Workers’ Compensation and Injury Management Act 1981

Workers’ Compensation and Injury Management (Scales of Fees) Regulations 1998

 

Workers’ Compensation and Injury Management (Scales of Fees) Regulations 1998

CONTENTS

1.Citation1

2.Scales of fees — medical specialists and other medical practitioners1

3.Scale of fees — physiotherapists2

4.Scale of fees — chiropractors2

5.Scale of fees — occupational therapists2

6.Scale of fees — clinical psychologists2

6A.Scale of fees — counselling psychology3

7.Scale of fees — speech therapists3

7A.Scale of fees — osteopaths3

7B.Scale of fees — exercise physiologists4

8.Scale of fees — vocational rehabilitation providers4

9.Scale of maximum fees — approved medical specialists4

10.Effect of GST5

Schedule 1 — Scale of fees: medical specialists and other medical practitioners

Part 1 — Medical specialists and other medical practitioners

Part 2 — Medical procedures

Part 3 — Diagnostic Imaging Services

Schedule 2 — Scale of fees: physiotherapists

Part 1 — General

Part 2 — Exercise‑based programs

Schedule 3 — Scale of fees: chiropractors

Schedule 4 — Scale of fees: occupational therapists

Schedule 5 — Scale of fees: speech pathologists

Schedule 5A — Scale of fees: exercise physiologists

Exercise‑based programs

Schedule 6 — Scale of maximum fees: approved medical specialists

Part 1 — Assessments

Part 2 — Attempted assessments

Notes

Compilation table81

Defined Terms

 

Workers’ Compensation and Injury Management Act 1981

Workers’ Compensation and Injury Management (Scales of Fees) Regulations 1998

1.Citation

These regulations may be cited as the Workers’ Compensation and Injury Management (Scales of Fees) Regulations 1998 1.

[Regulation 1 amended in Gazette 1 Nov 2005 p. 4977.]

2.Scales of fees — medical specialists and other medical practitioners

(1)Under section 292(2)(a)(i) of the Act, the scales of fees set out in Schedule 1 are prescribed as the scales of fees to be paid to medical specialists and other medical practitioners for attendance on, and treatment of, workers suffering injuries that are compensable under the Act.

(2)In Schedule 1 — 

MBS item number means the item number corresponding to a radiological service described in the Medicare Benefits Schedule published by the Commonwealth Department of Health and Aged Care, as at November 2006.

[Regulation 2 amended in Gazette 28 Dec 2001 p. 6691; 23 Sep 2003 p. 4174; 19 Mar 2004 p. 863; 11 Nov 2005 p. 5569 and 5570; 22 Dec 2006 p. 5757-8; 7 Dec 2007 p. 6034.]

3.Scale of fees — physiotherapists

(1)Under section 292(2)(a)(iii) of the Act, the scale of fees set out in Schedule 2 is prescribed as the scale of fees to be paid to physiotherapists for attendance on, and treatment of, workers suffering injuries that are compensable under the Act.

[(2)deleted]

[Regulation 3 amended in Gazette 21 Jan 2005 p. 278; 11 Nov 2005 p. 5569 and 5570; 22 Dec 2006 p. 5757-8; 7 Dec 2007 p. 6034.]

4.Scale of fees — chiropractors

Under section 292(2)(a)(iv) of the Act, the scale of fees set out in Schedule 3 is prescribed as the scale of fees to be paid to chiropractors for attendance on, and treatment of, workers suffering injuries that are compensable under the Act.

[Regulation 4 amended in Gazette 11 Nov 2005 p. 5569 and 5570; 22 Dec 2006 p. 5757-8; 7 Dec 2007 p. 6034.]

5.Scale of fees — occupational therapists

Under section 292(2)(a)(v) of the Act, the scale of fees set out in Schedule 4 is prescribed as the scale of fees to be paid to occupational therapists for attendance on, and treatment of, workers suffering injuries that are compensable under the Act.

[Regulation 5 amended in Gazette 11 Nov 2005 p. 5569 and 5570; 22 Dec 2006 p. 5757-8; 7 Dec 2007 p. 6034.]

6.Scale of fees — clinical psychologists

(1)Under section 292(2)(a)(vi) of the Act, the hourly rate of $202.35 per hour is prescribed as the fee to be paid to clinical psychologists for attendance on, and treatment of, workers suffering injuries that are compensable under the Act.

(2)The hourly rate under subregulation (1) is also payable for compiling a treatment report, but the hours required to compile a report cannot exceed 3 hours per report.

[Regulation 6 inserted in Gazette 22 Dec 2006 p. 5758; amended in Gazette 7 Dec 2007 p. 6035; 17 Dec 2008 p. 5290; 30 Oct 2009 p. 4345; 29 Oct 2010 p. 5348.]

6A.Scale of fees — counselling psychology

Under section 292(2)(a)(viii) of the Act, the hourly rate of $202.35 per hour is prescribed as the fee to be paid to a psychologist providing counselling services for the treatment of a worker suffering injuries that are compensable under the Act.

Note:“Counselling psychology” was approved as an “approved treatment” under section 5(1) of the Act in Gazette 10/1/2003, p. 55.

[Regulation 6A inserted in Gazette 22 Dec 2006 p. 5758; amended in Gazette 7 Dec 2007 p. 6035; 17 Dec 2008 p. 5290; 30 Oct 2009 p. 4346; 29 Oct 2010 p. 5348.]

7.Scale of fees — speech therapists

Under section 292(2)(a)(vii) of the Act, the scale of fees set out in Schedule 5 is prescribed as the scale of fees to be paid to speech pathologists for attendance on, and treatment of, workers suffering injuries that are compensable under the Act.

[Regulation 7 amended in Gazette 11 Nov 2005 p. 5569 and 5570; 22 Dec 2006 p. 5757-8; 7 Dec 2007 p. 6035.]

7A.Scale of fees — osteopaths

Under section 292(2)(a)(viii) of the Act, the amount of $64.05 is prescribed as the fee to be paid to an osteopath for an osteopathic consultation with a worker suffering injuries that are compensable under the Act.

Note:“Osteopathy” was approved as an “approved treatment” under section 5(1) of the Act in Gazette 29/9/2000, p. 5564.

[Regulation 7A inserted in Gazette 22 Dec 2006 p. 5759; amended in Gazette 7 Dec 2007 p. 6035; 17 Dec 2008 p. 5290; 30 Oct 2009 p. 4346; 29 Oct 2010 p. 5348.]

7B.Scale of fees — exercise physiologists

Under section 292(2)(a)(viii) of the Act, the scale of fees set out in Schedule 5A is prescribed as the scale of fees to be paid to exercise physiologists for attendance on, and treatment of, workers suffering injuries that are compensable under the Act.

[Regulation 7B inserted in Gazette 17 Dec 2008 p. 5290.]

8.Scale of fees — vocational rehabilitation providers

Under section 292(2)(b) of the Act, the hourly rate of $151.10 per hour is prescribed as the fee to be paid to approved providers of vocational rehabilitation services when those services are provided to workers in accordance with the Act.

[Regulation 8 amended in Gazette 21 Dec 2000 p. 7626; 28 Dec 2001 p. 6692; 23 Sep 2003 p. 4174; 9 Jan 2004 p. 99; 21 Jan 2005 p. 279; 11 Nov 2005 p. 5569; 10 Jan 2006 p. 44; 22 Dec 2006 p. 5759; 7 Dec 2007 p. 6036; 17 Dec 2008 p. 5291; 30 Oct 2009 p. 4346; 29 Oct 2010 p. 5348.]

9.Scale of maximum fees — approved medical specialists

(1)Under section 292(3) of the Act, the scale of maximum fees set out in Schedule 6 is prescribed as the scale of maximum fees to be paid to approved medical specialists for making or attempting to make assessments referred to in Part VII Division 2 of the Act.

(2)In Schedule 6 Part 1 —

assessor has the meaning given by the WorkCover Guides;

report and certificate means a report referred to in section 146H(1)(a) of the Act and a certificate referred to in section 146H(1)(b) of the Act.

[Regulation 9 inserted in Gazette 11 Nov 2005 p. 5567‑8.]

10.Effect of GST

(1)In this regulation —

GST has the meaning given in A New Tax System (Goods and Services Tax) Act 1999 of the Commonwealth.

(2)An amount fixed by these regulations is a net figure that does not include any GST that may be imposed due to the nature of the provision of the service or the service provider.

(3)If GST is payable on a service listed in these regulations, the fee for the service is the applicable fee increased by 10%.

(4)An injured worker’s prescribed entitlements are to be calculated using the net cost of the treatment or service, without deducting any GST component.

[Regulation 10 inserted in Gazette 7 Dec 2007 p. 6036.]

 

Schedule 1 — Scale of fees: medical specialists and other medical practitioners

[r. 2]

[Heading inserted in Gazette 29 Oct 2010 p. 5348.]

Part 1 — Medical specialists and other medical practitioners

[Heading inserted in Gazette 28 Dec 2001 p. 6692.]

Type of service/by whom

 

Fee

$

GENERAL PRACTITIONER

CONSULTATIONS

Surgery Consultation

in hours

Content based

 

Minor or Specific Service (Level A or B)

$62.90

Extended Service (Level C)

$114.95

Comprehensive Service (Level D)

$176.70

Time based

 

up to 5 minutes

$37.50

more than 5 minutes to 15 minutes

$48.95

more than 15 minutes to 30 minutes

$94.45

more than 30 minutes to 45 minutes

$142.85

more than 45 minutes to 60 minutes

$193.60

Surgery Consultations

out of hours

For attendances between the hours of 6 p.m. and 8 a.m. on a weekday or between 12 noon on Saturday and 8 a.m. on the following Monday, and Public Holiday.


