Who can provide occupational therapy services?

You can provide services if you are registered under the Health Practitioner Regulation National Law (e.g. AHPRA) to practice in the occupational therapy profession (other than as a student) and registered with the Occupational Therapy Board of Australia.

What we can pay for

Within the first 90 days of a client’s accident, we can help pay for the reasonable costs of an initial occupational therapy assessment and report without the need for you or the client to contact us for approval first. Our client may access services independently or following a referral from a medical practitioner or on discharge from hospital.

Following the initial assessment and report, we may help pay for the reasonable costs of the services listed below, after a review of the treatment plan.

Treatments or services 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.

The treating occupational therapist may recommend Allied Health Assistants at the rates approved by the TAC. Allied Health Assistance cannot be charged at the same rate as an occupational therapist.

Occupational therapists must ensure their insurance policy covers employing an Allied Health Assistant. When engaging an independent Allied Health Assistant, the occupational therapist must ensure the Allied Health Assistant holds the appropriate qualifications, experience, relevant liability and/or personal indemnity insurances and, where relevant, a current police check, working with children check and/or working with vulnerable people check. Occupational therapists are expected to:

1. provide the TAC with a program of activity when delegating to a Grade 2 or 3 Allied Health Assistant
2. refer and delegate to appropriately experienced and qualified Allied Health Assistants
3. ensure Allied Health Assistants are following the prescribed delegated program of activity while supporting the client to achieve their TAC approved goal
4. identify when a TAC client requires clinical support from an Allied Health Assistant delivering rehabilitation services or when the support is more appropriately delivered by

Attendant Care disability services such as disability maintenance and non-clinical support e.g. daily living.

Treatment and services

We can help pay for:

• Attending multidisciplinary consultation and team meetings.
• Hand Therapy via Accredited Hand Therapists.

Assessments and recommendations

We can help pay for assessments and recommendations related to:

• Home services
• Activities of daily living
• Assistive technology
• Home modifications
• Vehicle modifications
• Driving programs/lessons
• Vocational and return to work plans
• Transport and travel training
• Attendant care programs, including carer training, community access guidelines for a client and reviews of client functional capabilities
• Support and monitoring for clients engaged in community group programs
• Disability support services
• Neurobehavioural rehabilitation services

You can access a complete list of OT assessment forms. A TAC claim manager will direct you to the appropriate form when required.

Travel

We can help pay for:

• Travel to conduct treatment in the community, where this is clinically justified.

Travel time can be paid for travel to and from your practice address and your client's residence. Where more than one client is visited in a single travel period, total travel costs should be apportioned equally between clients. Travel should be a reasonable distance from your practice and invoiced in 15-minute increments.

Assistive technology

We can help pay for:

• Provision of basic assistive technology, including the supply of splints, supports and orthoses. Please read our Equipment guidelines for details on assistive technology prescription and what we can pay for.

For specialised equipment, use the Assistive technology assessment and recommendations form to submit written requests for specialised items such as wheelchairs and bathroom equipment.

Driving assessments

We can help pay for:

• Driving assessments performed by a VicRoads-authorised occupational therapist in cases where the transport accident injury imposes physical, psychological or cognitive restrictions on driving.

Other things to note

Certificates of Capacity

As part of the client’s treatment, you can complete Certificates of Capacity to assess and certify the client’s capacity for work.

Concurrent treatments

Concurrent allied health treatments are not generally recommended to treat the same injury. This is line with the principles of the Clinical Framework. There can be some exceptions, such as group exercise.

If you or your patient believe concurrent allied health treatments are necessary, please contact us to discuss their needs.

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.

Clients with a severe injury

If the client has a severe injury, the discussion, referral and approval of services will form part of the independence planning process between the client's treating team and one of the TAC's support coordinators.

If the client already has an individualised funding package, occupational therapy services may be included as part of that.

How much we can pay

Occupational therapists will be paid in line with our Occupational therapy fees.

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 services that are included as part of a hospital inpatient bed fee.

Also see general items we cannot pay for.

For more information

Access our policy for Occupational therapy.