Podiatrist guidelines

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

Who can provide podiatry services?

You can provide services if you are registered under the Health Practitioner Regulation National Law (e.g. AHPRA) to practice in the podiatry profession (other than as a student).

What we can pay for

We can pay the reasonable costs of your patient’s podiatry services, without prior approval, immediately after a transport accident when they are 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.

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:

  • Podiatry consultations.
  • Biomechanical examinations.
  • Orthomechanical services and procedures, such as impressions and models, prescription orthoses and simple digital or partial prosthesis.
  • Out of rooms consultations, where a patient is medically unfit to travel.
  • Visits to a patient who is an inpatient at a private hospital, where the cost of podiatry is not included in the hospital bed fee.
  • X-rays of the lower extremity, foot and ankle.
  • In-rooms podiatric surgery. For podiatric surgery occurring in hospital, see our Medical practitioner guidelines and Private hospital guidelines.

We can also pay for the provision of basic equipment, such as:

  • adaptive, modified or custom made orthopaedic footwear
  • modifications to a patient’s pre-injury footwear or off the shelf footwear
  • footwear that is required to accommodate an orthosis
  • prescription, manufacture, supply and fitting of an orthosis
  • repair, adjustment or replacement of a pre-existing orthosis damaged in a transport accident
  • prosthetic devices and splints

Our approval is required for specialised equipment. Please read our Medical and rehabilitation equipment guidelines and 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.
  • As part of your patient’s treatment, you can complete Certificates of Capacity to assess and certify your patient’s capacity for work.
  • 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.
  • If your patient already has an individualised funding package, podiatric services may be included as part of that.

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 Podiatry fees.

What we cannot pay for

We cannot pay for:

  • repair or replacement of an orthoses that was not damaged as a result of the transport accident injury
  • maintenance, repair, modification or replacement of an orthoses under warranty
  • footwear normally issued by an employer
  • non-orthopaedic or standard off the shelf footwear that is not required to fit custom modifications or orthotics required as a result of an accident