Drug and alcohol services guidelines
These guidelines should be read in conjunction with our General provider guidelines.
Who can provide drug and alcohol services?
Services can be provided by the following providers:
- Victorian Department of Health and Human Services (DHHS) funded alcohol and other drug services that comply with the Alcohol and Other Drug Program Guidelines 2017
- medical practitioners, including psychiatrists, with relevant qualifications and experience in treating drug and alcohol dependence
- a public or private hospital or a day procedure centre as defined by the Health Services Act 1988
What we can pay for
We have approved and can pay the reasonable costs of drug and alcohol services immediately after a transport accident to treat a drug and/or alcohol dependency condition that has developed as a direct result of the client’s transport accident injuries. Your client must be referred by a treating health practitioner.
We can pay for DHHS-funded drug and alcohol services, including:
- the DirectLine statewide screening and referral service
- catchment-based intake
- non-residential withdrawal
- residential withdrawal
- therapeutic day rehabilitation
- residential rehabilitation
- care and recovery coordination
- youth alcohol and other drug services
- Aboriginal alcohol and other drug services
- forensic alcohol and other drug services
We can pay for DHHS-funded drug and alcohol additional supports, including:
- drug and alcohol clinical advisory service
- statewide neuropsychology service
- the Victorian Dual Diagnosis Initiative
- women’s drug and other drug services
- mother and baby residential withdrawal unit
- compulsory drug withdrawal services
We can pay for services that include:
- consultations with medical practitioners
- consultations with psychologists
- drug services conducted by a private, denominational or public hospital
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.
Reviews help us understand our client’s injuries, treatment needs, their goals and how to best support them get their lives back on track. After a review we’ll let you and our client know the decision regarding further treatment.
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.
For clients with a severe injury, the discussion, referral and approval of drug and alcohol services may form part of the independence planning process between the client’s treating team and the TAC coordinator.
How much we can pay
We can pay for services in line with:
- the fees charged by DHHS, or
- the applicable fee schedule for relevant hospital or provider services
What we cannot pay for
We cannot pay for:
- services that are not clinically effective, reasonable or necessary
- services for an injury, condition or circumstance that existed before a transport accident or is not a direct result of a transport accident
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.