A future where every journey is a safe one

Rehabilitation services

We can pay for your rehabilitation after you leave hospital. You don't need to contact us for approval.

We may contact you or your provider to check your progress and see if you are getting the support you need. This will help us make sure your treatment is helping your recovery. It will allow us to make decisions about what treatment we can pay for and how long we can pay for it.

How to get rehabilitation

  1. Speak to your treatment team or the TAC about what rehabilitation options are best for you.
  2. You can choose to do outpatient rehabilitation services:
    1. at home
    2. in a community centre, or
    3. at another hospital.
  3. The hospital will organise your rehabilitation and bill the TAC.

Many TAC clients like the option of doing their rehabilitation at home. Sometimes this can help you leave hospital sooner. You can talk to your treatment team or the TAC to find out what option is best for you.

How to pay for rehabilitation

We will pay your hospital or service provider for rehabilitation services. All you need to do is give the hospital or service provider your claim number and ask them to invoice the TAC

What are rehabilitation (outpatient) services?

To help get your life back on track after you leave hospital after a transport accident, your treatment team may recommend a rehabilitation program.

This could include a mixture of physiotherapy, occupational therapy, speech pathology, podiatry, orthotic and prosthetic services, orthoptics, dietetics, pharmacy, psychology and social work.

Information for health and service providers

If you are a private hospital provider please refer to our TAC provider guidelines or your relevant contract and arrangement documents.

Medical services reimbursement rates

The TAC has adopted the Medicare Benefits Schedule (MBS) items, explanations, definitions, rules and conditions for services provided by medical practitioners.  When invoicing for medical services, medical practitioners are expected to adhere to the MBS rules unless otherwise specified by the TAC in the Reimbursement Rates for Medical Services booklet or its medical policies.

The Reimbursement Rates for Medical Services booklet below must be read in conjunction with:

At the time of production this publication contained up to date information as released by Medicare Australia (Medicare).  The relevant publication will be updated to reflect any further changes that are implemented by Medicare each year.  Please check our website for the latest version.

If you have any questions about these publications or the reimbursement rates, please contact the TAC on 1300 654 329. Alternatively, e-mail info@tac.vic.gov.au.

Private hospital (non-arrangement) services fees

Effective 1 July 2019

For private hospital services provided on or after 1 July 2019
Service DescriptionTAC Item NumberMaximum
Payment
Rate

INPATIENT SERVICES

Advanced Surgical Patients 1 - 14 Days $779.00
15 + Days $599.45
General Surgical Patients 1 - 14 Days $697.58
15 + Days $599.45
Special Medical Patients 1 - 14 Days $697.58
15 + Days $590.86
General Medical Patients 1 - 14 Days $545.24
15 + Days $502.93
Psychiatric Patients 1 - 30 Days $697.58
  31 - 65 Days $590.86
66 + Days $502.93
Rehabilitation Patients 1 - 25 Days $680.70
  26 + Days $519.82
Intensive Care Unit^ 1 - 4 Days $1,902.73
5 + Days Original Patient Classification or High Dependency Unit 
Intensive Care Unit (Metropolitan)^ 1 - 4 Days $2,848.91
5 + Days Original Patient Classification or High Dependency Unit
Coronary Care Unit^ 1 - 4 Days $1,697.83
5 + Days Original Patient Classification or High Dependency Unit 
High Dependency Unit
Hospitals must seek recognition of HDU's from the TAC prior to any payments being considered.
1 - 3 Days $1,180.00
4 + Days Original Patient Classification 
Nursing Home Type Patient
Applies when an Acute Care Certificate is not submitted to TAC for a surgical or medical patient after 35 days hospitalisation or each period up to 31 days thereafter.  
 $192.97
Same Day Patient Bed Fee
Only applicable if a procedure or operation is performed.
 $269.36
Bed Leave / Hospital Leave Fee   75% of the applicable bed fee
Hospital in the Home HIT $390.66
Facility Fee - Emergency Department Patients
A facility fee is only payable to hospitals with an approved Emergency Department.
 $45.10
Theatre Fees   
Band 1A $108.43
  1 $340.81
  2 $483.94
  3 $607.83
  4 $794.72
  5 $1,072.51
  6 $1,339.39
  7 $1,804.02
  8 $2,402.93
  9A $2,624.66
  9 $3,508.17
  10 $4,795.09
  11 $5,240.34
  12 $6,596.97
  13 $7,454.52
  0 (Lithotripsy) $3,214.93
  Electroconvulsive Therapy $243.94
  (Individual approval is required for electroconvulsive therapies)  
Therapy Services Refer Outpatient Services
^Reimbursements will be made only to hospitals with approved facilities

OUTPATIENT SERVICES
These fee and item numbers also apply to therapy services provided to Inpatients.

