Effective 1 July 2017
| Service Description | TAC Item Number | 2017/2018 Maximum Payment Rate | 2016/2017 Maximum Payment Rate |
|---|---|---|---|
| INPATIENT SERVICES | |||
| Advanced Surgical Patients | 1 - 14 Days | $732.64 | $714.91 |
| 15 + Days | $563.78 | $550.14 | |
| General Surgical Patients | 1 - 14 Days | $656.07 | $640.19 |
| 15 + Days | $563.78 | $550.14 | |
| Special Medical Patients | 1 - 14 Days | $656.07 | $640.19 |
| 15 + Days | $555.70 | $542.25 | |
| General Medical Patients | 1 - 14 Days | $512.79 | $500.38 |
| 15 + Days | $473.00 | $461.55 | |
| Psychiatric Patients | 1 - 30 Days | $656.07 | $640.19 |
| 31 - 65 Days | $555.70 | $542.25 | |
| 66 + Days | $473.00 | $461.55 | |
| Rehabilitation Patients | 1 - 25 Days | $640.19 | $624.70 |
| 26 + Days | $488.88 | $477.05 | |
| Intensive Care Unit^ | 1 - 4 Days | $1,789.50 | $1,746.19 |
| 5 + Days | Original Patient Classification or High Dependency Unit | ||
| Intensive Care Unit (Metropolitan)^ | 1 - 4 Days | $2,679.39 | $2,614.55 |
| 5 + Days | Original Patient Classification or High Dependency Unit | ||
| Coronary Care Unit^ | 1 - 4 Days | $1,596.80 | $1,558.16 |
| 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 | $1,109.79 | $1,082.93 |
| 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. | $181.49 | $177.10 | |
| Same Day Patient Bed Fee Only applicable if a procedure or operation is performed. | $253.33 | $247.20 | |
| Bed Leave / Hospital Leave Fee | 75% of the applicable bed fee | ||
| Hospital in the Home | HIT | $367.42 | $358.53 |
| Facility Fee - Emergency Department Patients A facility fee is only payable to hospitals with an approved Emergency Department. | $42.42 | $41.39 | |
| Theatre Fees | |||
| Band | 1A | $101.98 | $99.51 |
| 1 | $320.53 | $312.77 | |
| 2 | $455.15 | $444.14 | |
| 3 | $571.66 | $557.83 | |
| 4 | $747.43 | $729.34 | |
| 5 | $1,008.69 | $984.28 | |
| 6 | $1,259.69 | $1,229.21 | |
| 7 | $1,696.68 | $1,655.62 | |
| 8 | $2,259.94 | $2,205.25 | |
| 9A | $2,468.48 | $2,408.74 | |
| 9 | $3,299.42 | $3,219.57 | |
| 10 | $4,509.76 | $4,400.62 | |
| 11 | $4,928.51 | $4,809.24 | |
| 12 | $6,204.42 | $6,054.27 | |
| 13 | $7,010.94 | $6,841.28 | |
| 0 (Lithotripsy) | $3,023.63 | $2,950.46 | |
| Electroconvulsive Therapy | $229.42 | $223.87 | |
| (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 | $54.49 | $53.17 |
| Group Session | 99922 | $32.86 | $32.06 |
| Dietician | |||
| Individual Session | 99917 | $49.81 | $48.60 |
| Driving Assessment | |||
| Driving Assessment by Occupational Therapist | 99921 | $54.94 | $53.61 |
|
Driving Instruction By Driving School (30 minutes) (charge in 30 minute units) | 99957* | $52.25 | $50.99 |
| Occupational Therapy | |||
| Individual Session | 99920 | $49.81 | $48.60 |
| Group Session | 99919 | $29.95 | $29.23 |
| Worksite / Home Assessment & Report (charge in 30 min units) | 99967 | $49.81 | $48.60 |
| Physical Education | |||
| Individual Session | 99958* | $49.81 | $48.60 |
| Group Session | 99959* | $29.95 | $29.23 |
| Physiotherapy | |||
| Individual Session | 99913 | $54.49 | $53.17 |
| Group Session | 99914 | $32.86 | $32.06 |
|
Worksite / Home Assessment & Report (charge in 30 min units) | 99966 | $54.49 | $53.17 |
| Podiatry | |||
| Individual Session | 99941 | $49.81 | $48.60 |
| Psychology | |||
| Individual Session | 99908 | $85.47 | $83.40 |
| Group Session | 99907 | $51.31 | $50.07 |
| Rehabilitation Assessments & Reports | |||
| Initial Assessment and Preparation of Rehabilitation Plan | 99904 | $555.34 | $543.85 |
| Medical & Like Report / Reviews (Only payable when requested by TAC) | 99905* | $211.97 | $206.84 |
| Rehabilitation Counselling | |||
| Individual Session | 99928 | $47.43 | $46.28 |
| Group Session | 99937 | $28.28 | $27.60 |
| Social Work | |||
| Individual Session | 99940 | $49.81 | $48.60 |
| Group Session | 99952 | $29.95 | $29.23 |
| Special Education / Accredited Teacher | |||
| Individual Session | 99912* | $47.87 | $46.71 |
| Group Session | 99936* | $28.64 | $27.95 |
| Speech Therapy | |||
| Individual Session | 99930 | $49.81 | $48.60 |
| Group Session | 99929 | $29.95 | $29.23 |
^Reimbursements will be made only to hospitals with approved facilities
GST
*The TAC maximum fee includes a 10% allowance for GST for items which TAC believes are taxable supplies. If you are a provider not registered for GST:
- You are not legally permitted to charge GST
- You should indicate on all invoices submitted your status as 'not registered for GST purposes'
- The TAC will only reimburse you an amount which excludes the GST component for items billed where the maximum fee includes a 10% allowance for GST
If you are not registered for GST please state on all invoices the TAC item number listed for providers not registered.