Content based

 

Minor Service (Level A)

$47.20

Specific Service (Level B)

$94.45

Extended Service (Level C)

$171.95

Comprehensive Service (Level D)

$266.20

Time based

 

up to 5 minutes

$74.75

more than 5 minutes to 15 minutes

$81.10

more than 15 minutes to 30 minutes

$125.75

more than 30 minutes

$171.95

VISITS

Consultations at a place other than the Consulting Rooms

in hours

 

Minor Service (Level A)

$78.75

Specific Service (Level B)

$107.65

Extended Service (Level C)

$159.75

Comprehensive Service (Level D)

$222.65

out of hours

 

Minor Service (Level A)

$94.45

Specific Service (Level B)

$140.40

Extended Service (Level C)

$215.45

Comprehensive Service (Level D)

$314.65

TELEPHONE CONSULTATIONS

Time based

 

up to 5 minutes

$21.00

more than 5 minutes to 15 minutes

$26.30

more than 15 minutes to 30 minutes

$55.05

more than 30 minutes

$82.45

CASE CONFERENCES, discussions with employers/insurers, rehabilitation providers, workplace assessments, etc.

per hour

$236.65

TRAVELLING FEES

Rate per kilometre

$4.25

PHYSICIANS, OCCUPATIONAL & REHABILITATION PHYSICIANS

PHYSICIANS

CONSULTATIONS

Professional attendance at consulting rooms and issue of certificate (if required) et al

 

first attendance

$238.90

subsequent attendances

$119.55

VISITS

Professional attendance at a place other than consulting rooms and issue of certificate (if required) et al

 

first attendance

$286.15

subsequent attendances

$165.15

REHABILITATION PHYSICIANS

CONSULTATIONS

Professional attendance at consulting rooms and issue of certificate (if required) et al

 

first attendance

$238.90

subsequent attendances

$119.55

VISITS

Professional attendance at a place other than consulting rooms and issue of certificate (if required) et al

 

first attendance

$286.15

subsequent attendances

$165.15

OCCUPATIONAL PHYSICIANS

CONSULTATIONS

Professional attendance at consulting rooms and issue of certificate (if required) et al

 

first attendance

$242.90

subsequent attendances

$119.55

VISITS

Professional attendance at a place other than consulting rooms and issue of certificate (if required) et al

 

first attendance

$286.15

subsequent attendances

$165.15

TELEPHONE CONSULTATIONS

Time based

 

up to 5 minutes

$31.40

more than 5 minutes to 15 minutes

$38.70

more than 15 minutes to 30 minutes

$80.85

more than 30 minutes

$122.05

CASE CONFERENCES, discussions with employers/insurers, rehabilitation providers, workplace assessments, etc.

per hour

$350.95

TRAVELLING FEES

Rate per kilometre

$4.25

CONSULTANT PSYCHIATRISTS

CONSULTATIONS

Professional attendance at consulting rooms and issue of certificate (if required) et al

Time based

 

up to 15 minutes

$70.05

more than 15 minutes to 30 minutes

$139.85

more than 30 minutes to 45 minutes

$209.45

more than 45 minutes to 60 minutes

$280.20

more than 60 minutes to 75 minutes

$317.10

more than 75 minutes

$353.95

VISITS

Professional attendance at a place other than consulting rooms and issue of certificate (if required) et al
Visits include both attendance at hospitals and home visits

Time based

 

up to 15 minutes

$115.05

more than 15 minutes to 30 minutes

$185.85

more than 30 minutes to 45 minutes

$253.60

more than 45 minutes to 75 minutes

$324.45

more than 75 minutes

$390.90

TELEPHONE CONSULTATIONS

Time based

 

up to 45 minutes

$92.95

more than 45 minutes

$203.00

CASE CONFERENCES, discussions with employers/insurers, rehabilitation providers, workplace assessments, etc.

per hour

$350.95

TRAVELLING FEES

Rate per kilometre

$4.25

SPECIALISTS

SURGEONS

CONSULTATIONS

Professional attendance at consulting rooms and issue of certificate (if required) et al

 

first attendance

$135.85

subsequent attendances

$70.85

VISITS

Professional attendance at a place other than consulting rooms and issue of certificate (if required) et al

 

first attendance

$183.10

subsequent attendances

$116.70

DERMATOLOGISTS

CONSULTATIONS

Professional attendance at consulting rooms and issue of certificate (if required) et al

 

first attendance

$135.85

subsequent attendances

$70.85

VISITS

Professional attendance at a place other than consulting rooms and issue of certificate (if required) et al

 

first attendance

$182.80

subsequent attendances

$116.50

TELEPHONE CONSULTATIONS

Time based

 

up to 5 minutes

$31.40

more than 5 minutes to 15 minutes

$38.70

more than 15 minutes to 30 minutes

$80.85

more than 30 minutes

$122.05

CASE CONFERENCES, discussions with employers/insurers, rehabilitation providers, workplace assessments, etc.

per hour

$350.95

TRAVELLING FEES

Rate per kilometre

$4.25

ANAESTHETISTS

All anaesthesia fees are calculated by multiplying the units for the consultation, attendance, procedure or service by the $ value per unit allocated by this Schedule.

$ VALUE PER UNIT

$ value per unit

$70.65

CONSULTATIONS AND ATTENDANCES

Units

 

Anaesthetist Consultation

 

 — an attendance of 15 minutes or less duration

2

 — an attendance of more than 15 minutes but not more than 30 minutes duration

4

 — an attendance of more than 30 minutes but not more than 45 minutes duration

6

 — an attendance of more than 45 minutes duration

8

Post anaesthesia patient care following a day procedure

2

EMERGENCY ATTENDANCES

 

After hours — where immediate attendance is required after 6 p.m. and before 8 a.m. on any weekday, or at any time on a Saturday, Sunday or a public holiday

6

Note: No after hours loading applies to the above item

 

Attendance on a patient in imminent danger of death requiring continuous life saving emergency treatment to the exclusion of all other patients

6

Call back from home, office or other distant location for the provision of emergency services

4

PROCEDURES AND SERVICES

All anaesthesia fees in relation to procedures and services are to be charged on the relative value guide (RVG) system. In most cases, the RVG system comprises 3 elements: base units (BUs), modifying units (MUs) and time units (TUs).

In Part A, the fee for a procedure is calculated by adding the base units for the procedure, the time units, and any modifying units and multiplying the result by the $ value per unit allocated by this Schedule.

(BUs + TUs + MUs ) x $ value per unit = Fee

In Part B, the fee for a therapeutic or diagnostic service only includes modifying units (MUs), and time units (TUs) if the item notes that service as including either or both.

Base units

The appropriate number of base units for each procedure has been established and is set out in this Schedule.

[The number of base units for each procedure has been calculated so as to include usual postoperative visits, the administration of fluids and/or blood incidental to the anaesthesia care and usual monitoring procedures.]

Time units

For the first 2 hours, each 15 minutes (or part thereof) of anaesthetic time constitutes one time unit. After 2 hours, time units are calculated at one per 10 minutes (or part thereof).

Modifying units

Many anaesthetic services are provided under particularly difficult circumstances depending on factors such as the medical condition of the patient and unusual risk factors. These factors significantly affect the character of the anaesthetic services provided. Circumstances giving rise to additional modifying units are set out in this Schedule.

[Note: The modifying units are, in the main, derived from the modifying units set out in the AMA’s “List of Medical Services and Fees”.]

 

Description

Units

A normal healthy patient

0

A patient with a mild systemic disease

0

A patient with a severe systemic disease

1

A patient with a severe systemic disease that is a constant threat to life

4

A moribund patient who is not expected to survive for 24 hours with or without the operation

6

A patient who is morbidly obese (body mass index is more than 35)

2

A patient who is in the 3rd trimester of pregnancy

2

A patient declared brain dead whose organs are being removed for donor purposes

0

Where the patient is aged under 1 year or over 70 years old

1

Emergency surgery (i.e. When undue delay in treatment of the patient would lead to a significant increase in a threat to life or body part)

2

Anaesthesia in the prone position (not applicable to lower intestinal endoscopic procedures)

3

Anaesthesia for after‑hours emergencies

A 50% loading should apply to emergency after–hours anaesthesia. It is calculated using the “total relative value”. The 50% loading and the emergency surgery modifier should not be used together.

After‑hours is defined as that period between 6.00 p.m. and the following 8.00 a.m. on weekdays and between 8.00 a.m. and the following 8.00 a.m. on weekend days and public holidays.

PART A — PROCEDURES

Description of procedure, etc

Units

Head

 

Anaesthesia for all procedures on the skin and subcutaneous tissue, muscles, salivary glands and superficial blood vessels of the head, including biopsy, unless otherwise specified

5

 — plastic repair of cleft lip

6

Anaesthesia for electroconvulsive therapy

4

Anaesthesia for all procedures on external, middle or inner ear, including biopsy, unless otherwise specified

5

 — otoscopy

4

Anaesthesia for all procedures on eye unless otherwise specified

5

 — lens surgery

6

 — retinal surgery

6

 — corneal transplant

8

 — vitrectomy

8

 — biopsy of conjunctiva

5

 — ophthalmoscopy

4

Anaesthesia for all procedures on nose and accessory sinuses unless otherwise specified

6

 — radical surgery

7

 — biopsy, soft tissue

4

Anaesthesia for all intraoral procedures, including biopsy, unless otherwise specified

6

 — repair of cleft palate

7

 — excision of retropharyngeal tumour

9

 — radical intraoral surgery

10

Anaesthesia for all procedures on facial bones unless otherwise specified

5

 — extensive surgery on facial bones (including prognathism and extensive facial bone reconstruction)

10

Anaesthesia for all intracranial procedures unless otherwise specified

15

 — subdural taps

5

 — burr holes

9

 — intracranial vascular procedures including those for aneurysms and arterio‑venous abnormalities

20

 — spinal fluid shunt procedures

10

 — ablation of intracranial nerve

6

Anaesthesia for all cranial bone procedures

12

Neck

 

Anaesthesia for all procedures on the skin or subcutaneous tissue of the neck unless otherwise specified

5

Anaesthesia for incision and drainage of large haematoma, large abscess, cellulitis, or similar lesion causing life threatening airway obstruction

15

Anaesthesia for all procedures on oesophagus, thyroid, larynx, trachea and lymphatic system muscles, nerves or other deep tissues of the neck unless otherwise specified

6

 — for laryngectomy, hemi laryngectomy, laryngopharyngectomy, or pharyngectomy

10

Anaesthesia for laser surgery to the airway

8

Anaesthesia for all procedures on major vessels of neck unless otherwise specified

10

 — simple ligation

5

Thorax (Chest Wall/Shoulder Girdle)

 

Anaesthesia for all procedures on the skin or subcutaneous tissue of the chest unless otherwise specified

3

Anaesthesia for all procedures on the breast unless otherwise specified

4

 — reconstructive procedures on the breast (eg. reduction or augmentation, mammoplasty)

5

 — removal of breast lump or for breast segmentectomy where axillary node dissection is performed

5

 — mastectomy

6

 — reconstructive procedures on the breast using myocutaneous flaps

8

 — radical or modified radical procedures on breast with internal mammary node dissection

13

 — electrical conversion of arrhythmias

5

Anaesthesia for percutaneous bone marrow biopsy of the sternum

4

Anaesthesia for all procedures on the clavicle, scapula or sternum unless otherwise specified

5

 — radical surgery

6

Anaesthesia for partial rib resection unless otherwise specified

6

 — thoracoplasty

10

 — extensive procedures (eg. pectus excavatum)

13

Intrathoracic

 

Anaesthesia for open procedures on the oesophagus

15

Anaesthesia for all closed chest procedures (including rigid oesophagoscopy or bronchoscopy) unless otherwise specified

