100010000601.07.2023 O Y Y 2001.07.202300097.0000000.0000000.00 5001.07.2023SUBSEQUENT CONSULTATION - A one-on-one subsequent consultation in the 5001.07.2023treatment of work-related injuries or conditions. . The first six (6) 5001.07.2023consultations (including initial consultation) are pre-approved, provided the 5001.07.2023injuries or conditions have not previously been treated by an allied health 5001.07.2023provider. If additional treatment is required, submit a Provider Management 5001.07.2023Plan3 (PMP) by the 6th subsequent treatment consultation. The PMP should 5001.07.2023include a comprehensive treatment plan containing: expected functional gains, 5001.07.2023transition of care to self-management; and treatment timeframes. Services to 5001.07.2023be conducted in accordance with the Clinical Framework for the Delivery of 5001.07.2023Health Services2. Subsequent consultation may include: ongoing assessment 5001.07.2023(subjective and objective) intervention/treatment setting expectations of 5001.07.2023recovery and return to work clinical recording communication with the insurer 5001.07.2023of any relevant information for the workers rehabilitation. 100010002101.07.2023 O Y Y 2001.07.202300124.0000000.0000000.00 5001.07.2023INITIAL CONSULTATION - A one-on-one initial consultation for the treatment of 5001.07.2023work-related injuries or conditions, or the first consultation in a new 5001.07.2023episode of care for the same work-related injuries or conditions. Please Note: 5001.07.2023A provider cannot bill for multiple initial consultations or multiple 5001.07.2023subsequent consultations for the same claimant on the same day. Services to be 5001.07.2023conducted in accordance with the Clinical Framework for the Delivery of Health 5001.07.2023Services. Initial consultation may include: subjective assessment objective 5001.07.2023assessment treatment/service tailored goal setting and treatment planning 5001.07.2023setting expectations of recovery and return to work clinical recording 5001.07.2023communication with the insurer of any relevant information for the workers 5001.07.2023rehabilitation. 100010010601.07.2023 O Y Y 2001.07.202300053.0000000.0000000.00 5001.07.2023GROUP EXERCISE SESSIONS - Prior approval required before providing this 5001.07.2023service. A session where a common program is delivered to more than one 5001.07.2023individual at the same time. The group can consist of a maximum of eight (8) 5001.07.2023persons. The group session must be attended, conducted, and supervised by a 5001.07.2023physiotherapist. 100010022601.07.2023 H Y Y 2001.07.202300261.0000000.0000000.00 5001.07.2023INDEPENDENT CASE REVIEW - An independent physiotherapy examination and report 5001.07.2023on a worker. It is not carried out by the treating physiotherapist. The review 5001.07.2023is requested by the insurer where progress of treatment and/or rehabilitation 5001.07.2023falls outside the plan or expected course of injury management. The 5001.07.2023examination and report provide the insurer with an assessment and 5001.07.2023recommendations for ongoing treatment and prognosis. 100010028701.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023SPECIALISED HAND/UPPER LIMB CONSULTATION- PHYSIOTHERAPIST ONLY - Prior 5001.07.2023approval is required before providing this service, unless referred by a 5001.07.2023medical specialist, A one-on-one consultation and treatment for workers with 5001.07.2023hand and upper limb work-related injuries or conditions (below shoulder 5001.07.2023level). Treatment offered is considered specialist hand therapy provided by a 5001.07.2023qualified physiotherapist. Further details are provided below the tables. 5001.07.2023Consultations may include: ongoing assessment (subjective and objective) 5001.07.2023intervention/treatment setting expectations of recovery and return to work 5001.07.2023clinical recording communication with the insurer of any relevant information 5001.07.2023for the workers rehabilitation. A Provider Management Plan (PMP) is to be 5001.07.2023submitted following the initial assessment. The PMP should include an updated 5001.07.2023comprehensive treatment plan containing: expected functional gains, transition 5001.07.2023of care to self-management; and treatment timeframes. Maximum one (1) hour. 5001.07.2023Approval required for sessions exceeding 1 hr 100010031401.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023INITIAL CONSULTATION - WORK SPECIFIC FUNCTIONAL EXERCISE PROGRAM - Prior 5001.07.2023approval is required before providing this service. Development and 5001.07.2023instruction of a gym/pool-based exercise program focused on improving function 5001.07.2023of the work-related injury or condition, relevant to the work role. The aim of 5001.07.2023this program is for a successful transition of the workers program to a 5001.07.2023gym/pool-based setting in order to meet their work specific functional goals. 5001.07.2023This service may only be charged once. Refer to Item Number 300228 for Gym and 5001.07.2023Pool Entry Fees. Services to be conducted in accordance with the Clinical 5001.07.2023Framework for the Delivery of Health Services. The entire consultation must be 5001.07.2023one-on-one with the worker. Maximum one (1) hour. 100010040201.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023SUBSEQUENT CONSULTATION - WORK SPECIFIC FUNCTIONAL EXERCISE PROGRAM - Prior 5001.07.2023approval is required before providing this service. The insurer may request 5001.07.2023justification and will consider seeking an independent opinion if more than 5001.07.2023six (6) consultations are requested per episode of care. A one-on-one 5001.07.2023consultation with the worker for ongoing monitoring, review and progression of 5001.07.2023a gym/pool-based exercise program as developed during initial consultation 5001.07.2023(100314). The focus must be on improving function of the work-related injury 5001.07.2023or condition relevant to the work role and include education and progression 5001.07.2023to self-management. Services to be conducted in accordance with the Clinical 5001.07.2023Framework for the Delivery of Health Services. A Provider Management Plan 5001.07.2023(PMP) is to be submitted for approval following the initial consultation 5001.07.2023(100314) and before any treatment commences. The PMP should include a 5001.07.2023comprehensive treatment plan containing: expected functional gains, transition 5001.07.2023of care to self-management; and treatment timeframes. Maximum one (1) hour. 100010040601.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023SPECIFIC PHYSIOTHERAPY ASSESSMENT - Prior approval is required before 5001.07.2023providing this service and justification may be requested by the insurer. A 5001.07.2023one-on-one assessment used for specific conditions that cannot be adequately 5001.07.2023assessed, due to the complexity of the condition, within an initial 5001.07.2023consultation (100021, 100313 for multiple injuries or conditions, and 100314 5001.07.2023for work specific functional exercise program). These may include, but are not 5001.07.2023limited to: extensive burns acquired brain injuries severe spinal cord 5001.07.2023injuries multiple orthopaedic fractures limb amputations crush injuries. This 5001.07.2023service can also be used for the assessment (only) of suitability for entry 5001.07.2023into a Multi-Disciplinary Program or Pain Management Program. The service may 5001.07.2023only be used once by the physiotherapist in the treatment of a work-related 5001.07.2023injury or condition, or the first consultation in a new episode of care for 5001.07.2023the same work-related injury or condition. Maximum one (1) hour. 100010040701.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023SPECIFIC PHYSIOTHERAPY CONSULTATION - Prior approval is required before 5001.07.2023providing this service. The insurer may request justification and will 5001.07.2023consider seeking an independent opinion if more than six (6) consultations are 5001.07.2023requested per episode of care. A one-on-one consultation for recommended 5001.07.2023interventions identified during a Specific Physiotherapy Assessment (100406). 5001.07.2023These may include, but are not limited to: extensive burns acquired brain 5001.07.2023injuries severe spinal cord injuries multiple orthopaedic fractures limb 5001.07.2023amputations crush injuries. Please note: This service is not to be used for 5001.07.2023consultations within a Multi-Disciplinary Program or Pain Management Program 5001.07.2023and must not be already classified elsewhere in this table. A Provider 5001.07.2023Management Plan (PMP) is to be submitted following the initial assessment 5001.07.2023(100406). The PMP should include an updated comprehensive treatment plan 5001.07.2023containing: expected functional gains, transition of care to self-management; 5001.07.2023and treatment timeframes. Maximum one (1) hour. 100010055501.07.2023 O Y Y 2001.07.202300124.0000000.0000000.00 5001.07.2023REASSESSMENT OR PROGRAM REVIEW - A one-on-one comprehensive assessment used 5001.07.2023when: the worker has been in active rehabilitation for at least six weeks and 5001.07.2023further treatment is likely; and/or there are new clinical findings that might 5001.07.2023affect ongoing treatment; and/or there is a rapid change in worker's status 5001.07.2023and/or there is no response to current therapeutic interventions. It should 5001.07.2023include: all components of initial consultation a review of the workers 5001.07.2023progress based on established objective measures a recommendation for future 5001.07.2023treatment and management strategies to assist the worker to return to work. It 5001.07.2023may include referral recommendations to other providers, a change in therapy 5001.07.2023or outcome direction requiring a new return to work goal. Following 5001.07.2023reassessment submit a Provider Management Plan (PMP) with an updated 5001.07.2023comprehensive treatment plan containing: expected functional gains, transition 5001.07.2023of care to self-management; and treatment timeframes. 100020001101.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023COMPREHENSIVE ORAL EXAMINATION (ADA 011) - Insurer prior approval required 5001.07.2023Evaluation of all teeth, their supporting tissues, and the oral tissues in 5001.07.2023order to record the current condition of these structures. This evaluation 5001.07.2023includes recording an appropriate oral and medical history and any other 5001.07.2023relevant information. Usual practice fee applies. 100020001201.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023PERIODIC ORAL EXAMINATION (ADA 012) - Insurer prior approval required An 5001.07.2023evaluation performed on a patient of record to determine any changes in the 5001.07.2023patient's oral and medical health status since a previous comprehensive or 5001.07.2023periodic examination. Usual practice fee applies. 100020001301.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023ORAL EXAMINATION - LIMITED (ADA 013) - Insurer prior approval required A 5001.07.2023limited evaluation of the dentition, mouth and associated structures performed 5001.07.2023on a patient. This may be for a specific oral health problem or complaint. 5001.07.2023This evaluation includes recording an appropriate oral and medical history and 5001.07.2023any other relevant information. Usual practice fee applies. 100020001401.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023CONSULTATION (<30 MINUTES) (ADA 014) - Insurer prior approval required A 5001.07.2023consultation to seek advice or discuss treatment options regarding a specific 5001.07.2023dental or oral condition. This consultation includes recording an appropriate 5001.07.2023medical history and any other relevant information. Usual practice fee 5001.07.2023applies. 100020001501.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023CONSULTATION - EXTENDED (30 MINUTES) (ADA 015) - Insurer prior approval 5001.07.2023required. An extended consultation to seek advice or discuss treatment options 5001.07.2023about a specific dental or oral complaint. This consultation includes 5001.07.2023recording an appropriate medical history and any other relevant information. 5001.07.2023Usual practice fee applies. 100020002201.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023INTRAORAL PERIAPICAL OR BITEWING RADIOGRAPH (ADA 022) - Insurer prior approval 5001.07.2023required Taking and interpreting a radiograph made with the film inside the 5001.07.2023mouth. Usual practice fee per exposure applies. 100020002501.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023INTRAORAL RADIOGRAPH - OCCLUSAL, MAXILLARY, MANDIBULAR (ADA 025) - Insurer 5001.07.2023prior approval required Taking and interpreting an occlusal, maxillary, or 5001.07.2023mandibular intraoral radiograph. This radiograph shows a more extensive view 5001.07.2023of teeth and maxillary or mandibular bone. Usual practice fee per exposure 5001.07.2023applies 100020003701.