Massage/Myotherapy

Policy

For accidents on or after 1 January 1987 the TAC will consider funding the reasonable cost of massage/myotherapy services for injuries sustained by a TAC client in a transport accident when the treatment is performed by a physiotherapist, chiropractor or osteopath who is registered under the Health Practitioner Regulation National Law to practice in that profession.

Transport Accident Act 1986 reference: s.3 'medical service' and s.60

The TAC can only fund the reasonable cost of massage/myotherapy services provided by a masseur or myotherapist for injuries sustained by a client in a transport accident which occurred prior to 1 January 1987 (MAB claims).

Transport Accident Act 1986 reference: s.134 'therapeutic service' and s.145(e)

Background

The TAC has developed the Clinical Framework for the Delivery of Health Services (Clinical Framework) to set out key principles for delivery of services to clients.

The Clinical Framework is based on the following principles:

• Measurement and demonstration of the effectiveness of treatment
• Adoption of a biopsychosocial approach
• Empowering the client to manage their injury
• Implementing goals focused on optimising function, participation and/or return to work/health
• Base treatment on best available research evidence.

The TAC expects that all health professionals providing services to clients integrate the principles of the Clinical Framework into their daily practice.

Further information about the Clinical Framework can be found at www.tac.vic.gov.au

Definition

Massage/Myotherapy is used to assist in reducing muscle tightness and improve circulation and tissue repair.

Guidelines

What massage/myotherapy treatment will the TAC fund?

The TAC will consider funding the reasonable cost of massage/myotherapy treatment where:

• there is clinical justification for treatment, and
• the treatment is likely to be effective and achieve or maintain a measurable functional improvement, and
• the treatment promotes progress towards functional independence, participation and self management.

Fees for treatment are paid on a consultation basis in accordance with the TAC Fee Schedule for the relevant discipline.

What information does the TAC require to consider funding of massage/myotherapy treatment?

For Transport Accidents on or after 1 January 1987:
Provider reporting and billing requirements for Physiotherapists, Chiropractors and Osteopaths are outlined in the following TAC policies:

• Physiotherapy
• Chiropractic
• Osteopathy

Providers should read this Massage/Myotherapy policy in conjunction with the relevant policy for their discipline.

For Transport Accidents prior to 1 January 1987:

For clients with a 'severe injury' treatment will be approved as part of the independence planning process. The masseur will be required to submit initial baseline measures within 10 working days of approval of treatment from the TAC. Outcome measures are to be recorded throughout the treatment and provided to the TAC upon request.

For all other clients, the following information is required in writing from a masseur:

• accident injuries and clinical diagnosis
• reported symptoms and findings from physical assessment
• current objective and measurable functional limitations and goals of treatment with expected time frame for achievement
• proposed treatment plan including commencement and anticipated end dates
• where the client attended the practice prior to the accident, information regarding previous intervention including the condition treated and the treatment period.

For all clients the TAC may contact the client or masseur for further information if required. Masseurs should not submit a written report unless specifically requested by the TAC. 

Will the TAC consider funding concurrent treatment?

Refer to the Concurrent Physical Treatment by Health Care Providers policy.

Can the TAC fund massage/myotherapy services performed by a member of a client's immediate family?

Refer to the Funding Treatment by a Member of a Client's Immediate Family policy.

What will the TAC not fund?

• treatment or services for a person other than the injured client
• treatment or services for a condition that existed before the transport accident or that is not a direct result of the transport accident
• treatment or service where there is no clinical justification for this service
• treatment, services or equipment where there is no published evidence in a recent peer-reviewed journal article that the treatment, service or equipment is safe and effective. Refer to the Non-Established, New or Emerging Treatments and Services policy
• more than one massage/myotherapy consultation per day
• massage/myotherapy treatment provided by a masseur for accidents that occurred on or after 1 January 1987
• the cost of telephone calls and telephone consultations between providers and clients, and between other providers, including hospitals
• treatment or services subcontracted to a non-registered provider
• treatment or services provided outside the Commonwealth of Australia
• treatment or services provided more than 2 years prior to the request for funding except where the request for payment is made within 3 years of the transport accident. Refer to the Time Limit to Apply for the Payment of Medical and Like Expenses policy.