6

 — needle biopsy of pleura

4

 — pneumocentesis

4

 — thoracoscopy

10

 — mediastinoscopy

8

Anaesthesia for all thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum unless otherwise specified

13

 — pulmonary decortication

15

 — pulmonary resection with thoracoplasty

15

 — intrathoracic repair of trauma to trachea and bronchi

15

Anaesthesia for all open procedures on the heart, pericardium, and great vessels of the chest

20

Anaesthesia for heart transplant

20

Anaesthesia for heart and lung transplant

20

Cadaver harvesting of heart and/or lungs

8

Spine and spinal cord

 

Anaesthesia for all procedures on the cervical spine and/or cord unless otherwise specified (for myelography and discography see items in ‘Other Procedures’)

10

 — posterior cervical laminectomy in sitting position

13

Anaesthesia for all procedures on the thoracic spine and/or cord unless otherwise specified

10

 — thoracolumbar sympathectomy

13

Anaesthesia for all procedures in the lumbar region unless otherwise specified

8

 — lumbar sympathectomy

7

 — chemonucleolysis

10

Anaesthesia for extensive spine and spinal cord procedures

13

Anaesthesia for manipulation of spine

3

Anaesthesia for percutaneous spinal procedures

5

Upper abdomen

 

Anaesthesia for all procedures on the skin or subcutaneous tissue of the upper abdominal wall unless otherwise specified

3

Anaesthesia for all procedures on the nerves, muscles, tendons and fascia of the upper abdominal wall

4

Anaesthesia for diagnostic laparoscopy

6

Anaesthesia for laparoscopic procedures unless otherwise specified

7

Anaesthesia for extracorporeal shock wave lithotripsy

6

Anaesthesia for upper gastrointestinal endoscopic procedures

5

Anaesthesia for upper gastrointestinal endoscopic procedures in association with imaging techniques including fluoroscopy and ultrasound

6

Anaesthesia for upper gastrointestinal endoscopic procedures in association with acute gastrointestinal haemorrhage

6

Anaesthesia for all hernia repairs in upper abdomen unless otherwise specified

4

 — repair of incisional hernia and/or wound dehiscence

6

 — repair of omphalocele

7

 — transabdominal repair of diaphragmatic hernia

9

Anaesthesia for all procedures on major abdominal blood vessels

15

Anaesthesia for all procedures within the peritoneal cavity in upper abdomen including cholecystectomy, gastrectomy, laparoscopic nephrectomy, bowel shunts and cadaver harvesting of organs unless otherwise specified

8

Anaesthesia for gastric reduction or gastroplasty for the treatment of morbid obesity

10

Anaesthesia for partial hepatectomy (excluding liver biopsy)

13

Anaesthesia for extended or trisegmental hepatectomy

15

Anaesthesia for pancreatectomy, partial or total (eg. Whipple procedure)

12

Anaesthesia for liver transplant (recipient)

30

Anaesthesia for neuro endocrine tumour removal (eg. carcinoid)

10

Anaesthesia for percutaneous procedures on an intra‑abdominal organ in the upper abdomen

6

Lower abdomen

 

Anaesthesia for all procedures on the skin or subcutaneous tissue of the lower abdominal wall unless otherwise specified

3

 — lipectomy

5

Anaesthesia for all procedures on the nerves, muscles, tendons and fascia of the lower abdominal wall (with the exception of abdominal lipectomy)

4

Anaesthesia for diagnostic laparoscopy

6

Anaesthesia for laparoscopic procedures

7

Anaesthesia for all lower intestinal endoscopic procedures (modifier for prone position is not applicable)

4

Anaesthesia for extracorporeal shock wave lithotripsy

6

Anaesthesia for all hernia repairs in lower abdomen unless otherwise specified

4

 — repair of incisional hernia and/or wound dehiscence

6

Anaesthesia for all procedures within the peritoneal cavity in the lower abdomen (including appendicetomy) unless otherwise specified

6

Anaesthesia for bowel resection, including laparascopic bowel resection, unless otherwise specified

8

 — amniocentesis

4

 — abdominoperineal resection, including pull through procedures, ultra low anterior resection and formation of bowel reservoir

10

 — radical prostatectomy

10

 — radical hysterectomy

10

 — radical ovarian surgery

10

 — pelvic exenteration

10

 — Caesarean section

10

 — Caesarean hysterectomy or hysterectomy within 24 hours of delivery

15

Anaesthesia for all extraperitoneal procedures in lower abdomen, including urinary tract, unless otherwise specified

6

 — renal procedures, including upper 1/3 or ureter

7

 — total cystectomy

10

 — adrenalectomy

10

 — neuro endocrine tumour removal (eg. carcinoid)

10

 — renal transplant (donor or recipient)

10

Anaesthesia for all procedures on major lower abdominal vessels unless otherwise specified

15

 — inferior vena cava ligation

10

 — percutaneous umbrella insertion

5

Anaesthesia for percutaneous procedures on an intra‑abdominal organ in the lower abdomen

6

Perineum

 

Anaesthesia for all procedures on the skin or subcutaneous tissue of the perineum (including biopsy of male genital system) unless otherwise specified

3

 — anorectal procedure (including endoscopy and/or biopsy)

4

 — radical perineal procedure including radical perineal prostatectomy or radical vulvectomy

7

 — vulvectomy

4

Anaesthesia for all transurethral procedures (including urethrocystoscopy) unless otherwise specified

4

 — transurethral resection of bladder tumour(s)

5

 — transurethral resection of prostate

7

 — post‑transurethral resection bleeding

7

Anaesthesia for all procedures on male external genitalia unless otherwise specified

3

 — undescended testis, unilateral or bilateral

4

Anaesthesia for procedures on the cord and/or testes unless otherwise specified

4

 — radical orchidectomy, inguinal approach

4

 — radical orchidectomy, abdominal approach

6

 — orchiopexy, unilateral or bilateral

4

 — complete amputation of the penis

4

 — complete amputation of the penis with bilateral inguinal lymphadenectomy

6

 — complete amputation of the penis with bilateral inguinal and iliac lymphadenectomy

8

 — insertion of penile prosthesis (perianal approach)

4

Anaesthesia for all vaginal procedures (including biopsy of labia, vagina, cervix or endometrium) unless otherwise specified

4

 — colpotomy, colpectomy, colporrhaphy

5

 — transvaginal assisted reproductive services

4

 — vaginal hysterectomy

6

 — vaginal delivery

6

 — purse string ligation of cervix

4

 — culdoscopy

5

 — hysteroscopy

4

Anaesthesia for endometrial ablation or resection in association with hysteroscopy

5

 — correction of inverted uterus

8

Anaesthesia for evacuation of retained products of conception, as a complication of confinement

4

 — for the manual removal of retained placenta or for repair of vaginal or perineal tear following delivery

5

 — for vaginal procedures in the management of post partum haemorrhage

7

Pelvis — except hip

 

Anaesthesia for all procedures on the skin and subcutaneous tissue of the pelvic region, except external genitalia

3

Anaesthesia for percutaneous bone marrow biopsy of the anterior iliac crest

4

 — percutaneous bone marrow biopsy of the posterior iliac crest

5

Anaesthesia for percutaneous bone marrow harvesting from the pelvis

6

Anaesthesia for procedures on bony pelvis

6

Anaesthesia for body cast application or revision

3

Anaesthesia for interpelviabdominal (hind quarter) amputation

15

Anaesthesia for radical procedures for tumour of pelvis, except hind quarter amputation

10

Anaesthesia for closed procedures involving symphysis pubis or sacroiliac joint

4

Anaesthesia for open procedures involving symphysis pubis or sacroiliac joint

8

Upper leg — except knee

 

Anaesthesia for all procedures on the skin or subcutaneous tissue of the upper leg

3

 — on the nerves, muscles, tendons, fascia, or bursae of the upper leg

4

Anaesthesia for all closed procedures involving hip joint

4

Anaesthesia for arthroscopic procedures of hip joint

4

Anaesthesia for all open procedures involving hip joint unless otherwise specified

6

 — hip disarticulation

10

 — total hip replacement or revision

10

Anaesthesia for bilateral total hip replacement

14

Anaesthesia for all closed procedures involving upper 2/3 of femur

4

Anaesthesia for all open procedures involving upper 2/3 of femur unless otherwise specified

6

 — amputation

5

 — radical resection

8

Anaesthesia for all procedures involving veins of the upper leg including exploration

4

Anaesthesia for all procedures involving arteries of the upper leg, including bypass graft, unless otherwise specified

8

 — femoral artery ligation

4

 — femoral artery embolectomy

6

 — for microsurgical reimplantation of upper leg

15

Knee and popliteal area

 

Anaesthesia for all procedures on the skin and subcutaneous tissue of the knee and/or popliteal area

3

Anaesthesia for all procedures on nerves, muscles, tendons, fascia and bursae of the knee and/or popliteal area

4

Anaesthesia for all closed procedures on the lower 1/3 of femur

4

Anaesthesia for all open procedures on the lower 1/3 of femur

5

Anaesthesia for all closed procedures on the knee joint

3

Anaesthesia for arthroscopic procedures of the knee joint

4

Anaesthesia for all closed procedures on upper ends of the tibia and fibula, and/or patella

3

Anaesthesia for all open procedures on upper ends of the tibia and fibula, and/or patella

4

Anaesthesia for open procedures on the knee joint unless otherwise specified

4

 — knee replacement

7

 — bilateral knee replacement

10

 — disarticulation of knee

5

Anaesthesia for all cast applications, removal, or repair involving the knee joint

3

Anaesthesia for all procedures on the veins of the knee and popliteal area unless otherwise specified

4

 — repair of arteriovenous fistula

5

Anaesthesia for all procedures on the arteries of the knee and popliteal area unless otherwise specified

8

Lower leg — below knee (includes ankle and foot)

 

Anaesthesia for all procedures on the skin or subcutaneous tissue of the lower leg, ankle and foot

3

Anaesthesia for all procedures on the nerves, muscles, tendons and fascia of the lower leg, ankle, and foot unless otherwise specified

4

Anaesthesia for all closed procedures on the lower leg, ankle and foot

3

Anaesthesia for arthroscopic procedure of ankle joint

4

 — gastrocnemius recession

5

Anaesthesia for all open procedures on the bones of the lower leg, ankle and foot, including amputation, unless otherwise specified

4

 — radical resection

5

 — osteotomy or osteoplasty of tibia and fibula

5

 — total ankle replacement

7

Anaesthesia for lower leg cast application, removal or repair

3

Anaesthesia for all procedures on arteries of the lower leg, including bypass graft unless otherwise specified

8

 — embolectomy

6

Anaesthesia for all procedures on the veins of the lower leg unless otherwise specified