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023PANORAMIC RADIOGRAPH (OPG) (ADA 037) - Insurer prior approval required Taking 5001.07.2023and interpreting an extraoral radiograph presenting a panoramic view of part 5001.07.2023or all of the mandible and/or the maxilla and/or adjacent structures. Usual 5001.07.2023practice fee per exposure applies. 100020007101.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023DIAGNOSTIC MODEL (ADA 071) - Insurer prior approval required The preparation 5001.07.2023of a model from an impression or digital data. The model is used for 5001.07.2023examination and treatment planning procedures. This item should not be used to 5001.07.2023describe a working model. Usual practice fee per model applies. 100020031101.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023REMOVAL OF A TOOTH OR PART(S) THEREOF (ADA 311) - Insurer prior approval 5001.07.2023required A procedure consisting of the removal of a tooth or part(s) thereof. 5001.07.2023Usual practice fee applies. 100020031401.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023SECTIONAL REMOVAL OF A TOOTH OR PART(S) THEREOF (ADA 314) - Insurer prior 5001.07.2023approval required The removal of a tooth or part(s) thereof in sections. Bone 5001.07.2023removal may be necessary. Usual practice fee applies. 100020032201.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023SURGICAL REMOVAL OF A TOOTH OR FRAGMENT NOT REQUIRING REMOVAL OF BONE OR TOOTH 5001.07.2023DIVISION (ADA 322) - Insurer prior approval required Removal of a tooth or 5001.07.2023tooth fragment where an incision and the raising of a mucoperiosteal flap are 5001.07.2023required, but where removal of bone or sectioning of the tooth is not 5001.07.2023necessary to remove the tooth. Usual practice fee applies. 100020032301.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023SURGICAL REMOVAL OF A TOOTH OR TOOTH FRAGMENT REQUIRING REMOVAL OF BONE (ADA 5001.07.2023323) - Insurer prior approval required Removal of a tooth or tooth fragment 5001.07.2023where removal of bone is required after an incision and the raising of a 5001.07.2023mucoperiosteal flap. 100020035201.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023FRACTURE OF MAXILLA OR MANDIBLE - NOT REQUIRING FIXATION (ADA 352) - Insurer 5001.07.2023prior approval required Conservative treatment of a fracture of the maxilla or 5001.07.2023mandible where there is no marked displacement or mobility of the fragments. 5001.07.2023No physical reduction or fixation is required. Usual practice fee applies. 100020038701.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023REPLANTATION AND SPLINTING OF A TOOTH (ADA 387) - Insurer prior approval 5001.07.2023required Replantation of a tooth that has been avulsed or intentionally 5001.07.2023removed. It may be held in the correct position by splinting. Usual practice 5001.07.2023fee applies per tooth. 100020039901.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023CONTROL OF REACTIONARY OR SECONDARY POST-OPERATIVE HAEMORRHAGE (ADA 399) - 5001.07.2023Insurer prior approval required This procedure describes the control of 5001.07.2023reactionary or secondary post-operative haemorrhage. Usual practice fee 5001.07.2023applies. 100020041101.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023DIRECT PULP CAPPING (ADA 411) - Insurer prior approval required A procedure 5001.07.2023where an exposed pulp is directly covered with a protective dressing or 5001.07.2023cement. Usual practice fee applies. 100020041901.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023EXTIRPATION OF PULP OR DEBRIDEMENT OF ROOT CANAL(S) - EMERGENCY OR PALLIATIVE 5001.07.2023(ADA 419) - Insurer prior approval required The partial or thorough removal of 5001.07.2023pulp and/or debris from the root canal system of a tooth. This is an emergency 5001.07.2023or palliative procedure distinct from visits for scheduled endodontic 5001.07.2023treatment. Temporisation, other than the closure of an access cavity, should 5001.07.2023be itemised separately. Usual practice fee applies. 100020045501.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023ADDITIONAL VISIT FOR IRRIGATION AND/OR DRESSING OF THE ROOT CANAL SYSTEM (ADA 5001.07.2023455) - Insurer prior approval required Additional debridement irrigation and 5001.07.2023short-term dressing required where evidence of infection or inflammation 5001.07.2023persists following prior opening of the root canal and removal of its 5001.07.2023contents. Usual practice fee applies per tooth. 100020051101.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023METALLIC RESTORATION - ONE SURFACE - DIRECT (ADA 511) - Insurer prior approval 5001.07.2023required Direct metallic restoration involving one surface of a tooth. Usual 5001.07.2023practice fee applies. 100020051201.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023METALLIC RESTORATION - TWO SURFACES - DIRECT (ADA 512) - Insurer prior 5001.07.2023approval required Direct metallic restoration involving two surfaces of a 5001.07.2023tooth. Usual practice fee applies. 100020051301.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023ANY PROSTHODONTIC SERVICE (ADA 611-ADA 779) - Insurer prior approval required 5001.07.2023Provision of any service from the Prosthodontics chapter of The Australian 5001.07.2023Schedule of Dental Services and Glossary 13th edition. Usual practice fee 5001.07.2023applies. 100020071101.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023COMPLETE MAXILLARY DENTURE (ADA 711) - Insurer prior approval required 5001.07.2023Provision of a patient removable dental prosthesis replacing the natural teeth 5001.07.2023and adjacent tissues in the maxilla. Usual practice fee applies. 100020071201.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023COMPLETE MANDIBULAR DENTURE (ADA 712) - Insurer prior approval required 5001.07.2023Provision of a patient removable dental prosthesis replacing the natural teeth 5001.07.2023and adjacent tissues in the mandible. Usual practice fee applies. 100020072101.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023PARTIAL MAXILLARY DENTURE - RESIN BASE (ADA 721) - Insurer prior approval 5001.07.2023required Provision of a resin base for a patient removable dental prosthesis 5001.07.2023for the maxilla where some natural teeth remain. Other components of the 5001.07.2023denture such as teeth, rests, retainers, and immediate tooth replacements 5001.07.2023should be appropriately itemised. Usual practice fee applies. 100020072201.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023PARTIAL MANDIBULAR DENTURE - RESIN BASE (ADA 722) - Insurer prior approval 5001.07.2023required Provision of a resin base for a patient removable dental prosthesis 5001.07.2023for the mandible where some natural teeth remain. Other components of the 5001.07.2023denture such as teeth, rests, retainers, and immediate tooth replacements 5001.07.2023should be appropriately itemised. Usual practice fee applies. 100020072801.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023PARTIAL MANDIBULAR DENTURE - CAST METAL FRAMEWORK (ADA 728) - Insurer prior 5001.07.2023approval required Provision of the framework for a patient removable dental 5001.07.2023prosthesis made with a cast metal on which to replace teeth from the mandible 5001.07.2023where some natural teeth remain. Other components of the denture such as 5001.07.2023teeth, rests, retainers, and immediate tooth replacements should be 5001.07.2023appropriately itemised. Usual practice fee applies. 100020073101.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023RETAINER (ADA 731) - Insurer prior approval required A retainer or attachment 5001.07.2023fitted to a tooth to aid retention of a partial denture. The number of 5001.07.2023retainers should be indicated. Usual practice fee per tooth applies. 100020073201.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023OCCLUSAL REST (ADA 732) - Insurer prior approval required A unit of partial 5001.07.2023denture that rests upon a tooth surface to provide support for the denture. 5001.07.2023The number of rests used should be indicated. Usual practice fee per rest 5001.07.2023applies. 100020073301.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023TOOTH/TEETH (PARTIAL DENTURE) (ADA 733) - Insurer prior approval required An 5001.07.2023item to describe each tooth added to the base of new partial denture. The 5001.07.2023number of teeth should be indicated. Usual practice fee applies. 100020076401.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023REPAIRING BROKEN BASE OF A PARTIAL DENTURE (ADA 764) - Repair, insertion, and 5001.07.2023adjustment of a broken resin partial denture base. Usual practice fee applies. 100020076801.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023ADDING TOOTH TO PARTIAL DENTURE TO REPLACE AN EXTRACTED OR DECORONATED TOOTH 5001.07.2023(ADA 768) - Modification, insertion, and adjustment of a partial denture 5001.07.2023involving an addition to accommodate the loss of a natural tooth or its 5001.07.2023coronal section. Usual practice fee per tooth applies. 100020077601.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023IMPRESSION - DENTAL APPLIANCE REPAIR/ MODIFICATION (ADA 776) - An item to 5001.07.2023describe taking an impression where required for the repair or modification of 5001.07.2023a dental appliance. Usual practice fee applies. 100020091101.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023PALLIATIVE CARE (ADA 911) - An item to describe interim care to relieve pain, 5001.07.2023infection, bleeding, or other problems not associated with other treatment. 5001.07.2023Usual practice fee applies. 100020092701.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023PROVISION OF MEDICATION/MEDICAMENT (ADA 927) - An additional item to describe 5001.07.2023the actual supply, prescription or administration of appropriate medications 5001.07.2023and medicaments required for dental treatments. Usual practice fee applies. 100021000101.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023COMPLETE FORMS (SENT WITH REQUEST) - FOR TREATING DENTAL PRACTITIONERS TO 5001.07.2023PROVIDE BASIC INFORMATION - Complete forms (sent with request) for treating 5001.07.2023dental practitioners to provide basic information as set out in forms provided 5001.07.2023by the insurer. The treating dental practitioner is to indicate the need for 5001.07.2023phone contact or a full report if additional pertinent information is 5001.07.2023available. Basic fee payable for each form completed. Usual practice fee 5001.07.2023applies. 100021000201.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023SHORT REPORT - A short report written in response to a request for specific 5001.07.2023information e.g. a statement of attendance, history, diagnosis, record of 5001.07.2023visits, including results of an investigation. These reports should only 5001.07.2023address the information requested but should include any comments necessary to 5001.07.2023make the position clear to a lay person. Expected length is half a page to one 5001.07.2023(1) page. Received by insurer within 10 working days. Usual practice fee 5001.07.2023applies. 100021000501.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023BASIC REPORT - A basic report includes summing up and an opinion helpful to 5001.07.2023the insurer. A basic report should include all of the relevant items listed in 5001.07.2023the outline for the short report and also a case summary. Details would only 5001.07.2023be given where this assists in determining the merits of a claim, establishing 5001.07.2023a need for a particular line of treatment or rehabilitation, understanding the 5001.07.2023development of the condition and the prognosis, or clarifying early treatment 5001.07.2023and return to work goals. Expected length is one (1) to two (2) pages. 5001.07.2023Received by insurer within 10 working days. Usual practice fee applies. 100021000801.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023SUBSTANTIAL REPORT - A substantial report includes extensive research or case 5001.07.2023discussion and opinion helpful to the insurer or assessment of impairment on 5001.07.2023request; or if the claim is rejected, to compensate for clinical input to the 5001.07.2023report. To qualify as substantial, a report must include, in addition to the 5001.07.2023case summary and comments required for a basic report, at least one of the 5001.07.2023following: - an assessment of impairment at the insurer's request - a report 5001.07.2023on a work-related injury or condition where the claim is subsequently rejected 5001.07.2023as a result of the report - evidence of extensive research into clinical, 5001.07.2023technical, or scientific papers - considerable case discussion outlining the 5001.07.2023merits of the claim - or advice on the future management of the case which 5001.07.2023assists the insurer and/or rehabilitation providers to manage the claim. 