These guidelines should be read in conjunction with our General provider guidelines.

Who can provide orthoptic services?

You can provide services if you are eligible for registration with the Australian Orthoptic Board.

What we can pay for

Within the first 90 days of a client’s accident, we can help pay for orthoptic treatment or services without the need for you or the client to contact us for approval first. The treatment or service must be recommended by a health professional, related to the client’s accident injuries and delivered in line with the Clinical Framework.

If you intend to continue treating a TAC client beyond 90 days after their transport accident you will need to send us a request in writing or a copy of their treatment plan. We will review our client’s treatment to ensure it’s reasonable, clinically justified, outcome focused and in line with the Clinical Framework. We will assess your request and let you and the client know our decision about what we can help pay for and for how long.

If our client has not received treatment in 6 months they will need to seek approval from us before we will pay for further treatment. Ask our client for a copy of their approval if you haven’t seen them in 6 months.

For details see What we can pay for and How to seek TAC approval.

Orthoptic services

We can help pay for:

  • Orthoptic consultations.
  • Services that are part of a rehabilitation program.
  • Provision of  basic equipment. Our approval is required for specialised equipment. Please read our Equipment guidelines and use the Equipment Prescription Form to submit written requests.

Other things to note

Medical excess

For accidents that occurred prior to 14 February 2018 a medical excess may apply. Visit the medical excess page to see if it applies to your patient.  If the medical excess applies you will need to invoice the client directly.

Patients with a severe injury

If your patient has a severe injury, the discussion, referral and approval of services may form part of the independence planning process between the patient's treating team and our TAC coordinator.

If your patient already has an individualised funding package, orthoptic services may be included as part of that.

How much we can pay

We can pay for services in line with our Orthoptic services fees.

Fees for orthoptic services performed within a public hospital will be based on DHHS Schedule of Fees and Charges for acute health services in Victoria.

If your fee is higher than our fee, you may choose to charge the client the difference in the form of a gap payment.

What we cannot pay for

We cannot pay for the cost of travel for an orthoptist, as this cost is covered in the out of rooms fee rates.

For more information

Access our policy for Optical, orthoptic and optometry services.