4

 — venous thrombectomy

5

 — for microsurgical reimplantation of the lower leg, ankle or foot

15

 — for microsurgical reimplantation of the toe

8

Shoulder and axilla (includes humeral head and neck, sternoclavicular joint, acromioclavicular joint and shoulder joint)

 

Anaesthesia for all procedures on the skin or subcutaneous tissue of the shoulder or axilla

3

Anaesthesia for all procedures on nerves, muscles, tendons, fascia and bursae of shoulder and axilla, including axillary dissection

5

Anaesthesia for all closed procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint or the shoulder joint

4

Anaesthesia for all arthroscopic procedures of the shoulder joint

5

Anaesthesia for all open procedures on the humeral head and neck, sternoclavicular joint, acromioclavicular joint or the shoulder joint unless otherwise specified

5

 — radical resection

6

 — shoulder disarticulation

9

 — interthoracoscapular (forequarter) amputation

15

 — total shoulder replacement

10

Anaesthesia for all procedures on arteries of shoulder and axilla unless otherwise specified

8

 — axillary‑brachial aneurysm

10

 — bypass graft

8

 — axillary‑femoral bypass graft

10

Anaesthesia for all procedures on veins of shoulder and axilla

4

Anaesthesia for all shoulder cast application, removal or repair unless otherwise specified

3

 — shoulder spica

4

Upper arm and elbow

 

Anaesthesia for all procedures on the skin or subcutaneous tissue of the upper arm and elbow

3

Anaesthesia for all procedures on the nerves, muscles, tendons, fascia and bursae of upper arm and elbow, unless otherwise specified

4

 — tenotomy, elbow to shoulder, open

5

 — tenoplasty, elbow to shoulder

5

 — tenodesis, rupture of long tendon of biceps

5

Anaesthesia for all closed procedures on the humerus and elbow

3

Anaesthesia for arthroscopic procedures of elbow joint

4

Anaesthesia for all open procedures on the humerus and elbow unless otherwise specified

5

 — radical procedures

6

 — total elbow replacement

7

Anaesthesia for all procedures on the arteries of the upper arm unless otherwise specified

8

 — embolectomy

6

Anaesthesia for all procedures on the veins of the upper arm unless otherwise specified

4

 — for microsurgical reimplantation of the upper arm

15

Forearm, wrist and hand

 

Anaesthesia for all procedures on the skin or subcutaneous tissue of the forearm, wrist and hand

3

Anaesthesia for all procedures on the nerves, muscles, tendons, fascia and bursae of the forearm, wrist and hand

4

Anaesthesia for all closed procedures on radius, ulna, wrist, or hand bones

3

Anaesthesia for all open procedures on radius, ulna, wrist, or hand bones unless otherwise specified

4

 — total wrist replacement

7

Anaesthesia for arthroscopic procedures of the wrist joint

4

Anaesthesia for all procedures on the arteries of the forearm, wrist, and hand unless otherwise specified

8

 — embolectomy

6

Anaesthesia for all procedures on the veins of the forearm, wrist, and hand unless otherwise specified

4

Anaesthesia for forearm, wrist, or hand cast application, removal or repair

3

 — for microsurgical reimplantation of forearm, wrist or hand

15

 — for microsurgical reimplantation of a finger

8

Burns

 

Anaesthesia for excision of debridement of burns with or without skin grafting

 

 — where the burnt area involves not more than 3% of total body surface

3

 — where the burnt area involves more than 3% but less than 10% of total body surface

5

 — where the burnt area involves 10% or more but less than 20% of total body surface

7

 — where the burnt area involves 20% or more but less than 30% of total body surface

9

 — where the burnt area involves 30% or more but less than 40% of total body surface

11

 — where the burnt area involves 40% or more but less than 50% of total body surface

13

 — where the burnt area involves 50% or more but less than 60% of total body surface

15

 — where the burnt area involves 60% or more but less than 70% of total body surface

17

 — where the burnt area involves 70% or more but less than 80% of total body surface

19

 — where the burnt area involves 80% or more of total body surface

21

Other procedures

 

Anaesthesia for injection procedure for myelography:

 

 — lumbar or thoracic

5

 — cervical

6

 — posterior fossa

9

Anaesthesia for injection procedure for discography:

 

 — lumbar or thoracic

5

 — cervical

6

Anaesthesia for peripheral arteriogram

5

Anaesthesia for arteriograms:

 

 — carotid, cerebral or vertebral

5

 — retrograde, brachial or femoral

5

Anaesthesia for computerised axial tomography scanning, magnetic resonance scanning, ultrasound scanning or digital subtraction angiography scanning

7

Anaesthesia for radiology unless otherwise specified

4

Anaesthesia for retrograde cystography, retrograde urethrography or retrograde cystourethrography

4

Anaesthesia for flouroscopy

5

Anaesthesia for small bowel enema, barium or other opaque study of the small bowel

5

Anaesthesia for bronchography

6

Anaesthesia for phlebography

5

Anaesthesia for heart, 2 dimensional real time transoesophageal examination

6

Anaesthesia for peripheral venous cannulation

3

Anaesthesia for cardiac catheterisation including coronary arteriography, ventriculography, cardiac mapping, insertion of automatic defibrillator or transvenous pacemaker

7

Anaesthesia for cardiac electrophysiological procedures including radio frequency ablation

10

Anaesthesia for central vein catheterisation or insertion of right heart balloon catheter

5

Anaesthesia for lumbar puncture, cisternal puncture, or epidural injection

5

Anaesthesia for harvesting of bone marrow for the purpose of transplantation

5

Anaesthesia for muscle biopsy for malignant hyperpyrexia

10

Anaesthesia for electroencephalography

5

Anaesthesia for brain stem evoked audiometry

5

Anaesthesia for electrocochleography by extratympanic method or transtympanic membrane insertion method

5

Anaesthesia for a therapeutic procedure where it can be demonstrated that there is a clinical need for anaesthesia

5

Anaesthesia during hyperbaric therapy where the medical practitioner is not confined in the chamber (including the administration of oxygen)



8

Anaesthesia during hyperbaric therapy where the medical practitioner is confined in the chamber (including the administration of oxygen)



15

Anaesthesia for brachytherapy using radioactive sealed sources

5

Anaesthesia for therapeutic nuclear medicine

5

Anaesthesia for radiotherapy

7

Anaesthesia where no procedure ensues

3

Note — Unlisted anaesthetic procedures

The AMA recognise that in determining the number of units applicable, the anaesthetist shall have regard to equivalent procedures

PART B — THERAPEUTIC AND DIAGNOSTIC SERVICES

Description of service, etc.

MUs

TUs

BUs

Collection of blood for autologous transfusion or when homologous blood is required for immediate transfusion in an emergency situation

no

no

3

Administration of blood or bone marrow already collected when performed in association with the administration of anaesthesia

no

no

4

Venous cannulation and blood transfusion (or blood products) not associated with anaesthesia

no

no

5

Intubation, endotracheal, emergency procedure, where the patient’s airway is unsecured and at high risk of occlusion, (eg. epiglottitis or haematoma post thyroidectomy) not associated with surgery

yes

yes

15

Intubation, endotracheal, not associated with anaesthesia, when subsequent management is not in an intensive care unit

yes

yes

4

Awake endotracheal intubation with flexible fibreoptic scope, associated with difficult airway, when performed in association with the administration of anaesthesia

no

no

4

Double lumen endobronchial tube or bronchial blocker, insertion of, when performed in association with the administration of anaesthesia

no

no

4

Monitoring of depth of anaesthesia, incorporating continuous measurement of the EEG during anaesthesia for the diagnosis of awareness

no

no

3

Venous cannulation and commencement of intravenous infusion, under age of 3 years, not associated with anaesthesia

no

no

3

Venous cannulation, cutdown

no

no

5

Venous cannulation and commencement of intravenous infusion not associated with anaesthesia

no

no

2

Right heart balloon catheter, insertion of, including pulmonary wedge pressure and cardiac output measurement

no

no

7

Pulmonary artery pressure monitoring

no

no

3

Left atrial pressure monitoring via left atrial catheter

no

no

3

Invasive pressure monitoring, not otherwise listed

no

no

3

Measurement of the mechanical or gas exchange function of the respiration system, or of respiratory muscle function, or of ventilatory control mechanisms, using measurements of parameters including pressures, volumes, flow, gas concentrations in inspired or expired air, alveolar gas or blood and incorporating serial arterial blood gas analysis and a written record of the results, when performed in association with the administration of anaesthesia

no

no

7

Central vein catheterisation, percutaneous via jugular, subclavian or femoral vein

no

no

3

Central vein catheterisation by cutdown

no

no

5

Central venous pressure monitoring

no

no

3

Arterial cannulation, percutaneous

no

no

3

Arterial puncture, withdrawal of blood for diagnosis

no

no

1

Arterial cannulation, by cutdown

no

no

5

Intra arterial pressure monitoring

no

no

3

Catheterisation, umbilical artery, newborn, for diagnosis, or therapy

no

no

5

Intra‑arterial infusion or retrograde intravenous perfusion of a sympatholytic agent

no

no

4

Intravenous regional anaesthesia of limb by retrograde perfusion

no

no

4

Perfusion of limb or organ

no

no

12

Medical management of cardio‑pulmonary bypass perfusion using heart/lung machine

yes

yes

20

Hypothermia, total body

no

no

5

Cardioplegia, blood or crystalloid, administration by any route

no

no

10

Deep hypothermia to a core temperature of less than 22 degrees in association with circulatory arrest

no

no

15

Standby medical management of cardio‑pulmonary bypass perfusion using heart/lung machine

no

yes

5

Major nerve block (proximal to the elbow or knee), including intercostal nerve clock(s) or plexus block to provide post operative pain relief

no

no

4

Minor nerve block (specify type) to provide post operative pain relief (does not include subcutaneous infiltration)

no

no

2

Intrathecal or epidural injection (initial) of a therapeutic substance, with or without insertion of a catheter, in association with anaesthesia and surgery, for post operative pain management

no

no

5

Intrathecal or epidural injection (subsequent) of a therapeutic substance, in association with anaesthesia and surgery, for post operative pain management

no

no

3

Subarachnoid puncture, lumbar, diagnostic

no

no

5

Insertion of subarachnoid drain

no

no

8

Intrathecal, or epidural or injection, (initial or commencement of infusion) of a therapeutic substance, including up to one hour of continuous attendance by a medical practitioner

no

no

8

Intrathecal, or epidural or injection, (initial or commencement of infusion) of a therapeutic substance, where continuous attendance by a medical practitioner extends beyond the first hour. Derived fee being 8 units for the first hour plus one unit for each additional 15 minutes or part thereof

no

no

0

Intrathecal, or epidural or injection, (initial or commencement of infusion) of a therapeutic substance, including up to one hour of continuous attendance by a medical practitioner after hours for a patient in labour

no

no

15

Intrathecal, or epidural or injection, (initial or commencement of infusion) of a therapeutic substance, where continuous after hours attendance by a medical practitioner extends beyond the first hour for a patient in labour. Derived fee being 15 units for the first hour plus one unit for each additional 15 minutes or part thereof

no

no

0

Subsequent injection (or revision of infusion) of a therapeutic substance to maintain regional anaesthesia or analgesia where the period of continuous medical practitioner attendance is 15 minutes or less

no

no

3

Subsequent injection (or revision of infusion) of a therapeutic substance to maintain regional anaesthesia or analgesia where the period of continuous medical practitioner attendance is more than 15 minutes

no

no

4

Interpleural block, initial injection or commencement of infusion of a therapeutic substance

no

no

5

Intrathecal, epidural or caudal injection of neurolytic substance

no

no

20

Intrathecal, epidural or caudal injection of substance other than anaesthetic, contrast or neurolytic solutions, not being a service to which another item in the Group applies

no

no

8

Epidural injection of blood for blood patch

no

no

8

Injection of an anaesthetic agent

 