5001.07.2023Received by insurer within 10 working days. Usual practice fee applies. 100021001101.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023EXPERT SPECIALIST OPINION - An expert specialist opinion includes the above 5001.07.2023elements essential to the insurer in determining or managing claims. To 5001.07.2023attract the fee for an expert specialist report there should be evidence of 5001.07.2023two or more of the requirements for a substantial report, or the preparation 5001.07.2023of a report of a medico-legal standard for use by a medical assessment 5001.07.2023tribunal or a court. Expected length is three (3) or more pages. Note: only to 5001.07.2023be paid to specialists. Received by insurer within 10 working days. Usual 5001.07.2023practice fee applies. 100030000401.07.2023 O Y Y 2001.07.202300124.0000000.0000000.00 5001.07.2023INITIAL CONSULTATION - A one-on-one initial consultation for acupuncture in 5001.07.2023the treatment of work-related injuries or conditions, or the first 5001.07.2023consultation in a new episode of care for the same work-related injuries or 5001.07.2023conditions. Services to be conducted in accordance with the Clinical Framework 5001.07.2023for the Delivery of Health Services. Initial consultation may include: 5001.07.2023subjective assessment objective assessment treatment/service tailored goal 5001.07.2023setting and treatment planning setting expectations of recovery and return to 5001.07.2023work clinical recording communication (with referrer) any relevant information 5001.07.2023for the workers rehabilitation to the insurer. 100030000501.07.2023 O Y Y 2001.07.202300097.0000000.0000000.00 5001.07.2023SUBSEQUENT CONSULTATION - A one-on-one subsequent consultation for acupuncture 5001.07.2023in the treatment of work-related injuries or conditions. The first six (6) 5001.07.2023consultations (including initial consultation) are pre-approved, provided the 5001.07.2023injuries have not previously been treated by an allied health provider. If 5001.07.2023additional treatment is required, submit a Provider Management Plan (PMP) by 5001.07.2023the 6th subsequent treatment consultation. The PMP should include a 5001.07.2023comprehensive treatment plan containing: expected functional gains, transition 5001.07.2023of care to self-management; and treatment timeframes. Services to be conducted 5001.07.2023in accordance with the Clinical Framework for the Delivery of Health Services 5001.07.2023Subsequent consultation may include: ongoing assessment (subjective and 5001.07.2023objective) intervention/treatment setting expectations of recovery and return 5001.07.2023to work clinical recording communication with the insurer of any relevant 5001.07.2023information for the workers rehabilitation. 100030001401.07.2023 H Y Y 2001.07.202300083.0000000.0000000.00 5001.07.2023HOME NURSING SERVICES BY A REGISTERED NURSE - Home Nursing Services by a 5001.07.2023Registered Nurse-Prior approval is required before providing this service. 5001.07.2023Home nursing services such as dressing of wounds and assistance with daily 5001.07.2023care. The insurer will not pay for home nursing services in excess of four (4) 5001.07.2023weeks without a treating medical practitioner review. NB: must be referred by 5001.07.2023a medical practitioner. Day and evening rate: $83. Weekend rate: $107. Prior 5001.07.2023approval is required before providing this service. 100030007901.07.2023 O Y Y 2001.07.202300035.0000000.0000000.00 5001.07.2023COMMUNICATION - 3 TO 10 MINS - Communication-3 to 10 mins-Direct communication 5001.07.2023between treating provider and insurer, employer, insurer referred allied 5001.07.2023health provider and doctors to assist with faster and more effective 5001.07.2023rehabilitation and return to work for a worker. Excludes communication with a 5001.07.2023worker, and of a general administrative nature or conveying non-specific 5001.07.2023information. Must be more than three (3) minutes. Refer to details below the 5001.07.2023tables for a list of exclusions before using this item number. Treating 5001.07.2023providers are expected to keep a written record of the details of 5001.07.2023communication including date, time, and duration. The insurer may request 5001.07.2023evidence of communication at any time. 100030008101.07.2023 O Y Y 2001.07.202300046.0000000.0000000.00 5001.07.2023GENERAL MEDICAL PROCEDURES - Payable where a patient is seen by an advanced 5001.07.2023practice registered nurse (i.e. a nurse practitioner or rural and isolated 5001.07.2023practice nurse) and performs straightforward medical procedures that would 5001.07.2023normally be payable as part of a doctor's MBS attendance fee i.e. suturing a 5001.07.2023wound or removal of a superficial foreign body. This also includes outpatient 5001.07.2023care in hospitals. 100030008201.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023CASE CONFERENCE - Prior approval is required before providing the service. 5001.07.2023Face-to-face or phone communication involving the treating provider, insurer 5001.07.2023and one or more of the following: treating medical practitioner or specialist 5001.07.2023employer or employee representative worker allied health providers; or other. 100030008401.07.2023 O Y Y 2001.07.202300070.0000000.0000000.00 5001.07.2023UPDATED SUITABLE DUTIES PROGRAM (SDP) - Documentation of an updated or further 5001.07.2023suitable duties plan for a worker, detailing specific information necessary 5001.07.2023for a safe and effective return to the workplace. For WorkCover Queensland 5001.07.2023claims, only an approved RTW Services provider can provide this service.** 100030008601.07.2023 O Y Y 2001.07.202300070.0000000.0000000.00 5001.07.2023PROGRESS REPORT - A written report providing a brief summary of the worker's 5001.07.2023progress towards recovery and return to work. 100030008701.07.2023 O Y Y 2001.07.202300140.0000000.0000000.00 5001.07.2023PUBLIC HOSPITAL EMERGENCY NURSE SERVICES - To be billed where a worker 5001.07.2023receives primary emergency services provided by nursing staff only. This code 5001.07.2023is used if the care is of an emergency nature only and the hospital is not 5001.07.2023considered to have a recognised emergency department as per the Public Health 5001.07.2023Services Table of Costs. 100030008801.07.2023 O Y Y 2001.07.202300177.0000000.0000000.00 5001.07.2023STANDARD REPORT - A written report used for conveying relevant information 5001.07.2023about a worker's work-related injury or condition where the case or treatment 5001.07.2023is not extremely complex or where responses to a limited number of questions 5001.07.2023have been requested by the insurer. 100030008901.07.2023 O Y Y 2001.07.202300046.0000000.0000000.00 5001.07.2023ASSISTING DOCTOR IN MINOR SURGERY - This item will be payable only if the 5001.07.2023procedure attracts an MBS assistance fee and there is no other doctor 5001.07.2023available to assist. 100030009001.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023COMPREHENSIVE REPORT - A written report only used where the case and treatment 5001.07.2023is extremely complex. Hours to be negotiated with the insurer prior to 5001.07.2023providing the report. 100030009101.07.2023 H Y Y 2001.07.202300161.0000000.0000000.00 5001.07.2023TRAVEL - RTW SERVICES ONLY - Travel charges are applicable when the provider 5001.07.2023is required to leave their normal place of practice to treat a worker at a: 5001.07.2023rehabilitation facility hospital workplace their place of residence, or 5001.07.2023community-based setting. Travel is not payable where: the travel is between 5001.07.2023clinics or facilities owned and/or operated by the provider or their employer. 5001.07.2023the travel is for services delivered at an external facility where treatment 5001.07.2023at these external facilities is a regular part of that providers approach and 5001.07.2023there exists a contractual arrangement and/or agreement to use that external 5001.07.2023facility. Please see explanatory notes for further information. For WorkCover 5001.07.2023Queensland claims, only an approved RTW Services provider can provide this 5001.07.2023service.** 100030009201.07.2023 H Y Y 2001.07.202300155.0000000.0000000.00 5001.07.2023TRAVEL - TREATMENT - Travel - Prior approval is required for travel of more 5001.07.2023than one (1) hour. Travel charges are applicable when the provider is required 5001.07.2023to leave their normal place of practice to treat a worker at a: rehabilitation 5001.07.2023facility hospital workplace their place of residence, or community-based 5001.07.2023setting. Travel is not payable where: the travel is between clinics or 5001.07.2023facilities owned and/or operated by the provider or their employer. the travel 5001.07.2023is for services delivered at an external facility where treatment at these 5001.07.2023external facilities is a regular part of that providers approach and there 5001.07.2023exists a contractual arrangement and/or agreement to use that external 5001.07.2023facility. Please see explanatory notes for further information. 100030009301.07.2023 O Y Y 2001.07.202300029.0000000.0000000.00 5001.07.2023COPIES OF PATIENT RECORDS RELATING TO CLAIM - Copies of patient records 5001.07.2023relating to the worker's compensation claim including file notes, results of 5001.07.2023relevant tests e.g. pathology, diagnostic imaging, and reports from 5001.07.2023specialists. Paid at $29 flat fee plus $1 per page. 100030009401.07.2023 O Y Y 2001.07.202300080.0000000.0000000.00 5001.07.2023INCIDENTAL EXPENSES - Reasonable charges for incidental items required by the 5001.07.2023worker to assist in their recovery and which they take home with them 5001.07.2023following their treatment. Pharmacy items and consumables used by a provider 5001.07.2023during a consultation are not included. For further clarification refer to the 5001.07.2023information provided below the tables. * Payment will be made up to $80 in 5001.07.2023total for incidental expenses and up to $233 in total for supportive devices, 5001.07.2023per claim (not per consultation), without prior approval. Approval from the 5001.07.2023insurer must be obtained for items exceeding the pre-approved value. Hire of 5001.07.2023equipment to be negotiated with insurer. All expenses must be itemised on the 5001.07.2023invoice. Please note: This item number is not to be used for admission fees to 5001.07.2023external facilities such as gyms and pools. 100030010001.07.2023 O Y Y 2001.07.202300070.0000000.0000000.00 5001.07.2023COMMUNICATION - 11 TO 20 MINS - Communication-11 to 20 mins-Direct 5001.07.2023communication between treating provider and insurer, employer, insurer 5001.07.2023referred allied health provider and doctors to assist with faster and more 5001.07.2023effective rehabilitation and return to work for a worker. Excludes 5001.07.2023communication with a worker, and of a general administrative nature or 5001.07.2023conveying non-specific information. Must be more than ten (10) minutes. Refer 5001.07.2023to details below the tables for a list of exclusions before using this item 5001.07.2023number. Treating providers are expected to keep a written record of the 5001.07.2023details of communication including date, time, and duration. The insurer may 5001.07.2023request evidence of communication at any time. 100030010201.07.2023 O Y Y 2001.07.202300105.0000000.0000000.00 5001.07.2023INITIAL SUITABLE DUTIES PROGRAM (SDP) - Documentation of suitable duties for a 5001.07.2023worker, detailing specific information necessary for a safe and effective 5001.07.2023return to the workplace. For WorkCover Queensland claims, only an approved RTW 5001.07.2023Services provider can provide this service.** 100030015801.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023WORKPLACE EVALUATION/ASSESSMENT - Systematic process using the workplace to 5001.07.2023estimate work potential and work behaviour. Includes ergonomic assessments. 5001.07.2023For WorkCover Queensland claims, only an approved RTW Services provider can 5001.07.2023provide this service.** 100030015901.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023ACTIVITIES OF DAILY LIVING ASSESSMENT - A series of standardised tests and 5001.07.2023measures to assess a worker's activities of daily living and mobility 5001.07.2023(including Modified Barthel Index assessments for registered occupational 5001.07.2023therapy only). Service includes assessment and report, noting that WorkCover 5001.07.2023Queenslands template for Modified Barthel Index is to be used (for WorkCover 5001.07.2023claims). 