Fees are for 30 minute sessions unless otherwise stated. For times greater than 30 minutes, fees are charged in 15 minute units.
Hydrotherapy (by a Physiotherapist)
Individual Session 99923 $57.93
Group Session 99922 $34.93
Dietician
Individual Session 99917 $52.96
Driving Assessment
Driving Assessment by Occupational Therapist 99921 $58.42
Driving Instruction By Driving School (30 minutes) 
(charge in 30 minute units) 
99957* $55.55
Occupational Therapy
Individual Session 99920 $52.96
Group Session 99919 $31.84
Worksite / Home Assessment & Report (charge in 30 min units) 99967 $52.96
Physical Education
Individual Session 99958* $52.96
Group Session 99959* $31.84
Physiotherapy
Individual Session 99913 $57.93
Group Session 99914 $34.93
Worksite / Home Assessment & Report
(charge in 30 min units)
99966 $57.93
Podiatry   
Individual Session 99941 $52.96
Psychology
Individual Session 99908 $90.88
Group Session 99907 $54.55
Rehabilitation Assessments & Reports
Initial Assessment and Preparation of Rehabilitation Plan 99904 $592.60
Medical & Like Report / Reviews (Only payable when requested by TAC) 99905* $225.38
Rehabilitation Counselling
Individual Session 99928 $50.43
Group Session 99937 $30.07
Social Work
Individual Session 99940 $52.96
Group Session 99952 $31.84
Special Education / Accredited Teacher
Individual Session 99912* $50.90
Group Session 99936* $30.45
Speech Therapy
Individual Session 99930 $52.96
Group Session 99929 $31.84

^Reimbursements will be made only to hospitals with approved facilities

For private hospital services provided between 1 July 2018 and 30 June 2019
Service DescriptionTAC Item NumberMaximum
Payment
Rate

INPATIENT SERVICES

Advanced Surgical Patients 1 - 14 Days $755.94
15 + Days $581.71
General Surgical Patients 1 - 14 Days $676.93
15 + Days $581.71
Special Medical Patients 1 - 14 Days $676.93
15 + Days $573.37
General Medical Patients 1 - 14 Days $529.10
15 + Days $488.04
Psychiatric Patients 1 - 30 Days $676.93
  31 - 65 Days $573.37
66 + Days $488.04
Rehabilitation Patients 1 - 25 Days $660.55
  26 + Days $504.43
Intensive Care Unit^ 1 - 4 Days $1,846.41
5 + Days Original Patient Classification or High Dependency Unit 
Intensive Care Unit (Metropolitan)^ 1 - 4 Days $2,764.59
5 + Days Original Patient Classification or High Dependency Unit
Coronary Care Unit^ 1 - 4 Days $1,647.58
5 + Days Original Patient Classification or High Dependency Unit 
High Dependency Unit
Hospitals must seek recognition of HDU's from the TAC prior to any payments being considered.
1 - 3 Days $1,145.08
4 + Days Original Patient Classification 
Nursing Home Type Patient
Applies when an Acute Care Certificate is not submitted to TAC for a surgical or medical patient after 35 days hospitalisation or each period up to 31 days thereafter.  
  $187.26
Same Day Patient Bed Fee
Only applicable if a procedure or operation is performed.
  $261.39
Bed Leave / Hospital Leave Fee   75% of the applicable bed fee
Hospital in the Home HIT $379.10
Facility Fee - Emergency Department Patients
A facility fee is only payable to hospitals with an approved Emergency Department.
  $43.77
Theatre Fees   
Band 1A $105.22
  1 $330.72
  2 $469.62
  3 $589.84
  4 $771.20
  5 $1,040.77
  6 $1,299.75
  7 $1,750.63
  8 $2,331.81
  9A $2,546.98
  9 $3,404.34
  10 $4,653.17
  11 $5,085.24
  12 $6,401.72
  13 $7,233.89
  0 (Lithotripsy) $3,119.78
  Electroconvulsive Therapy $236.72
  (Individual approval is required for electroconvulsive therapies)  
Therapy Services Refer Outpatient Services
^Reimbursements will be made only to hospitals with approved facilities

OUTPATIENT SERVICES
These fee and item numbers also apply to therapy services provided to Inpatients.