 

 

 — trigeminal nerve, primary division of

no

no

10

 — trigeminal nerve, peripheral branch of

no

no

5

 — facial nerve

no

no

3

 — retrobulbar or peribulbar

no

no

5

 — greater occipital nerve

no

no

3

 — vagus nerve

no

no

8

 — glossopharyngeal nerve

no

no

8

 — phrenic nerve

no

no

7

 — spinal accessory nerve

no

no

5

 — cervical plexus

no

no

8

 — brachial plexus

no

no

8

 — suprascapular nerve

no

no

5

 — intercostal nerve, single

no

no

5

 — intercostal nerves, multiple

no

no

7

 — ilioinguinal, iliohypogastric or genito femoral nerves, one or more of

no

no

5

 — pudendal nerve

no

no

8

 — ulnar, radial or median nerve of main trunk, one or more of, not being associated with a brachial plexus block

no

no

5

 — paracervical (uterine) nerve

no

no

5

 — obturator nerve

no

no

7

 — femoral nerve

no

no

7

 — saphenous, sural, popliteal or posterior tibial nerve of main trunk, one or more of

no

no

5

 — paravertebral, cervical, thoracic, lumbar, sacral or coccygeal nerves, single vertebral level

no

no

7

 — paravertebral nerves, multiple levels

no

no

10

 — sciatic nerve

no

no

7

 — other peripheral nerve or branch

no

no

5

 — sphenopalatine ganglion

no

no

10

 — carotid sinus, as an independent percutaneous procedure

no

no

8

 — stellate ganglion (cervical sympathetic block)

no

no

8

 — lumbar or thoracic nerves (paravertebral sympathetic block)

no

no

8

 — coeliac plexus or splanchnic nerves

no

no

10

Cranial nerve other than trigeminal, destruction by a neurolytic agent, not being a service associated with the injection of botulinum toxin

no

no

20

Nerve branch, not covered by any other item in this Group, destruction by a neurolytic agent, not being a service associated with the injection of botulinum toxin

no

no

10

Coeliac plexus or splanchnic nerves, destruction by a neurolytic agent

no

no

20

Lumbar sympathetic chain, destruction by a neurolytic agent

no

no

15

Cervical or thoracic sympathetic chain, destruction by a neurolytic agent

no

no

20

Cardioversion, elective, electrical conversion of arrhythmia, external

no

no

4

Hyperbaric oxygen treatment when the specialist is inside the chamber

yes

yes

15

Hyperbaric oxygen treatment when the specialist is outside the chamber

yes

yes

8

Heart, 2 dimensional real time transoesophageal examination of, at least 2 oesophageal windows performed using a mechanical sector scanner or phased array transducer with —

 

 

 

(a)measurement blood flow velocities across the cardiac valves using pulsed wave and continuous Doppler techniques;

 

 

 

(b)real time colour flow mapping from at least 2 oesophageal windows; and

(c)recording on video tape

no

no

10

Intra‑operative 2 dimensional real time transoesophageal echocardiography incorporating Doppler techniques with colour flow mapping and recording onto video tape, performed during cardiac surgery incorporating sequential assessment of cardiac function before and after the surgical procedure

no

no

14

The use of 2 dimensional imaging ultrasound guidance to assist percutaneous major vascular access involving catheterisation of the jugular, subclavian or femoral vein

no

no

3

The use of 2 dimensional imaging ultrasound guidance to assist percutaneous neural blockade involving the branchial plexus, or femoral and/or sciatic nerve

no

no

3

Skin testing for allergy to anaesthetic agents

no

yes

4

Assistance in the administration of an anaesthetic

yes

yes

5

Note — Unlisted services

For an unlisted service, the number of units is to be determined by reference to the nearest listed anaesthetic procedure

[Part 1 inserted in Gazette 20 Jul 1999 p. 3250‑69; amended in Gazette 31 Aug 1999 p. 4244-5; 21 Dec 2000 p. 7626-34; 28 Dec 2001 p. 6692-7; 23 Sep 2003 p. 4174-7; 19 Mar 2004 p. 864‑96; 29 Oct 2004 p. 4941‑2; 21 Jan 2005 p. 279‑81; 10 Jan 2006 p. 44-52; 22 Dec 2006 p. 5759-68; 7 Dec 2007 p. 6037‑42; 17 Dec 2008 p. 5291‑6; 30 Oct 2009 p. 4346‑53; 29 Oct 2010 p. 5349-55.]

Part 2 — Medical procedures

[Heading inserted in Gazette 29 Oct 2010 p. 5355.]

Type of procedure

Fee
$

GENERAL

 

Localised burns

52.45

Localised burns, including dressing of, under general anaesthetic


149.25

Extensive burns

90.50

Extensive burns, including dressing of, under general anaesthetic


315.90

Dressing of wounds, under general anaesthetic

149.25

Acupuncture, including consultation

69.60

DISLOCATIONS

 

closed reduction means non‑operative reduction of the dislocation, and included percutaneous fixation and/or external splintage by cast or splint.

 

open reduction means treatment by either closed reduction and intra‑medullary fixation or treatment by operative exposure of the dislocation including internal or external fixation.

 

other means treatment by any other method and includes the use of external splintage.

 

[Where injuries are associated with a compound (open) wound, an additional fee of 50% of the fee listed is to apply.]

 

Elbow, by closed reduction

281.45

Elbow, by open reduction

373.25

Interphalangeal joint, by closed reduction

120.65

Interphalangeal joint, by open reduction

160.85

Mandible, by closed reduction

100.60

Clavicle, by closed reduction

119.30

Clavicle, by open reduction

241.25

Shoulder, not requiring general anaesthetic

134.20

Shoulder, by open reduction, with general anaesthetic

481.10

Shoulder, other, with general anaesthetic

238.30

Metacarpophalangeal joint, by closed reduction

160.85

Metacarpophalangeal joint, by open reduction

215.45

Patella, by closed reduction

180.85

Patella, by open reduction

241.25

Radioulnar joint, by closed reduction

281.45

Radioulnar joint, by open reduction

373.25

Toe, by closed reduction

100.60

Toe, by open reduction

133.55

REMOVAL OF FOREIGN BODIES

 

as independent procedure

43.75

superficial

195.25

deep tissue or muscle

545.70

ear, other than by syringing

140.65

nose, other than by simple probing

140.65

cornea or sclera, embedded

143.60

FRACTURES

 

closed reduction means non‑operative reduction of the fracture, and included percutaneous fixation and/or external splintage by cast or splint.

 

open reduction means treatment by either closed reduction and intra‑medullary fixation or treatment by operative exposure of the fracture including internal or external fixation.

 

other means treatment by any other method and includes the use of external splintage.

 

[Where injuries are associated with a compound (open) wound, an additional fee of 50% of the fee listed is to apply.]

 

Distal phalanx of finger or thumb

 

fracture, by closed reduction

180.85

fracture, intra‑articular, by closed reduction

209.65

fracture, by open reduction

241.25

fracture, intra‑articular, by open reduction

301.50

Middle phalanx of finger

 

fracture, by closed reduction

272.80

fracture, intra‑articular, by closed reduction

308.65

fracture, by open reduction

358.90

fracture, intra‑articular, by open reduction

452.25

Proximal phalanx of finger or thumb

 

fracture, by closed reduction

358.90

fracture, intra‑articular, by closed reduction

423.45

fracture, by open reduction

481.10

fracture, intra‑articular, by open reduction

603.05

Metacarpal

 

fracture, by closed reduction

358.90

fracture, intra‑articular, by closed reduction

423.45

fracture, by open reduction

481.10

fracture, intra‑articular, by open reduction

603.05

Carpal Scaphoid, by open reduction

804.05

Carpal Scaphoid, other

358.90

Carpus (excluding Scaphoid), by open reduction

502.45

Carpus (excluding Scaphoid), other

201.00

Radius

 

by closed management

401.95

by open management

804.05

Radius or Ulnar, distal end, (Colies’, Smith’s or Barton’s)

 

by closed reduction

603.05

by open reduction

804.05

Ribs (1 or more), each attendance

92.00

Tibia, plateau of, medial or lateral

 

by closed reduction

725.10

by open reduction

961.90

Tibia, plateau of, medial and lateral

 

by closed reduction

1 206.00

by open reduction

1 615.20

SUTURES

 

face or neck, less than 7 cm, superficial

143.60

face or neck, less than 7 cm, deep

218.20

face or neck, more than 7 cm, superficial

218.20

face or neck, more than 7 cm, deep

373.25

except face or neck, less than 7 cm, superficial

109.10

except face or neck, less than 7 cm, deep

163.70

except face or neck, more than 7 cm, superficial

163.70

except face or neck, more than 7 cm, deep

358.90

AMPUTATIONS

 

Hand, midcarpal or transmetacarpal

545.70

Hand, forearm or through arm

631.75

At shoulder

1 069.55

Interscapulothoracic

2 124.85

One digit of foot

287.05

Two digits of one foot

430.75

Three digits of one foot

581.45

Four digits of one foot

725.10

Five digits of one foot

868.60

Toe including metatarsal or part of metatarsal — each toe

338.95

Foot, at ankle

631.75

Foot, midtarsal or transmetatarsal

545.70

Through thigh, at knee or below knee

933.30

At hip

1 313.60

ASSISTANCE AT OPERATIONS

The fee for assistance at any operation (or series or combination of operations) is to be related to the fee listed for the operation (or series or combination of operations) itself.

 

The fee is 20% of the total fee or the minimum sum of $180.85, whichever is greater.

 

USE OF PRIVATE THEATRES

A theatre fee of $109.10 will be paid to practitioners for the use of their private theatre, but this fee may only be charged if the patient would otherwise have been sent to hospital.