100030016001.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023FUNCTIONAL CAPACITY EVALUATION (FCE) - Systematic assessment using a series of 5001.07.2023standardised tests and work specific simulation activities to assess a 5001.07.2023worker's functional capacity for work or potential to return to suitable work; 5001.07.2023includes assessment and report. For WorkCover Queensland claims, only an 5001.07.2023approved RTW Services provider can provide this service.** 100030016101.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023DRIVING ASSESSMENT - Off-road and on-road driving assessments of cognitive, 5001.07.2023psychological, and physical capacity to drive. Assessments must be conducted 5001.07.2023by a qualified driving assessor. Service includes assessment and report. 5001.07.2023Driving instructor is also required for on-road assessment component and fees 5001.07.2023are paid separately. 100030016201.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023VOCATIONAL ASSESSMENT AND REPORT* - Assessment of realistic vocational options 5001.07.2023in the current job market for a worker using integrated clinical and 5001.07.2023standardised assessment procedures and instruments; includes assessment and 5001.07.2023report. For WorkCover Queensland claims, only an approved RTW Services 5001.07.2023provider can provide this service.** 100030016401.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023RETURN TO WORK FACILITATION - Communication with a worker and employer to 5001.07.2023establish an updated suitable duties program where no worksite assessment or 5001.07.2023job placement services are required, or other service item number applies. 5001.07.2023Also used where there are significant barriers preventing a worker 5001.07.2023participating in a return to work program and the provider delivers strategies 5001.07.2023to overcome the barriers. Includes communication between the worker, employer, 5001.07.2023and insurer (does not include general communication relating to a suitable 5001.07.2023duties program or job placement or where another number applies). May include 5001.07.2023face-to-face or electronic file reviews for the insurer. For WorkCover 5001.07.2023Queensland claims, only an approved RTW Services provider can provide this 5001.07.2023service.** 100030016601.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023JOB SEEKING SKILLS ASSESSMENT - INITIAL* - Identify a worker's transferable 5001.07.2023skills and abilities for a new job/career or host placement; may involve the 5001.07.2023development of a vocational preparation action plan with the worker. For 5001.07.2023WorkCover Queensland claims, only an approved RTW Services provider can 5001.07.2023provide this service.** 100030016801.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023JOB PREPARATION SERVICES* - Prepare the worker to find suitable employment. 5001.07.2023Services will be based on the needs of the worker and may include development 5001.07.2023of or updating a resume and/or cover letter, interview preparation skills and 5001.07.2023career counselling. For WorkCover Queensland claims, only an approved RTW 5001.07.2023Services provider can provide this service.** 100030018601.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023INITIAL CONSULTATION - WORK SPECIFIC FUNCTIONAL EXERCISE PROGRAM - Initial 5001.07.2023development and instruction of an exercise program focused on improving 5001.07.2023function of the work-related injuries or conditions, relevant to their work 5001.07.2023role. This service may only be charged once for development of an exercise 5001.07.2023program to meet the workers work specific functional goals. Refer item number 5001.07.2023300228 for Gym and Pool Entry Fees. The exercise physiologist is then expected 5001.07.2023to submit a Provider Management Plan (PMP) following the initial consultation 5001.07.2023for approval before any treatment commences. The PMP should include a 5001.07.2023comprehensive treatment plan containing: expected functional gains, transition 5001.07.2023of care to self-management; and treatment timeframes. The PMP form is 5001.07.2023available on the Workers Compensation Regulatory Services website 5001.07.2023(www.worksafe.qld.gov.au). The insurer will not pay for the preparation or 5001.07.2023completion of a Provider Management Plan. The entire consultation must be 1 on 5001.07.20231 with the worker. Maximum of one (1) hour. 100030018701.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023SUBSEQUENT CONSULTATION - WORK SPECIFIC FUNCTIONAL EXERCISE PROGRAM - The 5001.07.2023first six (6) consultations (including initial consultation) are pre-approved, 5001.07.2023provided the injuries or conditions have not previously been treated by an 5001.07.2023allied health provider. If additional treatment is required, submit a Provider 5001.07.2023Management Plan3 (PMP) by the 6th subsequent treatment consultation. The PMP 5001.07.2023should include a comprehensive treatment plan containing: expected functional 5001.07.2023gains, transition of care to self-management; and treatment timeframes. 5001.07.2023Services to be conducted in accordance with the Clinical Framework for the 5001.07.2023Delivery of Health Services2. Subsequent consultation may include: ongoing 5001.07.2023assessment (subjective and objective) intervention/treatment setting 5001.07.2023expectations of recovery and return to work clinical recording communication 5001.07.2023with the insurer of any relevant information for the workers rehabilitation 5001.07.2023Maximum one (1) hour. 100030018801.07.2023 H Y Y 2001.07.202300234.0000000.0000000.00 5001.07.2023INITIAL CONSULTATION - ADJUSTMENT COUNSELLING - Undertaken where possible to 5001.07.2023clarify the presence of possible adjustment to injury issues and set goals of 5001.07.2023therapy to optimise rehabilitation outcomes; performed where worker is 5001.07.2023displaying psychological, social, cognitive, emotional, and behavioural 5001.07.2023problems after a work-related incident or injury. The purpose of the 5001.07.2023consultation is to identify appropriate interventions/treatments to optimise 5001.07.2023rehabilitation outcomes. Services to be conducted in accordance with the 5001.07.2023Clinical Framework for the Delivery of Health Services. Initial consultation 5001.07.2023may include: history taking assessment diagnostic formulation 5001.07.2023treatment/service tailored goal setting and treatment planning setting 5001.07.2023expectations of recovery and return to work clinical recording communication 5001.07.2023with the insurer of any relevant information for the workers rehabilitation 5001.07.2023Maximum one (1) hour. 100030019001.07.2023 O Y Y 2001.07.202300127.0000000.0000000.00 5001.07.2023DIETARY ASSESSMENT - Consultation to evaluate dietary issues and objective 5001.07.2023tests to formulate an intervention plan focused on a return to work goal. 5001.07.2023Prior approval required before providing service. Services must be provided by 5001.07.2023a person with a tertiary degree in dietetics. 100030019801.07.2023 H Y Y 2001.07.202300056.0000000.0000000.00 5001.07.2023PERSONAL CARE ASSISTANCE - Prior approval is required before providing this 5001.07.2023service - generally a limited service. May need an Occupational Therapist 5001.07.2023Assessment. Provided through an agency - includes services for injury/wound 5001.07.2023care, personal hygiene and grooming etc. where the worker is living at home 5001.07.2023and has been assessed as incapable (for physical, cognitive or emotional 5001.07.2023reasons) of undertaking these tasks and has no family or other social support 5001.07.2023network. Day rate: $56 per hour. Weekend rate: $80 per hour. 100030020001.07.2023 H Y Y 2001.07.202300050.0000000.0000000.00 5001.07.2023DIVERSIONAL THERAPY PROGRAM - Prior approval is required before providing this 5001.07.2023service Services to be provided by a diversional therapist at a nursing home 5001.07.2023including therapeutic activities. Services must be provided by a person with a 5001.07.2023minimum of an Associate Diploma in Diversional Therapy. The service should 5001.07.2023only be used under the supervision of an occupational therapist, who has 5001.07.2023recommended therapeutic activities as part of the overall treatment program. 100030020101.07.2023 H Y Y 2001.07.202300053.0000000.0000000.00 5001.07.2023DOMESTIC ASSISTANCE - HOME CARE SERVICES - Prior approval is required before 5001.07.2023providing this service Provided through an agency - includes cleaning, 5001.07.2023shopping and washing etc. where the worker is living at home and has been 5001.07.2023assessed by an occupational therapist as incapable of undertaking these tasks 5001.07.2023(for physical, cognitive or emotional reasons) of undertaking these tasks, and 5001.07.2023has no family or other social support network. Usually limited timeframe of 5001.07.2023delivery. Note: weekend and public holiday rates may be negotiated with the 5001.07.2023insurer. - Attendant care and support services are generally services to help 5001.07.2023a worker with serious injuries and complex injuries to participate with 5001.07.2023everyday tasks. 100030020201.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023LITERACY SKILLS - Prior approval is required before providing this service 5001.07.2023Private tutoring by a qualified tutor to improve literacy skills for job 5001.07.2023placement prospects. Program should be limited to achieving a base level of 5001.07.2023competency up to four (4) to six (6) weeks. Typically, literacy services are 5001.07.2023provided through the local TAFE or appropriately qualified private literacy 5001.07.2023services. 100030021001.07.2023 O Y Y 2001.07.202300035.0000000.0000000.00 5001.07.2023RTW COMMUNICATION - 3 TO 10 MINS - Communication by a RTW Services provider 5001.07.2023who has received a referral from an insurer for the following services: 5001.07.2023worksite assessment/evaluation development of suitable duties program or 5001.07.2023updated program monitoring of suitable duties programs communication with 5001.07.2023relevant stakeholders about a worker's progress or issues related to an 5001.07.2023existing suitable duties program functional capacity evaluation vocational 5001.07.2023assessment job seeking, job preparation or job placement services. Direct 5001.07.2023communication between a RTW Services provider and the following: insurer 5001.07.2023employer worker insurer referred providers; and treating providers to assist 5001.07.2023with faster, more effective rehabilitation and return to work for a worker. 5001.07.2023Refer to the exclusions listed below these tables before using this item 5001.07.2023number. For WorkCover Queensland claims, only an approved RTW Services 5001.07.2023provider can provide this service.** 100030021101.07.2023 O Y Y 2001.07.202300070.0000000.0000000.00 5001.07.2023RTW COMMUNICATION - 11 TO 20 MINS - Communication by a RTW Services provider 5001.07.2023who has received a referral from an insurer for the following services: 5001.07.2023worksite assessment/evaluation development of suitable duties program or 5001.07.2023updated program monitoring of suitable duties programs communication with 5001.07.2023relevant stakeholders about a worker's progress or issues related to an 5001.07.2023existing suitable duties program functional capacity evaluation vocational 5001.07.2023assessment job seeking, job preparation or job placement services. Direct 5001.07.2023communication between a RTW Services provider and the following: insurer 5001.07.2023employer worker insurer referred providers; and treating providers to assist 5001.07.2023with faster, more effective rehabilitation and return to work for a worker. 5001.07.2023Must be more than ten (10) minutes. Refer to the exclusions listed below these 5001.07.2023tables before using this item number. For WorkCover Queensland claims, only an 5001.07.2023approved RTW Services provider can provide this service.** 100030021201.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023JOB PLACEMENT SERVICES - NEW EMPLOYER* - The process of actively sourcing and 5001.07.2023placing a worker in a host placement or for WorkCover also includes placing a 5001.07.2023worker in a Recover at Work program with a view to a durable return to work 5001.07.2023outcome. Also includes seeking new employment with/for the worker. Includes 5001.07.2023employer and worker liaison, job application and coaching. For WorkCover 5001.07.2023Queensland claims, only an approved RTW Services provider can provide this 5001.07.2023service.** 100030021301.