Fees

We provide a table of costs for different kinds of services. These tables list who can provide services, approved item numbers and the scheduled maximum fees payable.

A scheduled fee exists for most services. For those without a fee, please contact us before delivering these services.

Current fees

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The table of costs are updated regularly. Please make sure you use the correct fee when you invoice us.

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What we'll pay for

If we accept a claim, we‘ll pay for the cost of approved and reasonable treatment and rehabilitation related to the work-related injury. This includes:

• treatment and services by an approved and registered service provider for the work-related injury, when a current work capacity certificate is provided
• costs based on the scheduled fees in the table of costs, up to the maximum amount listed
• non-elective hospitalisation costs as an in-patient, at a private or public hospital, up to four days without prior approval or, more than four days if prior approval is given
• elective hospitalisation, when prior approval is obtained.

You can also see our policy on providing new (non-established) or emerging treatments and services to workers.

Surgery

A request for surgery (PDF, 0.11 MB) form must be submitted and approved before hospital admission. If you provide the supplementary medical information in questions 11-13 you can charge can charge item code 100808 as listed in the specialist supplementary services table of costs.  If these are not completed, you can't charge for the request.

The surgical guidelines can also help you determine the most appropriate surgical item number/s.

What we won’t pay for

We're unable to pay for any costs associated with:

• claims that haven't been accepted
• withdrawn claims
• claims that have been put on hold
• report only claims
• charges above the maximum listed fee
• services or treatment by a non-approved provider
• services that aren't listed in the current table of costs or that haven't been discussed with us
• surgery charges that are not in line with the multiple operation rule
• repair, replacement or ongoing maintenance of any hired equipment provided to the worker.

Equipment

Hiring equipment that assists the rehabilitation journey is supported.

When deciding on equipment, it's recommended to review all options available. This might include comparing the cost of hiring to the cost of buying the item.  It’s good to consider the most affordable yet clinically effective option.

Requesting incidental expenses

Our tables of costs across various allied health services provide more information on incidental expenses, supportive devices and hiring of equipment to workers.

Here’s how you can invoice us.