 

[Part 2 inserted in Gazette 29 Oct 2010 p. 5355-60.]

Part 3 — Diagnostic Imaging Services

[Heading inserted in Gazette 29 Oct 2010 p. 5360.]

ULTRASOUND

MBS item number
(1 November 2008)

Fee
$

55028

175.85

55029

61.00

55030

175.85

55031

61.00

55032

175.85

55033

61.00

55036

179.35

55037

61.00

55038

175.85

55039

61.00

55044

179.35

55045

61.00

55048

175.85

55049

61.00

55054

175.85

55070

158.35

55073

54.80

55076

175.85

55079

61.00

55084

158.35

55085

54.80

55113

371.75

55114

371.75

55115

371.75

55116

413.40

55117

413.40

55118

444.00

55130

274.05

55135

569.90

55238

273.15

55244

273.15

55246

273.15

55248

273.15

55252

273.15

55274

273.15

55276

273.15

55278

273.15

55280

273.15

55282

273.15

55284

273.15

55292

273.15

55294

273.15

55296

179.05

55600

175.85

55603

175.85

55700

96.60

55703

56.40

55704

112.85

55705

56.40

55706

161.20

55707

112.85

55708

56.40

55709

61.25

55712

185.35

55715

64.45

55718

161.20

55721

185.35

55723

61.25

55725

64.45

55729

43.90

55731

158.05

55733

56.40

55736

204.65

55739

91.80

55759

241.75

55762

96.60

55764

257.85

55766

104.70

55768

241.75

55770

96.60

55772

257.85

55774

104.70

55800

175.85

55802

61.00

55804

175.85

55806

61.00

55808

175.85

55810

61.00

55812

175.85

55814

61.00

55816

175.85

55818

61.00

55820

175.85

55822

61.00

55824

175.85

55826

61.00

55828

175.85

55830

61.00

55832

175.85

55834

61.00

55836

175.85

55838

61.00

55840

175.85

55842

61.00

55844

140.75

55846

61.00

55848

175.85

55850

246.35

55852

175.85

55854

61.00

COMPUTED TOMOGRAPHY — 
EXAMINATION AND REPORT

MBS item number
(1 November 2008)

Fee
$

56001

288.65

56007

370.10

56010

373.10

56013

370.10

56016

429.30

56022

333.05

56028

498.55

56030

333.05

56036

498.55

56041

146.25

56047

186.70

56050

189.80

56053

189.80

56056

230.00

56062

167.45

56068

249.30

56070

167.45

56076

249.30

56101

340.55

56107

503.40

56141

172.35

56147

254.05

56219

482.85

56220

355.30

56221

355.30

56223

355.30

56224

520.20

56225

520.20

56226

520.20

56227

181.30

56228

181.30

56229

181.30

56230

262.65

56231

262.65

56232

262.65

56233

355.30

56234

520.20

56235

181.25

56236

262.65

56237

355.30

56238

520.20

56239

181.25

56240

262.65

56259

243.90

56301

436.75

56307

592.00

56341

221.25

56347

299.00

56401

370.10

56407

532.85

56409

370.10

56412

532.85

56441

187.65

56447

268.60

56449

187.65

56452

268.60

56501

569.90

56507

710.55

56541

285.90

56547

360.80

56549

569.90

56551

569.90

56619

325.70

56625

495.35

56659

165.90

56665

247.85

56801

690.65

56807

829.00

56841

345.40

56847

420.25

57001

690.80

57007

840.40

57041

345.50

57047

420.30

57201

229.70

57247

114.75

57341

695.75

57345

357.65

57350

754.95

57351

754.95

57355

391.00

57356

391.00

DIAGNOSTIC RADIOLOGY

MBS item number
(1 November 2008)

Fee
$

57506

50.85

57509

67.95

57512

69.25

57515

92.30

57518

55.55

57521

74.15

57524

84.55

57527

112.45

57700

69.25

57703

92.30

57706

55.55

57709

74.15

57712

80.60

57715

104.15

57721

169.65

57901

110.20

57902

110.20

57903

80.85

57906

110.20

57909

110.20

57912

80.60

57915

80.60

57918

80.60

57921

80.60

57924

80.60

57927

84.80

57930

56.20

57933

133.75

57939

110.20

57942

84.80

57945

74.15

57960

81.05

57963

81.05

57966

81.05

57969

81.05

58100

114.75

58103

94.20

58106

131.60

58108

227.15

58109

80.40

58112

166.25

58115

227.15

58300

68.60

58306

152.80

58500

60.45

58503

80.60

58506

103.95

58509

67.95

58521

74.15

58524

96.55

58527

118.60

58700

78.80

58706

269.90

58715

259.05

58718

215.65

58721

236.35

58900

61.00

58903

81.30

58909

153.70

58912

188.50

58915

134.90

58916

236.70

58921

231.20

58924

143.70

58927

130.75

58933

351.50

58936

335.00

58939

238.15

59103

36.45

59300

153.00

59303

92.25

59306

171.50

59309

342.85

59312

148.75

59314

89.70

59318

80.45

59503

152.80

59700

165.10

59703

129.75

59712

194.40

59715

245.40

59718

230.25

59724

387.15

59733

184.10

59736

106.00

59739

126.20

59751

237.90

59754

374.95

59760

196.85

59763

228.95

59903

195.85

59912

521.75

59925

619.55

59970

287.80

59971

97.95

59972

260.85

59973

309.80

59974

143.90

60000

964.15

60003

1 413.95

60006

2 010.55

60009

2 352.85

60012

964.15

60015

1 413.95

60018

2 010.55

60021

2 352.85

60024

964.15

60027

1 413.95

60030

2 010.55

60033

2 352.85

60036

964.15

60039

1 413.95

60042

2 010.55

60045

2 352.85

60048

964.15

60051

1 413.95

60054

2 010.55

60057

2 352.85

60060

964.15

60063

1 413.95

60066

2 010.55

60069

2 352.85

60072

82.30

60075

164.25

60078

246.55

60100

103.95

60500

74.15

60503

50.85

60506

109.00

60509

169.00

60918

80.60

60927

65.10

61109

442.60

NUCLEAR MEDICINE IMAGING

MBS item number
(1 November 2008)

Fee
$

61302

591.05

61303

744.35

61306

934.45

61307

1 099.40

61310

483.65

61313

399.45

61314

553.00

61316

501.95

61317

648.35

61320

301.40

61328

299.75

61340

333.10

61348

583.80

61352

341.45

61353

509.00

61356

517.20

61360

531.10

61361

607.60

61364

654.40

61368

293.80

61369

2 654.15

61372

293.80

61373

644.75

61376

188.80

61381

756.20

61383

822.80

61384

905.50

61386

437.85

61387

567.20

61389

487.90

61390

539.85

61393

797.25

61397

325.00

61401

213.75

61402

796.75

61405

455.60

61409

1 150.20

61413

297.50

61417

156.50

61421

631.80

61425

790.90

61426

730.45

61429

714.95

61430

868.30

61433

654.40

61434

810.35

61437

714.75

61438

886.15

61441

644.75

61442

990.70

61445

377.60

61446

439.25

61449

600.70

61450

523.45

61453

677.70

61454

458.30

61457

619.45

61458

522.60

61461

694.95

61462

171.55

61465

349.55

61469

458.30

61473

230.90

61480

509.40

61484

1 159.95

61485

1 315.65

61495

293.80

61499

333.10

61650

1 156.95

MAGNETIC RESONANCE IMAGING

MBS item number
(1 November 2008)

Fee
$

63000‑63200

857.45

63201

1 286.10

63202‑63203

857.45

63204

1 286.10

63219‑63243

1 286.10

63271‑63473

857.45

63491‑63494

98.00

63497

294.25

[Part 3 inserted in Gazette 29 Oct 2010 p. 5360-74.]

Schedule 2 — Scale of fees: physiotherapists

[r. 3]

[Heading inserted in Gazette 29 Oct 2010 p. 5375.]

Part 1 — General

[Heading inserted in Gazette 29 Oct 2010 p. 5375.]

Service Code

Service

 

PA001

Initial Consultation

A consultation with the physiotherapist including the following elements —

Set Fee

$70.05

 

Subjective assessment — of the following points as required:

Major symptoms and lifestyle dysfunction; current history and treatment; past history and treatment; pain, 24‑hour behaviour, aggravating and relieving factors; general health, medication, risk factors.

 

 

Objective assessment — of the following points as required:

Movement — active, passive, resisted, repeated; muscle tone, spasm, weakness; accessory movements, passive intervertebral movements etc. Appropriate procedures/tests as indicated.

 

 

Appropriate initial management, treatment or advice — based on assessment findings that could include the following as required:

Provisional diagnosis; goals of treatment; treatment plan. Discussion with the patient regarding working hypothesis and treatment goals and expected outcomes; initial treatment and response; advice regarding home care including any exercise programs to be followed.

 

 

Documentation of consultation — as required that could include:

The assessment findings, physiotherapy intervention(s), evaluation of intervention(s), plan for future treatment and results of other relevant tests and warnings (if applicable).

 

 

Includes:

·Individual services provided in rooms, home or hospital; hydrotherapy treatment; extended treatments; and services provided outside of normal business hours.

 

 

·Courtesy communication by the physiotherapist with the medical practitioner such as acknowledgment of referral.

 

 

·The physiotherapist’s notes of the consultation.

 

 

Does not include:

·Oral or written communication by the physiotherapist with a medical specialist, medical practitioner, employer, insurer or vocational rehabilitation provider (other than a courtesy communication with the medical practitioner). Oral communication has a specific item number in this Table (PK001).

 

 

·The physiotherapist’s involvement in case conferences. This service has a specific item number in this Table (PQ001).

 

PB001

Standard Consultation

Consultation for one body area or condition including the following elements —

Set Fee

$56.25

 

·subjective re‑assessment;

·objective re‑assessment;

·appropriate management, intervention or advice;

·documentation of consultation.

 

 

Includes:

·Individual services provided in rooms, home or hospital; hydrotherapy treatment; extended treatments; and services provided outside of normal business hours.

 

 

·Courtesy communication by the physiotherapist such as brief oral or written communication with the medical practitioner.

 

 

Does not include:

·Oral or written communication by the physiotherapist with a medical specialist, medical practitioner, employer, insurer or vocational rehabilitation provider (other than a courtesy communication with the medical practitioner). Oral communication has a specific item number in this Table (PK001).

 

 

·The physiotherapist’s involvement in case conferences. This service has a specific item number in this Table (PQ001).

 

PC001

Two distinct areas of treatment per visit

Same description as PB001 except relates to the treatment/management of 2 distinct areas/conditions.