Fees are for 30 minute sessions unless otherwise stated. For times greater than 30 minutes, fees are charged in 15 minute units.
Hydrotherapy (by a Physiotherapist)
Individual Session 99923 $56.22
Group Session 99922 $33.90
Dietician
Individual Session 99917 $51.39
Driving Assessment
Driving Assessment by Occupational Therapist 99921 $56.69
Driving Instruction By Driving School (30 minutes) 
(charge in 30 minute units) 
99957* $53.91
Occupational Therapy
Individual Session 99920 $51.39
Group Session 99919 $30.90
Worksite / Home Assessment & Report (charge in 30 min units) 99967 $51.39
Physical Education
Individual Session 99958* $51.39
Group Session 99959* $30.90
Physiotherapy
Individual Session 99913 $56.22
Group Session 99914 $33.90
Worksite / Home Assessment & Report
(charge in 30 min units)
99966 $56.22
Podiatry   
Individual Session 99941 $51.39
Psychology
Individual Session 99908 $88.19
Group Session 99907 $52.94
Rehabilitation Assessments & Reports
Initial Assessment and Preparation of Rehabilitation Plan 99904 $575.06
Medical & Like Report / Reviews (Only payable when requested by TAC) 99905* $218.71
Rehabilitation Counselling
Individual Session 99928 $48.94
Group Session 99937 $29.18
Social Work
Individual Session 99940 $51.39
Group Session 99952 $30.90
Special Education / Accredited Teacher
Individual Session 99912* $49.39
Group Session 99936* $29.55
Speech Therapy
Individual Session 99930 $51.39
Group Session 99929 $30.90

^Reimbursements will be made only to hospitals with approved facilities

Better Health Channel - Rehabilitation after major trauma

The Better Health Channel has more information about how different rehabilitation services could help you.

Rehabilitation - at the rehabilitation hospital

Summary:

This booklet provides information and assurance for clients moving into a rehabilitation facility about what to expect and how the TAC can assist. Topics include: how your rehabilitation program will help improve your ability to do things and increase independence; and preparing your Independence Plan of individual goals you want to achieve in the short and long term.


Rehabilitation - preparing to go home

Summary:

This booklet provides information and assurance for people with major injuries who are preparing to leave the rehabilitation hospital and return home. It explains the next stage of your rehabilitation and Independence Plan as well the support services that the TAC can fund to help with day-to-day tasks.


At home with the family (for families of children with injuries)

Summary:

This booklet contains information and suggestions for families of children who've been injured in a transport accident and are about to leave hospital and return home. Topics include: how the TAC can help; adjusting to life at home and overcoming challenges that may arise; community organisations that offer support and counselling; and looking after the welfare of family members.


Outpatient rehabilitation services

We’re here to help you get your life back on track after your transport accident. To help you with your transport accident injuries we will pay for rehabilitation services provided in an outpatient setting by a hospital in Australia.

You can get this treatment immediately after your transport accident without initial approval from the TAC.

If it’s been more than 6 months since you had any treatment or service paid for by the TAC, you need to call us to find out if we can pay for this treatment.

When we can pay for outpatient rehabilitation services

You can immediately access the rehabilitation (outpatient) services you require following your accident. We will directly pay the hospital for these services, including a range of allied health and medical services to treat your transport accident injuries.

We will, where appropriate, work with your treating team to ensure that you receive the rehabilitation services you require as a result of your transport accident.

We will also pay the cost of medications, travel and equipment in some circumstances.  For more information please see the following policies:

We may contact a member of your treating team to discuss your progress or request an assessment to make sure that:

  • You have access to appropriate treatment and support.
  • You are getting proven, evidence-based treatment and not receiving treatment that isn't helping you recover.
  • You are moving towards getting your life back on track or being able to live independently.

Treatments and services we can't pay for

We can’t pay for services that:

  • Do not treat your transport accident injuries.
  • Are not reasonable, necessary or appropriate.
  • Are not clinically justified, safe and effective.

What does a rehabilitation service do?

To help get your life back on track after you leave hospital, your treatment team may recommend that you do a rehabilitation program.

This could include a mixture of physiotherapy, occupational therapy, speech pathology, podiatry, orthotic and prosthetic services, orthoptics, dietetics, pharmacy, psychology and social work.

Alternatively your treating team may recommend a specific rehabilitation program which can include:

  • Rehab in the home
  • Alfred Health ABI Rehabilitation Centre (ABI Slow Stream Service)
  • Spinal Community Integration Service
  • Sub-acute Ambulatory Care Service
  • Victorian Paediatric Rehabilitation Services
  • Mental Health Clinical Community Care
  • Speciality clinics such as:
    • Continence Clinics
    • Gait Analysis
    • Network Pain Management
    • Pain Management Services

How rehabilitation services are paid for

We pay for your treatment:

  • Directly to your rehabilitation provider, when you have provided them with your TAC claim number, or
  • If you have to pay, use myTAC to send a copy of your receipt to us and we will repay you.

We pay for your services in line with our responsibilities under our guiding legislation, the Transport Accident Act 1986.

