Acupuncture guidelines

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

Who can provide acupuncture services?

You can provide services if:

  • You are registered as a Chinese medicine practitioner in the Division of Acupuncturists under the Health Practitioner Regulation National Law, or
  • Your registration is endorsed under section 97 of the Health Practitioner Regulation National Law as being qualified to practice as an acupuncturist. For example, if you are endorsed by the Osteopathy or Physiotherapy Boards of Australia.

What we can pay for

We can pay the reasonable costs of your patient’s acupuncture, without prior approval, immediately after a transport accident when it is required as a result of a transport accident injury.

We will review our client’s treatment to ensure it’s reasonable, clinically justified, outcome focused and in line with the Clinical Framework. We'll ask you and our client for information during these reviews and may temporarily stop funding treatment if we don’t receive it. When requested, you must complete the Allied health treatment and recovery plan and return it to us. We may temporarily cease funding our client’s treatment until the plan is received.

Reviews help us understand our client’s injuries, treatment needs and goals and how to best support them to get their life back on track. After a review we’ll let you and our client know the decision regarding further treatment.

We can pay for:

  • Acupuncture consultations, including lasers and dry needling techniques.
  • Provision of basic equipment. Our approval is required for specialised equipment. Use the Equipment Prescription Form to submit written requests.

Other things to note

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.

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

Gap in treatment

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.

How much we can pay

We can pay for services in line with our Chinese medicine (acupuncture) fees.

What we cannot pay for

We cannot pay for:

  • Any form of treatment from a Chinese medicine practitioner other than acupuncture, such as alternative therapy, Chinese herbs and medicines etc.
  • The cost of disposable acupuncture needles or dressings.
  • Services that are included in a hospital inpatient bed fee.