Set Fee

$71.15

PG001

Group Consultation — per person

Includes non‑individualised services provided to more than one individual whether —

Cost per participant

$17.30

 

·in rooms, home or hospital;

·hydrotherapy treatment;

·extended treatments;

·services provided outside of normal business hours.

 

PE001

Worksite Visit — prior approval from insurer required.

Prior to a worksite evaluation, consideration of details such as relevance to injury; intended outcomes; likely duration and reporting requirements should be made and discussed with the insurer with a suggested maximum duration of 2 hours.

Does not include reports or travel.

Hourly rate**

$159.85

PR001

Progress/Standard report

A report relating to a specific worker that is provided to a medical specialist, medical practitioner, employer, insurer or vocational rehabilitation provider that contains (where applicable) —

·a summary of assessment findings;

·treatment/management services provided and results obtained;

·recommendations for further treatment/management;

Set Fee

$70.05

 

·functional and objective improvements;

·perceived treatment duration required;

·return to work recommendation;

 

 

·perceived barriers to return to work;

·questionnaire results and implications.

A maximum combined total of 3 reports or Treatment Management Plans (PR003) permitted without prior approval from insurer. Additional reports require prior approval from insurer.

 

 

Does not include:

·Courtesy communication by the physiotherapist such as brief oral or written communication with the medical practitioner.

 

PR002

Comprehensive report

As above for progress/standard report and contains information relating to more detailed assessments and interventions performed.

Hourly rate**

$159.85

 

The specific requirements for a comprehensive report must be discussed with the insurer prior to approval with a suggested maximum duration of 2 hours.

 

PR003

Treatment Management Plan

Provision of a completed Treatment Management Plan that must contain —

Set Fee

$70.05

 

·clinical assessment of injured worker and results of any investigation;

·injured worker’s current work status and level of incapacity;

·proposed management plan including —

1.the proposed work and functional goals and estimated timeframe in weeks;

2.description and number of proposed treatment methods;

3.the number of weeks treatment is to be conducted;

 

 

4.the injured worker’s expected fitness for work at the end of the management plan;

5.other comments or recommendations (including barriers to recovery where relevant).

A maximum combined total of 3 Treatment Management Plans or reports (PR001) permitted without prior approval from insurer. Additional Treatment Management Plans require prior approval from insurer.

 

PT001

Travel

Travel when the most appropriate management of the patient requires the provider to travel away from their normal practice. The insurer must provide pre‑approval for travel in excess of one hour.

Hourly rate**

$127.90

 

If services are provided to more than one worker before leaving a venue, the fee for the journey is to be apportioned equally between workers.

 

PQ001

Case Conferences

Face‑to‑face or telephone communication involving the physiotherapist with one or more of the following —

 

$16.10
per 6 minute block

 

doctor, employer, insurer/claims manager, rehabilitation providers and worker.

 

 

The aim of the case conference is to plan, implement, manage or review treatment options and/or rehabilitation plan.

 

 

PK001

Communication

Any required oral communication by the physiotherapist with a medical specialist, medical practitioner, employer, insurer or vocational rehabilitation provider (other than a courtesy communication with the medical practitioner) relating to the treatment or rehabilitation of a specific worker.

 

$16.10 
per 6 minute block

 

 

The physiotherapist must keep a written record of the details of the communication, including its date, time and duration.

 

 

Maximum duration per communication is 30 minutes.

 

 

Maximum cumulative duration of communications per claim is one hour. When the maximum cumulative duration has been reached, prior approval from insurer for a minimum of 5 blocks of 6 minutes is required.

 

PS001

Specific Physiotherapy Assessment — prior approval from insurer required.

Includes specific types of assessments not classified elsewhere in these scales required by the insurer which physiotherapists may undertake (e.g. diagnostic ultrasound imaging, Functional Capacity Assessments (FCE’s), seating and wheelchair assessments).

Hourly rate**

$159.85

PW001

Specific Physiotherapy Intervention — prior approval from insurer required (*replaces PD001).

Includes treatments not classified elsewhere in these scales required by the insurer which physiotherapists may undertake (e.g. treatment of severe multiple area trauma, burns, neurologically injured patients and patients with severe spinal injuries, ergonomic corrections of workplace, specialised real‑time ultrasound imaging, short consultations).

Hourly rate**

$159.85
per hour to a maximum of 2 hours**

**Denotes that where the service provided is a fraction of one hour, the amount chargeable is to be calculated as that fraction of the maximum amount.

[Part 1 inserted in Gazette 29 Oct 2010 p. 5375-82.]

Part 2 — Exercise‑based programs

[Heading inserted in Gazette 29 Oct 2010 p. 5382.]

 

Type of service

Fee

EXE20

Initial Consultation/Assessment

Insurer approval must be obtained prior to undertaking the service.

Review of current medical and vocational status.

 

$159.85
per hour to a maximum of 2 hours**

 

·Communication/Liaison with relevant parties.

 

 

·Physiological Assessment/testing.

 

 

·Screening questionnaires relating to worker’s level of function.

 

 

·Program design based on above.

 

 

·Exercise facility/equipment coordination (pool or gym based).

 

 

·Provider to patient ratio must be 1:1 for the duration of the consultation.

 

EXE21

Subsequent Exercise Consultation/Assessment

Includes —

·program implementation — prescription and provision of exercises (land or pool based);

·program monitoring;

·post program screening questionnaire relating to worker’s level of function;

·psychosocial reassessment;

·communication/liaison with relevant parties.

 

$159.85
per hour to a maximum of one hour**

EXE02

Initial report

Includes —

·initial assessment report outlining results (self‑reported and objective), recommendations and exercise rehabilitation plan;

 

$159.85
per hour to a maximum of one hour**

 

·current status as per medical certification and proposed outcome status;

 

 

·detailed cost plan outlining proposed outcome, services required and proposed costs for insurer approval.

 

EXE03

Subsequent reports

Progress report to be provided at the request of the referrer.

 

$159.85
per hour to a maximum of 30 minutes**

EXE04

Final report

Comprehensive report to be provided at the end of the service delivery detailing —

·physiological testing results pre and post program;

·worker attendance/program compliance.

 

$159.85
per hour to a maximum of 30 minutes**

EXE05

Gym membership/Entry fees

Includes direct cost of membership (pool or gym).

Prior approval from insurer required.

 

Market rates

EXE06

Travel

Travel when the most appropriate management of the patient requires the provider to travel away from their normal practice.

The insurer must provide pre‑approval for travel in excess of one hour.

If services are provided to more than one worker before leaving a venue, the fee for the journey is to be apportioned equally between workers.

 

$127.90
per hour **

EXE08

Communication

Any requested or required oral communication with relevant parties (treating medical practitioners, employers and insurers) relating to the treatment of a specific worker.

Excludes courtesy communication such as acknowledgment of referral and brief updates to the medical practitioner.

Maximum time allowable per communication of 30 minutes.

 

$16.10
per 6 minute block

EXE09

Attendance at Medical Case Conferences

Insurer approval must be obtained prior to undertaking the service.

 

$159.85
per hour **

**Denotes that where the service provided is a fraction of one hour, the amount chargeable is to be calculated as that fraction of the maximum amount.

[Part 2 inserted in Gazette 29 Oct 2010 p. 5382-5.]

Schedule 3 — Scale of fees: chiropractors

[r. 4]

[Heading inserted in Gazette 29 Oct 2010 p. 5385.]

 

Type of service

Fee
$

1.

Initial consultation and examination

55.45

2.

Subsequent consultation

46.20

3.

Spinal x‑ray, one region

110.10

4.

Spinal x‑ray, 2 or more regions

165.35

5.

Travel (per kilometre)

0.80

[Schedule 3 inserted in Gazette 29 Oct 2010 p. 5385.]

Schedule 4 — Scale of fees: occupational therapists

[r. 5]

[Heading inserted in Gazette 29 Oct 2010 p. 5386.]

 

Type of service

Fee
$

1.

Brief consultation (< 15 minutes)

23.90

2.

Short consultation (15 minutes to < 30 minutes)

47.95

3.

Standard consultation (30 minutes to < 45 minutes)

79.05

4.

Extended consultation (45 minutes to < one hour)

118.55

5.

Extended consultation ( > one hour)

158.15

6.

Standard group consultation (30 minutes) per person

51.90

7.

Travel costs are to be calculated at the hourly rate by
the length of time spent travelling.

[Schedule 4 inserted in Gazette 29 Oct 2010 p. 5386.]

Schedule 5 — Scale of fees: speech pathologists

[r. 7]

[Heading inserted in Gazette 29 Oct 2010 p. 5386.]

 

Type of service

Fee
$

1.

Initial consultation/assessment (up to and including one hour)


146.10

2.

Initial consultation/assessment (exceeding one hour)

189.25

3.

Subsequent consultation (< ½ hour)

63.80

4.

Subsequent consultation (½ hour – one hour)

82.75

5.

Subsequent consultation (> one hour)

111.70

[Schedule 5 inserted in Gazette 29 Oct 2010 p. 5386.]

Schedule 5A — Scale of fees: exercise physiologists

[r. 7B]

[Heading inserted in Gazette 29 Oct 2010 p. 5387.]

Exercise‑based programs

[Heading inserted in Gazette 29 Oct 2010 p. 5387.]

 

Type of service

Fee

EXE20

Initial Consultation/Assessment

Insurer approval must be obtained prior to undertaking the service.

 

$159.85
per hour to a maximum of 2 hours**

 

Review of current medical and vocational status.

 

 

Communication/Liaison with relevant parties.

 

 

Physiological Assessment/testing.

 

 

Screening questionnaires relating to worker’s level of function.

 

 

Program design based on above.

 

 

Exercise facility/equipment coordination (pool or gym based).

 

 

Provider to patient ratio must be 1:1 for the duration of the consultation.

 

EXE21

Subsequent Exercise Consultation/Assessment

Includes —

program implementation — prescription and provision of exercises (land or pool based);

program monitoring;

post program screening questionnaire relating to worker’s level of function;

psychosocial reassessment;

communication/liaison with relevant parties.

 

$159.85
per hour to a maximum of one hour**

EXE02

Initial report

Includes —

initial assessment report outlining results (self‑reported and objective), recommendations and exercise rehabilitation plan;

 

$159.85
per hour to a maximum of one hour**

 

current status as per medical certification and proposed outcome status;

 

 

detailed cost plan outlining proposed outcome, services required and proposed costs for insurer approval.

 

EXE03

Subsequent reports

Progress report to be provided at the request of the referrer.

 

$159.85
per hour to a maximum of 30 minutes**

EXE04

Final report

Comprehensive report to be provided at the end of the service delivery detailing —

physiological testing results pre and post program;

worker attendance/program compliance.

 

$159.85
per hour to a maximum of 30 minutes**

EXE05

Gym membership/Entry fees

Includes direct cost of membership (pool or gym).