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023JOB PREPARATION SERVICES - WORK HARDENING PROGRAM* - The process of actively 5001.07.2023sourcing and placing a worker in a host placement or for WorkCover also 5001.07.2023includes placing a worker in a Recover at Work program where the worker has a 5001.07.2023job to return to. Includes employer and worker liaison, job application and 5001.07.2023coaching. For WorkCover Queensland claims, only an approved RTW Services 5001.07.2023provider can provide this service.** 100030022801.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023GYM AND POOL ENTRY FEES - Prior approval is required before providing this 5001.07.2023service. The insurer may request justification and will consider seeking a 5001.07.2023second opinion if more than three (3) months facility membership is requested 5001.07.2023per episode of care. Entry fee for the worker to attend a gym or pool for 5001.07.2023assessment and treatment (up to a maximum three-month membership). Entry fees 5001.07.2023will be paid for the worker, only where the facility is not owned or operated 5001.07.2023by the provider, their employer, or where either party contracts their 5001.07.2023services to the facility. Entry fees will not be paid for providers. A 5001.07.2023Provider Management Plan3 (PMP) is expected to be submitted for approval 5001.07.2023before any treatment commences. The PMP should include a comprehensive 5001.07.2023treatment plan containing: expected functional gains, transition of care to 5001.07.2023self-management; and treatment timeframes. The provider is then expected to 5001.07.2023submit Provider Management Plan (PMP) for approval before any treatment 5001.07.2023commences. 100030028501.07.2023 H Y Y 2001.07.202300234.0000000.0000000.00 5001.07.2023ADJUSTMENT COUNSELLING - SUBSEQUENT CONSULTATION - Ongoing treatment of 5001.07.2023work-related components of presenting adjustment to injury issues; 5001.07.2023intervention would be based on treatment formulated from the initial 5001.07.2023consultation (300188). The first six (6) hours (including initial 5001.07.2023consultation) are pre-approved, provided this issue has not previously been 5001.07.2023treated by an allied health provider, with a maximum of one (1) hours on any 5001.07.2023one day. If additional treatment is required, submit a Provider Management 5001.07.2023Plan (PMP) within six (6) hours of consultations which includes a 5001.07.2023comprehensive treatment plan containing: expected functional gains, transition 5001.07.2023to self-care management; and treatment timeframes. Services to be conducted in 5001.07.2023accordance with the Clinical Framework for the Delivery of Health Services. 5001.07.2023Subsequent consultation may include: ongoing assessment intervention/treatment 5001.07.2023setting expectations of recovery and return to work clinical recording 5001.07.2023communication with the insurer of any relevant information for the workers 5001.07.2023rehabilitation 100030029501.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023EXTERNAL CASE MANAGEMENT - Includes an initial needs assessment and report; 5001.07.2023should outline a case management plan indicating the goals of the program, 5001.07.2023services required, timeframes and costs. Insurer request only. 100030030901.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023AMBULANCE TRANSPORT - NON QAS - INITIAL TRANSPORTATION - Transport provided 5001.07.2023immediately after the work-related injury or condition is sustained. 100030031001.07.2023 O Y Y 2001.07.202300000.0000000.0000000.00 5001.07.2023AMBULANCE TRANSPORT - NON QAS - SUBSEQUENT TRANSPORTATION - Subsequent 5001.07.2023transport must be certified in writing by a doctor as necessary because of the 5001.07.2023worker's physical condition resulting from a work-related injury or condition. 100030040101.07.2023 O Y Y 2001.07.202300053.0000000.0000000.00 5001.07.2023GROUP EXERCISE SESSIONS - Prior approval is required before providing this 5001.07.2023service. A group session where a common exercise programs is delivered to more 5001.07.2023than one individual at the same time. The group can consist of a maximum of 5001.07.2023eight (8) persons. The group session must be attended, conducted, and 5001.07.2023supervised by an exercise physiologist. 100040008801.07.2023 H Y Y 2001.07.202300250.0000000.0000000.00 5001.07.2023INITIAL CONSULTATION- PSYCHOLOGIST ONLY - The initial consultation in the 5001.07.2023treatment of possible psychological, social, cognitive, emotional, and 5001.07.2023behavioural problems occurring after a work-related injury or condition. The 5001.07.2023purpose of the assessment is to identify appropriate interventions/treatments 5001.07.2023to optimise rehabilitation outcomes (maximum two (2) hours direct contact and 5001.07.2023test scoring time). Services to be conducted in accordance with the Clinical 5001.07.2023Framework for the Delivery of Health Services. Initial consultation may 5001.07.2023include: history taking assessment diagnostic formulation treatment/service 5001.07.2023tailored goal setting and treatment planning setting expectations of recovery 5001.07.2023and return to work clinical recording communication with the insurer of any 5001.07.2023relevant information for the workers rehabilitation. The entire consultation 5001.07.2023must be one-on-one with the worker. 100040009101.07.2023 H Y Y 2001.07.202300250.0000000.0000000.00 5001.07.2023NEUROPSYCHOLOGICAL ASSESSMENT - An assessment to clarify the presence of 5001.07.2023possible acquired brain injury or brain dysfunction where possible 5001.07.2023psychological, social, cognitive, emotional, and behavioural problems are 5001.07.2023occurring after a work-related injury or condition (four to five (4-5) hours 5001.07.2023direct contact and test scoring time). This does not include a report. Prior 5001.07.2023approval required for this assessment. 100040009501.07.2023 H Y Y 2001.07.202300250.0000000.0000000.00 5001.07.2023SUBSEQUENT CONSULTATION - PSYCHOLOGIST ONLY - A one-on-one subsequent 5001.07.2023consultation with the worker in the ongoing management and treatment of their 5001.07.2023work-related psychological issues. Intervention is based on treatment 5001.07.2023formulated in the initial consultation. The first six (6) hours (including 5001.07.2023initial consultation) are preapproved provided this condition has not 5001.07.2023previously been treated by an allied health provider. If additional treatment 5001.07.2023is required, submit a Provider Management Plan3 (PMP) within six (6) hours of 5001.07.2023consultations, which includes a comprehensive treatment plan containing: 5001.07.2023expected functional gains, transition to self-care management; and treatment 5001.07.2023timeframes. Services to be conducted in accordance with the Clinical Framework 5001.07.2023for the Delivery of Health Services2 Max two (2) hours on any one day. 100040010101.07.2023 H Y Y 2001.07.202300185.0000000.0000000.00 5001.07.2023INITIAL ASSESSMENT COUNSELLING SERVICES ONLY - A one-on-one initial 5001.07.2023consultation where possible psychological, social, cognitive, emotional, and 5001.07.2023behavioural problems are occurring after a work-related injury or condition. 5001.07.2023The purpose of the assessment is to identify appropriate 5001.07.2023interventions/treatments to optimise rehabilitation outcomes (maximum two (2) 5001.07.2023hours direct contact and test scoring time). Services to be conducted in 5001.07.2023accordance with the Clinical Framework for the Delivery of Health Services. 5001.07.2023Initial consultation may include: history taking assessment diagnostic 5001.07.2023formulation treatment/service tailored goal setting and treatment planning 5001.07.2023setting expectations of recovery and return to work clinical recording 5001.07.2023communication with the insurer of any relevant information for the workers 5001.07.2023rehabilitation. 100040010201.07.2023 H Y Y 2001.07.202300185.0000000.0000000.00 5001.07.2023SUBSEQUENT CONSULTATION COUNSELLING SERVICES ONLY - A one-on-one subsequent 5001.07.2023consultation with the worker in their ongoing management and treatment. 5001.07.2023Intervention is based on treatment formulated in the initial consultation. The 5001.07.2023first six (6) hours (including initial consultation) are pre-approved, 5001.07.2023provided this issue has not previously been treated by an allied health 5001.07.2023provider, with a maximum of two (2) hours on any one day. If additional 5001.07.2023treatment is required, submit a Provider Management Plan (PMP) within six (6) 5001.07.2023hours of consultations which includes a comprehensive treatment plan 5001.07.2023containing: expected functional gains, transition to self-care management; and 5001.07.2023treatment timeframes. Services to be conducted in accordance with the Clinical 5001.07.2023Framework for the Delivery of Health Services. Subsequent consultation may 5001.07.2023include: ongoing assessment intervention/treatment setting expectations of 5001.07.2023recovery and return to work clinical recording communication with the insurer 5001.07.2023of any relevant information for the workers rehabilitation. 100040018401.07.2023 H Y Y 2001.07.202300250.0000000.0000000.00 5001.07.2023CRITICAL INCIDENT DEBRIEFING SESSIONS - A process where, following exposure to 5001.07.2023a critical incident, an individual or group of workers are debriefed by a 5001.07.2023psychologist to assist them to deal more effectively with their experience. 5001.07.2023Approval required after the first two (2) pre-approved sessions. 100040022601.07.2023 H Y Y 2001.07.202300261.0000000.0000000.00 5001.07.2023INDEPENDENT CASE REVIEW - An independent psychologist examination and report 5001.07.2023of a worker (not by the treating psychologist). Only provided following a 5001.07.2023request from the insurer. The review is requested by the insurer where 5001.07.2023progress of treatment and/or rehabilitation falls outside the plan or expected 5001.07.2023course of injury management. The examination and report provide the insurer 5001.07.2023with an assessment and recommendations for ongoing treatment and prognosis. 100050000601.07.2023 O Y Y 2001.07.202300097.0000000.0000000.00 5001.07.2023SUBSEQUENT CONSULTATION - A one-on-one subsequent consultation in the 5001.07.2023treatment of work-related injuries or conditions. The first six (6) 5001.07.2023consultations (including initial consultation) are pre-approved, provided the 5001.07.2023injuries or conditions have not previously been treated by an allied health 5001.07.2023provider. If additional treatment is required, submit a Provider Management 5001.07.2023Plan (PMP) by the 6th subsequent treatment consultation. The PMP should 5001.07.2023include a comprehensive treatment plan containing: expected functional gains, 5001.07.2023transition of care to self-management; and treatment timeframes. Services to 5001.07.2023be conducted in accordance with the Clinical Framework for the Delivery of 5001.07.2023Health Services. Subsequent consultation may include: ongoing assessment 5001.07.2023(subjective and objective) intervention/treatment setting expectations of 5001.07.2023recovery and return to work clinical recording communication with the insurer 5001.07.2023of any relevant information for the workers rehabilitation. 100050002101.07.2023 O Y Y 2001.07.202300124.0000000.0000000.00 5001.07.2023INITIAL CONSULTATION - A one-on-one initial consultation in the treatment of 5001.07.2023work-related injuries or conditions, or the first consultation in a new 5001.07.2023episode of care for the same work-related injuries or conditions. Services to 5001.07.2023be conducted in accordance with the Clinical Framework for the Delivery of 5001.07.2023Health Services. Initial consultation may include: subjective assessment 5001.07.2023objective assessment treatment/service tailored goal setting and treatment 5001.07.2023planning setting expectations of recovery and return to work clinical 5001.07.2023recording communication with the insurer of any relevant information for the 5001.07.2023workers rehabilitation. 100050005501.07.2023 O Y Y 2001.07.202300124.0000000.0000000.00 5001.07.2023REASSESSMENT OR PROGRAM REVIEW - A comprehensive assessment used when: the 5001.07.2023worker has been in active rehabilitation for at least six weeks and further 5001.07.2023treatment is likely; and/or there are new clinical findings that might affect 5001.07.2023ongoing treatment; and/or there is a rapid change in worker's status and/or 5001.07.2023there is no response to current therapeutic interventions. It should include: 5001.07.2023all components of initial consultation a review of the workers progress based 5001.07.2023on established objective measures a recommendation for future treatment and 5001.07.2023management strategies to assist the worker to return to work. It may include 5001.07.2023referral recommendations to other providers, a change in therapy or outcome 5001.07.2023direction requiring a new return to work goal. Following reassessment submit a 5001.07.2023Provider Management Plan3 (PMP) with an updated comprehensive treatment plan 5001.07.2023containing: expected functional gains, transition of care to self-management; 5001.07.2023and treatment timeframes. 