How much we will pay

We will pay for outpatient rehabilitation services on a fee-for-service basis based on 30 minute treatment sessions.

We pay the cost of treatment provided in public hospitals in Victoria in line with the Department of Health and Human Services Fees Manual.

We pay the cost of treatment provided in private hospitals in line with our Hospital treatment policy.

For providers

Hospitals should refer to our TAC provider guidelines or to your hospital contract and arrangement documents.

Hospital treatment

We’re here to help you get your life back on track after your transport accident. To help you recover from your injuries we will pay for services that you receive from any public or private hospital within Australia.

You can get this treatment immediately after your transport accident without initial approval from the TAC.

If it’s been more than 6 months since you had any treatment or service paid for by the TAC, you need to call us to find out if we can pay for this treatment.

When we can pay for hospital services

As hospital treatment is a TAC approved service, we will pay for your hospital treatment immediately after your transport accident, including the cost of your emergency, inpatient and outpatient services. We will also work with your hospital to ensure that you receive the services you require.

We may need to approve admissions for non-emergency treatment beforehand. For more information please see: Surgery and medical specialists

Hospital treatment options

You may be admitted to a hospital as a:

  • public patient
  • private patient in a public hospital
  • private patient in a private hospital

As a private patient you can choose which doctor treats you, and you may have a private room. However this service may cost more than our approved rate and you may need to pay any difference.

Hospital services you may need include:

  • emergency services
  • inpatient services, including hospital in the home or rehab in the home
  • outpatient services

Other services you can use

We will also pay for support services to help you at home when you leave hospital.

We can also pay for your family’s visiting expenses if they live more than 100kms from the hospital and they visit you in hospital.

Checking your progress

We may contact your physical therapist to discuss your progress or request an assessment to make sure that:

  • You have access to appropriate treatment and supports required for your transport accident injuries.
  • You are getting proven, evidence-based treatment and not receiving treatment that isn't helping you recover.
  • You are moving towards getting your life back on track or being able to live independently.

How treatments and services are paid for

We pay for your hospital treatment:

  • Directly to your hospital, when you have given them your TAC claim number, or
  • If you have to pay, use myTAC to send a copy of your receipt to us and we will repay you.

This includes any allied health and medical services you need.

We will also pay for outpatient services, such as emergency department attendances, specialist rehabilitation services and mental health services you need because of your injuries.

We pay for your services in line with our responsibilities under the Transport Accident Act 1986.

Treatments and services we can't pay for

We can’t pay for services that:

  • Do not treat your transport accident injuries
  • Are not reasonable, necessary or appropriate
  • Are not clinically justified, safe and effective

Incidental items that you may have chosen to get as part of your inpatient stay such as newspapers, cable television, entertainment systems, telephone calls and toiletries.

About Victoria’s hospital system

Hospitals provide services including emergency care, surgery and specialist clinics.

Victoria’s hospital system is made up of:

You can receive treatment as:

  • An inpatient, when you are admitted to hospital
  • An outpatient, where you are treated in hospital but are not admitted.

We deal with public and private hospitals in different ways. Public hospitals are mainly funded by both the state and federal governments, while private hospitals and day procedures are funded by a number of sources, including private health insurance and the federal government.

For more information, see:

How much we will pay

Public hospitals

We will pay the cost of treatment provided in public hospitals in Victoria in line with the Department of Health and Human Services Fees Manual.

Private hospitals

We will pay the cost of treatment provided in private hospitals in Victoria in line with arrangements and contracts we have in place with each provider.

When there is no existing arrangement in place, fees are paid in line with the Private hospital (non-arrangement) services fee schedule.

We will pay for your treatment and services according to our fee schedule. If your private hospital charges more than the TAC rate, you may need to pay the difference.

Contracted private hospitals:

  • Epworth (all locations)
  • Healthe Care (Brunswick Private Hospital, South Eastern Private Hospital and The Valley Private Hospital)
  • Healthscope (Victorian Rehabilitation Centre and North East Rehabilitation Centre)

Arrangement private hospitals:

  • The Avenue Private Hospital
  • Bayside Private Hospital
  • Donvale Rehabilitation Hospital
  • Dorset Rehabilitation Hospital
  • Jessie McPherson Private Hospital
  • Knox Private Hospital
  • The Melbourne Clinic
  • Peninsula Private Hospital
  • Cabrini Hospital (Malvern and Brighton locations)
  • St John of God Ballarat
  • Warringal Private Hospital

In other States and Territories of Australia, payment is made on a case-by-case basis.

For providers

If you are a private hospital provider please refer to our TAC provider guidelines or your relevant contract and arrangement documents.