Prior approval from insurer required.

 

Market rates

EXE06

Travel

Travel when the most appropriate management of the patient requires the provider to travel away from their normal practice.

The insurer must provide pre‑approval for travel in excess of one hour.

If services are provided to more than one worker before leaving a venue, the fee for the journey is to be apportioned equally between workers.

 

$127.90
per hour **

EXE08

Communication

Any requested or required oral communication with relevant parties (treating medical practitioners, employers and insurers) relating to the treatment of a specific worker.

Excludes courtesy communication such as acknowledgment of referral and brief updates to the medical practitioner.

Maximum time allowable per communication of 30 minutes.

 

$16.10
per 6 minute block

EXE09

Attendance at Medical Case Conferences

Insurer approval must be obtained prior to undertaking the service.

 

$159.85
per hour **

**Denotes that where the service provided is a fraction of one hour, the amount chargeable is to be calculated as that fraction of the maximum amount.

[Schedule 5A inserted in Gazette 29 Oct 2010 p. 5387-90.]

Schedule 6 — Scale of maximum fees: approved medical specialists

[r. 9]

[Heading inserted in Gazette 29 Oct 2010 p. 5390.]

Part 1 — Assessments

[Heading inserted in Gazette 29 Oct 2010 p. 5390.]

 

Description of assessment

Maximum fee**

1.

Examination and provision of report and certificate — straightforward assessment — other than a service mentioned in item 4, 5, 6 or 8.

$1 078.05 (or, if an interpreter is present at the examination, $1 347.50 excluding any fee payable to the interpreter)

2.

Examination and provision of report and certificate — moderately complex assessment (e.g. reviewing multiple questions and reports; impairment involving more complex assessments; more than one body system involved) — other than a service mentioned in item 4, 5, 6 or 8.

$1 347.50 (or, if an interpreter is present at the examination, $1 617.00 excluding any fee payable to the interpreter)

3.

Examination and provision of report and certificate — complex assessment (e.g. multiple injuries; severe impairment such as spinal cord injury or head injury) — other than a service mentioned in item 4, 5, 6 or 8.

$1 617.00 (or, if an interpreter is present at the examination, $1 886.50 excluding any fee payable to the interpreter)

4.

Examination of any of ear, nose and throat only, including audiometric testing and provision of report and certificate — other than a service mentioned in item 8.

$1 078.05 (or, if an interpreter is present at the examination, $1 347.50 excluding any fee payable to the interpreter)

5.

Examination and provision of report and certificate — psychiatric — standard assessment — other than a service mentioned in item 8.

$1 617.00 (or, if an interpreter is present at the examination, $1 886.50 excluding any fee payable to the interpreter)

6.

Examination and provision of report and certificate — psychiatric — complex assessment (e.g. reviewing significant documented prior psychiatric history) — other than a service mentioned in item 8.

$2 694.95 (or, if an interpreter is present at the examination, $2 964.45 excluding any fee payable to the interpreter)

7.

Consolidation of written assessments from multiple assessors.

$538.95

8.

Re‑examination and provision of report and certificate.

$808.50 (or, if an interpreter is present at the examination, $1 078.05 excluding any fee payable to the interpreter)

9.

Provision of supplementary report and certificate.

$269.55

[Part 1 inserted in Gazette 29 Oct 2010 p. 5390-1.]

Part 2 — Attempted assessments

[Heading inserted in Gazette 29 Oct 2010 p. 5392.]

Description of circumstances

Maximum fee**

1.

If a worker who is required under Part VII Division 2 of the Act to submit to an examination by an approved medical specialist does not attend, in a case in which —

$538.95

 

(a)no prior arrangements to cancel the examination are made; or

 

 

(b)the examination is cancelled, otherwise than at the request of the approved medical specialist, with less than one working day’s notice.

 

**Denotes that where the service provided is a fraction of one hour, the amount chargeable is to be calculated as that fraction of the maximum amount.

[Part 2 inserted in Gazette 29 Oct 2010 p. 5392.]

 

Notes

1This is a compilation of the Workers’ Compensation and Injury Management (Scales of Fees) Regulations 1998 and includes the amendments made by the other written laws referred to in the following table 2. The table also contains information about any reprint.

Compilation table

Citation

Gazettal

Commencement

Workers’ Compensation and Rehabilitation (Scales of Fees) Regulations 1998 3

13 Oct 1998 p. 5709‑25

13 Oct 1998

Workers’ Compensation and Rehabilitation (Scales of Fees) Amendment Regulations 1999

20 Jul 1999 p. 3249‑77

20 Jul 1999

Workers’ Compensation and Rehabilitation (Scales of Fees) Amendment Regulations (No. 2) 1999

31 Aug 1999 p. 4264‑5

31 Aug 1999

Workers’ Compensation and Rehabilitation (Scales of Fees) Amendment Regulations 2000

21 Dec 2000 p. 7623‑51
(correction 6 Feb 2001 p. 743)

21 Dec 2000

Workers’ Compensation and Rehabilitation (Scales of Fees) Amendment Regulations 2001

14 Dec 2001 p. 6416‑17

14 Dec 2001

Workers’ Compensation and Rehabilitation (Scales of Fees) Amendment Regulations (No. 2) 2001

28 Dec 2001 p. 6691‑710

28 Dec 2001

Workers’ Compensation and Rehabilitation (Scales of Fees) Amendment Regulations 2002

21 May 2002 p. 2593‑4

21 May 2002

Reprint of the Workers’ Compensation and Rehabilitation (Scales of Fees) Regulations 1998 as at 24 May 2002 (includes amendments listed above)

Workers’ Compensation and Rehabilitation (Scales of Fees) Amendment Regulations (No. 2) 2002

10 Sep 2002 p. 4602‑3

10 Sep 2002

Workers’ Compensation and Rehabilitation (Scales of Fees) Amendment Regulations 2003

7 Mar 2003 p. 741‑2

7 Mar 2003

Workers’ Compensation and Rehabilitation (Scales of Fees) Amendment Regulations (No. 2) 2003

25 Mar 2003 p. 922‑3

25 Mar 2003

Workers’ Compensation and Rehabilitation (Scales of Fees) Amendment Regulations (No. 3) 2003

9 May 2003 p. 1626

9 May 2003

Workers’ Compensation and Rehabilitation (Scales of Fees) Amendment Regulations (No. 4) 2003

12 Sep 2003 p. 4081‑2

12 Sep 2003

Workers’ Compensation and Rehabilitation (Scales of Fees) Amendment Regulations (No. 5) 2003

23 Sep 2003 p. 4173‑86

23 Sep 2003

Workers’ Compensation and Rehabilitation (Scales of Fees) Amendment Regulations (No. 6) 2003

9 Jan 2004 p. 98‑100

9 Jan 2004

Workers’ Compensation and Rehabilitation (Scales of Fees) Amendment Regulations 2004

19 Mar 2004 p. 861‑910

19 Mar 2004

Workers’ Compensation and Rehabilitation (Scales of Fees) Amendment Regulations (No. 2) 2004

29 Oct 2004 p. 4940‑2

29 Oct 2004

Workers’ Compensation and Rehabilitation (Scales of Fees) Amendment Regulations 2005

21 Jan 2005 p. 278‑86

21 Jan 2005

Workers’ Compensation and Rehabilitation (Scales of Fees) Amendment Regulations (No. 2) 2005

1 Nov 2005 p. 4976‑84

1 Nov 2005

Workers’ Compensation and Injury Management (Scales of Fees) Amendment Regulations (No. 3) 2005

11 Nov 2005 p. 5567‑70

14 Nov 2005 (see r. 2 and Gazette 31 Dec 2004 p. 7131 and 17 Jun 2005 p. 2657)

Workers’ Compensation and Injury Management (Scales of Fees) Amendment Regulations 2006

10 Jan 2006 p. 41‑71

10 Jan 2006

Reprint 2: The Workers’ Compensation and Injury Management (Scales of Fees) Regulations 1998 as at 3 Mar 2006 (includes amendments listed above)

Workers’ Compensation and Injury Management (Scales of Fees) Amendment Regulations (No. 2) 2006

28 Apr 2006 p. 1660

28 Apr 2006

Workers’ Compensation and Injury Management (Scales of Fees) Amendment Regulations (No. 3) 2006

22 Dec 2006 p. 5755-94

22 Dec 2006

Reprint 3: The Workers’ Compensation and Injury Management (Scales of Fees) Regulations 1998 as at 2 Mar 2007 (includes amendments listed above)

Workers’ Compensation and Injury Management (Scales of Fees) Amendment Regulations 2007

7 Dec 2007 p. 6031‑71

r. 1 and 2: 7 Dec 2007 (see r. 2(a));
Regulations other than r. 1 and 2: 8 Dec 2007 (see r. 2(b))

Workers’ Compensation and Injury Management (Scales of Fees) Amendment Regulations 2008

17 Dec 2008 p. 5287‑330

r. 1 and 2: 17 Dec 2008 (see r. 2(a));
Regulations other than r. 1 and 2: 18 Dec 2008 (see r. 2(b))

Workers’ Compensation and Injury Management (Scales of Fees) Amendment Regulations 2009

30 Oct 2009 p. 4343‑91

r. 1 and 2: 30 Oct 2009 (see r. 2(a));
Regulations other than r. 1 and 2: 1 Nov 2009 (see r. 2(b))

Workers’ Compensation and Injury Management (Scales of Fees) Amendment Regulations (No. 2) 2009

22 Dec 2009 p. 5276‑7

r. 1 and 2: 22 Dec 2009 (see r. 2(a));
Regulations other than r. 1 and 2: 23 Dec 2009 (see r. 2(b))

Reprint 4: The Workers’ Compensation and Injury Management (Scales of Fees) Regulations 1998 as at 7 May 2010 (includes amendments listed above)

Workers’ Compensation and Injury Management (Scales of Fees) Amendment Regulations 2010

29 Oct 2010 p. 5347-92

r. 1 and 2: 29 Oct 2010 (see r. 2(a));
Regulations other than r. 1 and 2: 1 Nov 2010 (see r. 2(b))

2The amendments in the Workers’ Compensation and Rehabilitation (Scales of Fees) Amendment Regulations (No. 3) 2004 published in Gazette 4 Jan 2005
p. 6-14 have no effect because of an error in the reference to the principal regulations to be amended.

3Now known as the Workers’ Compensation and Injury Management (Scales of Fees) Regulations 1998; citation changed (see note under r. 1).

 

 

Defined Terms

 

[This is a list of terms defined and the provisions where they are defined. The list is not part of the law.]

Defined TermProvision(s)

After‑hoursSch. 1

assessor9(2)

GST10(1)

MBS item number2(2)

report and certificate9(2)