100050022601.07.2023 H Y Y 2001.07.202300261.0000000.0000000.00 5001.07.2023INDEPENDENT CASE REVIEW - An independent chiropractic examination and report 5001.07.2023on a worker and is not carried out by the treating chiropractor. The review is 5001.07.2023requested by the insurer where progress of treatment and/or rehabilitation 5001.07.2023falls outside the plan or expected course of injury management. The 5001.07.2023examination and report provide the insurer with an assessment and 5001.07.2023recommendations for ongoing treatment and prognosis. 100055810001.07.2023 O Y Y 2001.07.202300138.0000000.0000000.00 5001.07.2023X-RAY - CERVICAL SPINE - X-Ray - Cervical Spine. Must be clinically 5001.07.2023justifiable. 100055810301.07.2023 O Y Y 2001.07.202300113.0000000.0000000.00 5001.07.2023X-RAY - THORACIC SPINE - X-Ray - Thoracic Spine. Must be clinically 5001.07.2023justifiable. 100055810601.07.2023 O Y Y 2001.07.202300158.0000000.0000000.00 5001.07.2023X-RAY - LUMBOSACRAL SPINE - X-Ray - Lumbosacral Spine. Must be clinically 5001.07.2023justifiable. 100055811201.07.2023 O Y Y 2001.07.202300199.0000000.0000000.00 5001.07.2023X-RAY - ANY TWO REGIONS OF THE SPINE - X-Ray - Any two regions of the spine. 5001.07.2023Must be clinically justifiable. 100055811501.07.2023 O Y Y 2001.07.202300225.0000000.0000000.00 5001.07.2023X-RAY - ANY THREE REGIONS OF THE SPINE - X-Ray - Any three regions of the 5001.07.2023spine. Must be clinically justifiable. 100060001501.07.2023 O Y Y 2001.07.202300124.0000000.0000000.00 5001.07.2023INITIAL CONSULTATION - A one-on-one initial consultation in the treatment of 5001.07.2023work-related injuries or conditions, or the first consultation in a new 5001.07.2023episode of care for the same work-related injuries or conditions. Services to 5001.07.2023be conducted in accordance with the Clinical Framework for the Delivery of 5001.07.2023Health Services. Initial consultation may include: subjective assessment 5001.07.2023objective assessment treatment/service tailored goal setting and treatment 5001.07.2023planning setting expectations of recovery and return to work clinical 5001.07.2023recording communication (with referrer) any relevant information for the 5001.07.2023workers rehabilitation to the insurer. 100060001601.07.2023 O Y Y 2001.07.202300097.0000000.0000000.00 5001.07.2023SUBSEQUENT CONSULTATION - A one-on-one subsequent consultation in the 5001.07.2023treatment of work-related injuries or conditions. The first six (6) 5001.07.2023consultations (including initial consultation) are pre-approved, provided the 5001.07.2023injury has not previously been treated by an allied health provider. If 5001.07.2023additional treatment is required, the provider is expected to submit a 5001.07.2023Provider Management Plan (PMP) by the 6th subsequent treatment consultation. 5001.07.2023The PMP should include a comprehensive treatment plan containing: expected 5001.07.2023functional gains, transition of care to self-management; and treatment 5001.07.2023timeframes. Services to be conducted in accordance with the Clinical Framework 5001.07.2023for the Delivery of Health Services. Subsequent consultation may include: 5001.07.2023ongoing assessment (subjective and objective) intervention/treatment setting 5001.07.2023expectations of recovery and return to work clinical recording communication 5001.07.2023with the insurer of any relevant information for the workers rehabilitation. 100060005501.07.2023 O Y Y 2001.07.202300124.0000000.0000000.00 5001.07.2023REASSESSMENT OR PROGRAM REVIEW - This reassessment or program review is 5001.07.2023indicated when: the worker has been in active rehabilitation for at least six 5001.07.2023weeks and further treatment is likely; and/or there are new clinical findings 5001.07.2023that might affect ongoing treatment; and/or there is a rapid change in 5001.07.2023worker's status and/or there is no response to current therapeutic 5001.07.2023interventions. A reassessment or program review is a comprehensive assessment 5001.07.2023including: all components of initial consultation a review of the workers 5001.07.2023progress based on established objective measures a recommendation for future 5001.07.2023treatment and management strategies to assist the worker to return to work. A 5001.07.2023reassessment or program review may include referral recommendations to other 5001.07.2023providers, a change in therapy direction or a change on outcome direction 5001.07.2023requiring a new return to work goal. The occupational therapist is expected to 5001.07.2023submit a Provider Management Plan (PMP) following the reassessment. 100060017001.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023SPECIFIC OCCUPATIONAL THERAPY ASSESSMENT - Prior approval is required before 5001.07.2023providing this service and justification may be requested by the insurer. This 5001.07.2023service is to be used for assessing specific conditions that cannot be 5001.07.2023adequately assessed, due to the complexity of the condition, within an initial 5001.07.2023consultation 600015 and 600020 for multiple injuries or conditions. The entire 5001.07.2023consultation must be one-on-one with the worker. These may include, but are 5001.07.2023not limited to: extensive burns acquired brain injuries severe spinal cord 5001.07.2023injuries multiple orthopaedic fractures limb amputations crush injuries. This 5001.07.2023service can also be used for the assessment (only) of suitability for entry 5001.07.2023into a Multi-Disciplinary Program or Pain Management Program. The service may 5001.07.2023only be used once by the occupational therapist in the treatment of a 5001.07.2023work-related injury or condition, or the first consultation in a new episode 5001.07.2023of care for the same work-related injury or condition. Maximum one (1) hour. 100060022601.07.2023 H Y Y 2001.07.202300261.0000000.0000000.00 5001.07.2023INDEPENDENT CASE REVIEW - An independent occupational therapist examination 5001.07.2023and report on a worker and is not carried out by the treating occupational 5001.07.2023therapist. The review is requested by the insurer where progress of treatment 5001.07.2023and/or rehabilitation falls outside the plan or expected course of injury 5001.07.2023management. The examination and report provide the insurer with an assessment 5001.07.2023and recommendations for ongoing treatment and prognosis. 100060028701.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023SPECIALISED HAND/UPPER LIMB THERAPY CONSULTATION- OCCUPATIONAL THERAPIST ONLY 5001.07.2023- Prior approval is required before providing this service, unless referred by 5001.07.2023a medical specialist, then the first six (6) consultations are pre-approved. 5001.07.2023Prior approval for sessions exceeding 1 hr. A one-on-one consultation and 5001.07.2023treatment for workers with hand and upper limb work-related injuries or 5001.07.2023conditions (below shoulder level). Treatment offered is considered specialist 5001.07.2023hand therapy provided by a qualified occupational therapist. Further details 5001.07.2023are provided below the tables. Consultations may include: ongoing assessment 5001.07.2023(subjective and objective) intervention/treatment setting expectations of 5001.07.2023recovery and return to work clinical recording communication with the insurer 5001.07.2023of any relevant information for the workers rehabilitation. The occupational 5001.07.2023therapist is expected to submit a Provider Management Plan (PMP) following the 5001.07.2023initial assessment. Maximum one (1) hour. 100060029201.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023SPECIFIC OCCUPATIONAL THERAPY CONSULTATION - Prior approval is required before 5001.07.2023providing this service. The insurer may request justification and will 5001.07.2023consider seeking an independent opinion if more than six (6) consultations are 5001.07.2023requested per episode of care. A one-on-one consultation for recommended 5001.07.2023interventions identified during a Specific Occupational Therapist Assessment 5001.07.2023(600170). These may include, but are not limited to: extensive burns acquired 5001.07.2023brain injuries severe spinal cord injuries multiple orthopaedic fractures limb 5001.07.2023amputations crush injuries. Please note: This service is not to be used for 5001.07.2023ongoing consultations within a Multi-Disciplinary Program and/or Pain 5001.07.2023Management Program. This service must not be already classified elsewhere in 5001.07.2023this table of costs. A Provider Management Plan (PMP) is to be submitted 5001.07.2023following the initial assessment (600170). Maximum one (1) hour. 100070005101.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023INITIAL CONSULTATION - A one-on-one initial consultation in the treatment of 5001.07.2023work-related injuries or conditions, or the first consultation in a new 5001.07.2023episode of care for the same work-related injuries or conditions. Services to 5001.07.2023be conducted in accordance with the Clinical Framework for the Delivery of 5001.07.2023Health Services. Initial consultation may include: subjective assessment 5001.07.2023objective assessment treatment/service tailored goal setting and treatment 5001.07.2023planning setting expectations of recovery and return to work clinical 5001.07.2023recording communication with the insurer of any relevant information for the 5001.07.2023workers rehabilitation. 100070005301.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023SUBSEQUENT CONSULTATION - A one-on-one subsequent consultation in the 5001.07.2023treatment of work-related injuries or conditions. If additional treatment is 5001.07.2023required, the provider must submit a Provider Management Plan (PMP) after the 5001.07.2023initial consultation and before commencing any treatment consultations. The 5001.07.2023PMP should include a comprehensive treatment plan containing: expected 5001.07.2023functional gains, transition of care to self-management; and treatment 5001.07.2023timeframes. Services to be conducted in accordance with the Clinical Framework 5001.07.2023for the Delivery of Health Services. Subsequent consultation may include: 5001.07.2023ongoing assessment (subjective and objective) intervention/treatment setting 5001.07.2023expectations of recovery and return to work clinical recording communication 5001.07.2023with the insurer of any relevant information for the workers rehabilitation. 5001.07.2023Maximum one (1) hour. 100070022601.07.2023 H Y Y 2001.07.202300261.0000000.0000000.00 5001.07.2023INDEPENDENT CASE REVIEW - An independent speech pathologist examination and 5001.07.2023report on a worker and is not carried out by the treating speech pathologist. 5001.07.2023The review is requested by the insurer where progress of treatment and/or 5001.07.2023rehabilitation falls outside the plan or expected course of injury management. 5001.07.2023The examination and report provide the insurer with an assessment and 5001.07.2023recommendations for ongoing treatment and prognosis. 100080002801.07.2023 O Y Y 2001.07.202300124.0000000.0000000.00 5001.07.2023INITIAL CONSULTATION - A one-one-one initial consultation in the treatment of 5001.07.2023work-related injuries or conditions, or the first consultation in a new 5001.07.2023episode of care for the same work-related injuries or conditions. Services to 5001.07.2023be conducted in accordance with the Clinical Framework for the Delivery of 5001.07.2023Health Services. Initial consultation may include: subjective assessment 5001.07.2023objective assessment treatment/service tailored goal setting and treatment 5001.07.2023planning setting expectations of recovery and return to work clinical 5001.07.2023recording communication (with referrer) any relevant information for the 5001.07.2023workers rehabilitation to the insurer. 100080002901.07.2023 O Y Y 2001.07.202300097.0000000.0000000.00 5001.07.2023SUBSEQUENT CONSULTATION - A one-on-one subsequent consultation in the 5001.07.2023treatment of work-related injuries or conditions. The first six (6) 5001.07.2023consultations (including initial consultation) are pre-approved, provided the 5001.07.2023injuries have not previously been treated by an allied health provider. If 5001.07.2023additional treatment is required, submit a Provider Management Plan (PMP) by 5001.07.2023the 6th subsequent treatment consultation. The PMP should include a 5001.07.2023comprehensive treatment plan containing: expected functional gains, transition 5001.07.2023of care to self-management; and treatment timeframes. Services to be conducted 5001.07.2023in accordance with the Clinical Framework for the Delivery of Health Services. 