the cost of the treatment or service is reasonable in relation to the relevant fee schedule.

3. Clinical justification

When deciding if a treatment or service is clinically justified, the TAC considers whether the following conditions are met:

• The treatment or service is clinically appropriate for the client’s transport accident injuries and presentation.
• The treatment or service complies with the principles of the Clinical Framework in that it:
  • results in a measurable benefit to the injured person
  • reflects the adoption of a biopsychosocial approach
  • empowers the client to self-manage their injury
  • has goals focused on optimising function, participation and return to work and health
  • is based on the best available research evidence.
• The treatment or service has a duration and frequency appropriate to the client’s condition and recovery progress. These factors are assessed on a case-by-case basis.  Treatment or service sessions may be more frequent during the acute recovery phase but are expected to become less frequent over time.
• Clients with severe injury or permanent disability may require longer term allied health supports as part of their MyPlan. Please refer to Treating clients with severe injury or permanent disability section above.
• The treatment or service should be discontinued and the client discharged when either:
  • the client can independently manage their recovery,
  • the client reaches a phase of maintenance and further progress is unlikely with ongoing treatments or services, or
  • there is no measurable benefit on outcome measure scores from continued treatments or services.

4. Outcome focused

When deciding if a treatment or service is outcome focused, the TAC considers whether it is progressing or achieving individualised recovery or participation goals that are meaningful to the client.