5001.07.2023Subsequent consultation may include: ongoing assessment (subjective and 5001.07.2023objective) intervention/treatment setting expectations of recovery and return 5001.07.2023to work clinical recording communication with the insurer of any relevant 5001.07.2023information for the workers rehabilitation. 100080003701.07.2023 O Y Y 2001.07.202300241.0000000.0000000.00 5001.07.2023ORTHOSES - Thermoplastic shell - Intrinsic fore/rearfoot post - single. Prior 5001.07.2023insurer approval is required. 100080003801.07.2023 O Y Y 2001.07.202300470.0000000.0000000.00 5001.07.2023ORTHOSES - Thermoplastic shell - Intrinsic fore/rearfoot post - pair. Prior 5001.07.2023approval from the insurer is required. 100080003901.07.2023 O Y Y 2001.07.202300040.0000000.0000000.00 5001.07.2023INSOLES - Plain - single. Prior insurer approval is required. 100080004001.07.2023 O Y Y 2001.07.202300073.0000000.0000000.00 5001.07.2023INSOLES - Plain - pair. Prior insurer approval is required. 100080004101.07.2023 O Y Y 2001.07.202300085.0000000.0000000.00 5001.07.2023INSOLES - Padded insole - single. Prior insurer approval is required. 100080004201.07.2023 O Y Y 2001.07.202300162.0000000.0000000.00 5001.07.2023INSOLES - Padded insole - pair. Prior insurer approval is required. 100080004301.07.2023 O Y Y 2001.07.202300206.0000000.0000000.00 5001.07.2023INSOLES - Balance inlay - single custom. Prior insurer approval is required. 100080004401.07.2023 O Y Y 2001.07.202300391.0000000.0000000.00 5001.07.2023INSOLES - Balance inlay - pair custom. Prior insurer approval is required. 100080004501.07.2023 O Y Y 2001.07.202300141.0000000.0000000.00 5001.07.2023INSOLES - Balance inlay - Thermo non-cast single. Prior insurer approval is 5001.07.2023required. 100080004601.07.2023 O Y Y 2001.07.202300226.0000000.0000000.00 5001.07.2023INSOLES - Balance inlay - Thermo non-cast pair. Prior insurer approval is 5001.07.2023required. 100080004701.07.2023 O Y Y 2001.07.202300035.0000000.0000000.00 5001.07.2023ORTHOSES - Heel lift - single. Prior insurer approval is required. 100080004801.07.2023 O Y Y 2001.07.202300032.0000000.0000000.00 5001.07.2023ORTHOSES - Extrinsic fore/rear foot post - single. Prior approval from the 5001.07.2023insurer is required. 100080004901.07.2023 O Y Y 2001.07.202300096.0000000.0000000.00 5001.07.2023CAST - Negative impression- single. Prior insurer approval is required. 100080005001.07.2023 O Y Y 2001.07.202300133.0000000.0000000.00 5001.07.2023CAST - Negative impression - pair. Prior insurer approval is required. 100080008401.07.2023 O Y Y 2001.07.202300077.0000000.0000000.00 5001.07.2023INSOLES - Soft tissue supplement - pair. Prior insurer approval is required. 100080022601.07.2023 H Y Y 2001.07.202300261.0000000.0000000.00 5001.07.2023INDEPENDENT CASE REVIEW - This is an independent podiatrist examination and 5001.07.2023report on a worker and is not carried out by the treating podiatrist. The 5001.07.2023review is requested by the insurer where progress of treatment and/or 5001.07.2023rehabilitation falls outside the plan or expected course of injury management. 5001.07.2023The examination and report provide the insurer with an assessment and 5001.07.2023recommendations for ongoing treatment and prognosis. 100080023201.07.2023 O Y Y 2001.07.202300061.0000000.0000000.00 5001.07.2023ORTHOSES - Extrinsic fore/rear foot post - pair. Prior insurer approval is 5001.07.2023required. 100080028301.07.2023 O Y Y 2001.07.202300041.0000000.0000000.00 5001.07.2023INSOLES - Covers - plain. Prior insurer approval is required. 100080028401.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023NAIL REMOVAL - Nail removal under local anaesthetic. Prior insurer approval is 5001.07.2023required. 100090000601.07.2023 O Y Y 2001.07.202300097.0000000.0000000.00 5001.07.2023SUBSEQUENT CONSULTATION - A one-on-one subsequent consultation in the 5001.07.2023treatment of work-related injuries or conditions. The first six (6) 5001.07.2023consultations (including initial consultation) are pre-approved, provided the 5001.07.2023injuries or conditions have not previously been treated by an allied health 5001.07.2023provider. If additional treatment is required, submit a Provider Management 5001.07.2023Plan (PMP) by the 6th subsequent treatment consultation. The PMP should 5001.07.2023include a comprehensive treatment plan containing: expected functional gains, 5001.07.2023transition of care to self-management; and treatment timeframes. Services to 5001.07.2023be conducted in accordance with the Clinical Framework for the Delivery of 5001.07.2023Health Services. Subsequent consultation may include: ongoing assessment 5001.07.2023(subjective and objective) intervention/treatment setting expectations of 5001.07.2023recovery and return to work clinical recording communication with the insurer 5001.07.2023of any relevant information for the workers rehabilitation. 100090002101.07.2023 O Y Y 2001.07.202300124.0000000.0000000.00 5001.07.2023INITIAL CONSULTATION - A one-on-one initial consultation in the treatment of 5001.07.2023work-related injuries or conditions, or the first consultation in a new 5001.07.2023episode of care for the same work-related injuries or conditions. Services to 5001.07.2023be conducted in accordance with the Clinical Framework for the Delivery of 5001.07.2023Health Services. Initial consultation may include: subjective assessment 5001.07.2023objective assessment treatment/service tailored goal setting and treatment 5001.07.2023planning setting expectations of recovery and return to work clinical 5001.07.2023recording communication (with referrer) any relevant information for the 5001.07.2023workers rehabilitation to the insurer. 100090005501.07.2023 O Y Y 2001.07.202300124.0000000.0000000.00 5001.07.2023REASSESSMENT OR PROGRAM REVIEW - A one-one-one comprehensive assessment used 5001.07.2023when: the worker has been in active rehabilitation for at least six weeks and 5001.07.2023further treatment is likely; and/or there are new clinical findings that might 5001.07.2023affect ongoing treatment; and/or there is a rapid change in worker's status 5001.07.2023and/or there is no response to current therapeutic interventions. It should 5001.07.2023include: all components of initial consultation a review of the workers 5001.07.2023progress based on established objective measures a recommendation for future 5001.07.2023treatment and management strategies to assist the worker to return to work. It 5001.07.2023may include referral recommendations to other providers, a change in therapy 5001.07.2023or outcome direction requiring a new return to work goal. Following 5001.07.2023reassessment submit a Provider Management Plan3 (PMP) which should include an 5001.07.2023updated comprehensive treatment plan containing: expected functional gains, 5001.07.2023transition of care to self-management; and treatment timeframes. 100090022601.07.2023 H Y Y 2001.07.202300261.0000000.0000000.00 5001.07.2023INDEPENDENT CASE REVIEW - An independent osteopathy examination and report on 5001.07.2023a worker and is not carried out by the treating osteopath. The review is 5001.07.2023requested by the insurer where progress of treatment and/or rehabilitation 5001.07.2023falls outside the plan or expected course of injury management. The 5001.07.2023examination and report provide the insurer with an assessment and 5001.07.2023recommendations for ongoing treatment and prognosis. 100100023501.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023INITIAL CONSULTATION MENTAL HEALTH OCCUPATIONAL THERAPIST SERVICES - Mental 5001.07.2023Health Occupational Therapist Services Undertaken where possible 5001.07.2023psychological, social, cognitive, emotional, and behavioural problems are 5001.07.2023occurring after a work-related incident or injury. The purpose of the 5001.07.2023assessment is to identify appropriate interventions/treatments to optimise 5001.07.2023rehabilitation outcomes (maximum 2 hours direct contact and test scoring 5001.07.2023time). Services to be conducted in accordance with the Clinical Framework for 5001.07.2023the Delivery of Health Services. Initial consultation may include: History 5001.07.2023taking Assessment Diagnostic formulation Treatment/service Tailored goal 5001.07.2023setting and treatment planning Setting expectations of recovery and return to 5001.07.2023work Clinical recording Maximum one (1) hour. 100100023601.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023SUBSEQUENT CONSULTATION MENTAL HEALTH OCCUPATIONAL THERAPIST - Mental Health 5001.07.2023Occupational Therapist A one-on-one subsequent consultation in the treatment 5001.07.2023of work-related injuries or conditions. The first six (6) hours (including 5001.07.2023initial consultation) are pre-approved, provided the injuries or conditions 5001.07.2023have not previously been treated by an allied health provider. If additional 5001.07.2023treatment is required, submit a Provider Management Plan3 (PMP) by the 6th 5001.07.2023subsequent treatment consultation. The PMP should include a comprehensive 5001.07.2023treatment plan containing: expected functional gains, transition of care to 5001.07.2023self-management; and treatment timeframes. Subsequent consultation may 5001.07.2023include: ongoing assessment (subjective and objective) intervention/treatment 5001.07.2023setting expectations of recovery and return to work clinical recording 5001.07.2023communication with the insurer of any relevant information for the workers 5001.07.2023rehabilitation. 100100023701.07.2023 H Y Y 2001.07.202300177.0000000.0000000.00 5001.07.2023STANDARD REPORT (ITEM CODE FOR PSYCHOLOGY ONLY) - A written report used for 5001.07.2023conveying relevant information about a worker's work-related injury or 5001.07.2023condition where the case or treatment is not extremely complex or where 5001.07.2023responses to a limited number of questions have been requested by the insurer. 100100023801.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023COMPREHENSIVE REPORT (ITEM CODE FOR PSYCHOLOGY ONLY) - Comprehensive Report 5001.07.2023(Item Code for Psychology only) A written report only used where the case and 5001.07.2023treatment are extremely complex. Hours to be negotiated with the insurer prior 5001.07.2023to providing the report. 100100023901.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023INITIAL NEEDS ASSESSMENT (INA) AND REPORT - Max 2-4 hrs. Assessment with a 5001.07.2023worker completed prior to commencement of return to work services to establish 5001.07.2023injuries and formulate recovery process and develop goals for return to work 5001.07.2023and/or reengagement with workplace based on expectation from all parties. 5001.07.2023Includes worksite assessment, interview with the employer and worker and 5001.07.2023liaison with relevant treating medical/allied health providers. Includes 5001.07.2023report. Assists with claims with complex diagnosis, secondary diagnosis or 5001.07.2023flags raised by worker and/or employer. Leads to development of rehabilitation 5001.07.2023program for return to work outcomes. For WorkCover Queensland claims, only an 5001.07.2023approved RTW Services provider can provide this service.** 100100024001.07.2023 H Y Y 2001.07.202300209.0000000.0000000.00 5001.07.2023PSYCHOLOGICAL FUNCTIONAL CAPACITY EVALUATION (PFCE) - Max 3-5 hrs. Assessment 5001.07.2023of a workers capacity to perform cognitive tasks, offering a baseline 5001.07.2023measurement of current symptoms and fitness for work. Determines capacity for 5001.07.2023return to work program, assists in graduation of duties in psychological 5001.07.2023claims or where cognitive deficits are identified by treating team. Assists 5001.07.2023with claims with delayed return to work in psychological or 5001.07.2023significant/complex physical injury claims, secondary psychological claims, 5001.07.2023minimal progression in return to work capacity despite ongoing treatment For 5001.07.2023WorkCover Queensland claims, only an approved RTW Services provider can 5001.07.2023provide this service.** (Psychologists, Rehabilitation Counsellors and 5001.07.2023Occupational Therapists to perform this service. 100100024101.07.2023 H Y Y 2001.07.202300234.0000000.0000000.00 5001.07.2023INITIAL CONSULTATION MENTAL HEALTH SOCIAL WORKER - Undertaken where possible 5001.07.2023to clarify the presence of possible adjustment to injury issues and set goals 5001.07.2023of therapy to optimise rehabilitation outcomes; performed where worker is 5001.07.2023displaying psychological, social, cognitive, emotional, and behavioural 5001.07.2023problems after a work-related incident or injury. The purpose of the 5001.07.2023consultation is to identify appropriate interventions/treatments to optimise 5001.07.2023rehabilitation outcomes. Services to be conducted in accordance with the 5001.07.2023Clinical Framework for the Delivery of Health Services. Initial consultation 5001.07.2023may include: history taking assessment diagnostic formulation 5001.07.2023treatment/service tailored goal setting and treatment planning setting 5001.07.2023expectations of recovery and return to work clinical recording communication 5001.07.2023with the insurer of any relevant information for the workers rehabilitation 5001.07.2023Maximum one (1) hour. 100100024201.07.2023 H Y Y 2001.07.202300234.0000000.0000000.00 5001.07.2023SUBSEQUENT CONSULTATION MENTAL HEALTH SOCIAL WORKER - Subsequent Consultation 5001.07.2023A one-on-one subsequent consultation in the treatment of work-related injuries 5001.07.2023or conditions. The first six (6) consultations (including initial 5001.07.2023consultation) are pre-approved, provided the injuries or conditions have not 5001.07.2023previously been treated by an allied health provider. If additional treatment 5001.07.2023is required, submit a Provider Management Plan3 (PMP) by the 6th subsequent 5001.07.2023treatment consultation. The PMP should include a comprehensive treatment plan 5001.07.2023containing: expected functional gains, transition of care to self-management; 5001.07.2023and treatment timeframes. Services to be conducted in accordance with the 5001.07.2023Clinical Framework for the Delivery of Health Services2. Subsequent 5001.07.2023consultation may include: ongoing assessment (subjective and objective) 5001.07.2023intervention/treatment setting expectations of recovery and return to work 5001.07.2023clinical recording communication with the insurer of any relevant information 5001.07.2023for the workers rehabilitation. 100100024301.07.2023 H Y Y 2001.07.202300185.0000000.0000000.00 5001.07.2023INITIAL CONSULTATION PSYCHOTHERAPY SERVICES ONLY - Initial Consultation 5001.07.2023Psychotherapy Services Undertaken where possible psychological, social, 5001.07.2023cognitive, emotional, and behavioural problems are occurring after a 5001.07.2023work-related incident or injury. The purpose of the assessment is to identify 5001.07.2023appropriate interventions/treatments to optimise rehabilitation outcomes 5001.07.2023(maximum 2 hours direct contact and test scoring time). Services to be 5001.07.2023conducted in accordance with the Clinical Framework for the Delivery of Health 5001.07.2023Services. Initial consultation may include: History taking Assessment 5001.07.2023Diagnostic formulation Treatment/service Tailored goal setting and treatment 5001.07.2023planning Setting expectations of recovery and return to work Clinical 5001.07.2023recording Communication with referrer, insurer, and other relevant parties. 5001.07.2023The entire consultation must be 1 on 1 with the worker. 100100024401.07.2023 H Y Y 2001.07.202300185.0000000.0000000.00 5001.07.2023SUBSEQUENT CONSULTATION PSYCHOTHERAPY SERVICES ONLY - A one-on-one subsequent 5001.07.2023consultation with the worker in their ongoing management and treatment. 5001.07.2023Intervention is based on treatment formulated in the initial consultation. The 5001.07.2023first six (6) hours (including initial consultation) are pre-approved, 5001.07.2023provided this issue has not previously been treated by an allied health 5001.07.2023provider, with a maximum of two (2) hours on any one day. If additional 5001.07.2023treatment is required, submit a Provider Management Plan (PMP) within six (6) 5001.07.2023hours of consultations which includes a comprehensive treatment plan 5001.07.2023containing: expected functional gains, transition to self-care management; and 5001.07.2023treatment timeframes. Services to be conducted in accordance with the Clinical 5001.07.2023Framework for the Delivery of Health Services. Subsequent consultation may 5001.07.2023include: ongoing assessment intervention/treatment setting expectations of 5001.07.2023recovery and return to work clinical recording communication with the insurer 5001.07.2023of any relevant information for the workers rehabilitation. 100100024501.07.2023 H Y Y 2001.07.202300063.0000000.0000000.00 5001.07.2023ATTENDANT CARE STANDARD WEEKDAY- DAYTIME - Weekday Daytime Support is any 5001.07.2023support to a participant that starts at or after 6:00 am and ends before or at 5001.07.20238:00 pm on a single weekday (unless it is a Public Holiday or Night-time 5001.07.2023Sleepover Support). - Attendant care and support services are generally 5001.07.2023services to help a worker with serious injuries and complex injuries to 5001.07.2023participate with everyday tasks. - Please Note: Prior approval required before 5001.07.2023approving these services. Prior approval required before approving this 5001.07.2023service. 100100024601.07.2023 H Y Y 2001.07.202300068.0000000.0000000.00 5001.07.2023ATTENDANT CARE -STANDARD - WEEKDAY EVENING - Weekday Evening Support is any 5001.07.2023support to a participant that starts after 8:00 pm and finishes at or before 5001.07.2023midnight on a single weekday (unless it is a Public Holiday or Night-time 5001.07.2023Sleepover Support). - Attendant care and support services are generally 5001.07.2023services to help a worker with serious injuries and complex injuries to 5001.07.2023participate with everyday tasks. - Please Note: Prior approval required before 5001.07.2023approving these services. 100100024701.07.2023 H Y Y 2001.07.202300070.0000000.0000000.00 5001.07.2023ATTENDANT CARE - STANDARD - WEEKDAY NIGHT - Weekday Night Support is any 5001.07.2023support to a participant that commences at or before midnight on a weekday and 5001.07.2023finishes after midnight on that weekday or commences before 6:00 am on a 5001.07.2023weekday and finishes on that weekday (unless it is a Public Holiday, Saturday, 5001.07.2023Sunday, or Night-time Sleepover Support). - Attendant care and support 5001.07.2023services are generally services to help a worker with serious injuries and 5001.07.2023complex injuries to participate with everyday tasks. - Please Note: Prior 5001.07.2023approval required before approving these services. 100100024801.07.2023 H Y Y 2001.07.202300088.0000000.0000000.00 5001.07.2023ATTENDANT CARE - STANDARD - SATURDAY - Saturday Support is any support to a 5001.07.2023participant that starts at or after midnight on the night prior to a Saturday 5001.07.2023and ends before or at midnight of that Saturday (unless it is a Public Holiday 5001.07.2023or Night-time Sleepover Support). - Attendant care and support services are 5001.07.2023generally services to help a worker with serious injuries and complex injuries 5001.07.2023to participate with everyday tasks. - Please Note: Prior approval required 5001.07.2023before approving these services. 100100024901.07.2023 H Y Y 2001.07.202300113.0000000.0000000.00 5001.07.2023ATTENDANT CARE - STANDARD - SUNDAY - Sunday Support is any support to a 5001.07.2023participant that starts at or after midnight on the night prior to a Sunday 5001.07.2023and ends before or at midnight of that Sunday (unless it is a Public Holiday 5001.07.2023or Night-time Sleepover Support). - Attendant care and support services are 5001.07.2023generally services to help a worker with serious injuries and complex injuries 5001.07.2023to participate with everyday tasks. - Please Note: Prior approval required 5001.07.2023before approving these services. 100100025001.07.2023 H Y Y 2001.07.202300139.0000000.0000000.00 5001.07.2023ATTENDANT CARE - STANDARD - PUBLIC HOLIDAY - Public Holiday Support is any 5001.07.2023support to a participant that starts at or after midnight on the night prior 5001.07.2023to a Public Holiday and ends before or at midnight of that Public Holiday 5001.07.2023(unless it is a Night-time Sleepover Support). - Attendant care and support 5001.07.2023services are generally services to help a worker with serious injuries and 5001.07.2023complex injuries to participate with everyday tasks. - Please Note: Prior 5001.07.2023approval required before approving these services. 100100025101.07.2023 H Y Y 2001.07.202300262.0000000.0000000.00 5001.07.2023ATTENDANT CARE - ASSISTANCE WITH SELF-CARE ACTIVITIES - NIGHT-TIME SLEEPOVER - 5001.07.2023Night-time Sleepover Support is any support to a participant delivered on a 5001.07.2023weekday, a Saturday, a Sunday, or a Public Holiday that: o Commences before 5001.07.2023midnight on a day and finishes after midnight on that day; and o Is for a 5001.07.2023continuous period of eight (8) hours or more; and o The worker is allowed to 5001.07.2023sleep when they are not providing support. - Attendant care and support 5001.07.2023services are generally services to help a worker with serious injuries and 5001.07.2023complex injuries to participate with everyday tasks. - Please Note: Prior 5001.07.2023approval required before approving these services. 100100025201.07.2023 O Y Y 2001.07.202301300.0000000.0000000.00 5001.07.2023ATTENDANT CARE PROGRAM ESTABLISHMENT FEE - Establishment fee- One off set up 5001.07.2023fee for complex attendant care program of ongoing support services 100100025301.07.2023 H Y Y 2001.07.202300053.0000000.0000000.00 5001.07.2023GARDEN MAINTENANCE - HOME CARE SERVICES - Provided through an agency - 5001.07.2023includes basic gardening assistance. where the worker is living at home and 5001.07.2023has been assessed by an occupational therapist as incapable of undertaking 5001.07.2023these tasks (for physical, cognitive, or emotional reasons) of undertaking 5001.07.2023these tasks, and Note: Prior approval is required before providing this 5001.07.2023service NOTE: Yard maintenance (lawn mowing, light pruning, and rubbish 5001.07.2023removal) is limited to work ordinarily required for an average residence and 5001.07.2023excludes excessive or high frequency maintenance work. See further information 5001.07.2023below has no family or other social support network. 100100025401.07.2023 H Y Y 2001.07.202300053.0000000.0000000.00 5001.07.2023HOME MAINTENANCE- HOME CARE SERVICES - Provided through an agency - includes 5001.07.2023basic home maintenance. where the worker is living at home and has been 5001.07.2023assessed by an occupational therapist as incapable of undertaking these tasks 5001.07.2023(for physical, cognitive, or emotional reasons) of undertaking these tasks, 5001.07.2023and has no family or other social support network. Prior approval is required 5001.07.2023before providing this service Note: Home and garden maintenance services 5001.07.2023exclude services or works that are ordinarily undertaken by a skilled 5001.07.2023tradesperson (for example carpentry services for home repairs, painting 5001.07.2023services, electrical and plumbing services, roofing repair services). See 5001.07.2023Further information below. 100100025501.07.2023 O Y Y 2001.07.202300030.0000000.0000000.00 5001.07.2023BASIC DRESSING PACK SIMPLE - Basic wound dressings e.g. Primapore Opsite 5001.07.2023Mepilex lite Melolite Hypafix Steri-strips transparent Opsite Simple 5001.07.2023post-operative wound dressings Disposable Wound Management Kit Sterile field 5001.07.2023(sterile pack incl. gauze) Sterile instruments (scissors and tweezers) Stitch 5001.07.2023cutters (for suture removal) Saline solution (for wound irrigation) Peroxide 5001.07.2023Betadine Chlorohexidine (for wound irrigation) 100100025601.07.2023 O Y Y 2001.07.202300050.0000000.0000000.00 5001.07.2023BASIC DRESSING PACK COMPLEX - Complex wound dressings Multiple basic wound 5001.07.2023dressings e.g. Primapore Opsite Mepilex lite Mepitel Mepilex border lite 5001.07.2023Melolite Hypafix Steri-strips transparent Opsite Crepe bandaging Multiple 5001.07.2023wounds, infected wounds, specialised dressings, wounds requiring healing with 5001.07.2023secondary intention Disposable Wound Management Kit Sterile field (sterile 5001.07.2023pack incl. gauze) Sterile instruments (scissors and tweezers) Stitch cutters 5001.07.2023(for suture removal) Saline solution (for wound irrigation) Peroxide Betadine 5001.07.2023Chlorohexidine (for wound irrigation) 100100025701.07.2023 O Y Y 2001.07.202300070.0000000.0000000.00 5001.07.2023MULTI TRAUMA DRESSINGS - Variety of basic and complex wound dressings for 5001.07.2023multiple or large wounds e.g. Mepitel Mepilex border lite Primapore Opsite 5001.07.2023Mepilex lite Melolite Hypafix Steri-strips transparent Opsite Large wound 5001.07.2023margins requiring multiple dressings and large dressings, specialised 5001.07.2023dressings, burns, wound debridement isposable Wound Management Kit Sterile 5001.07.2023field (sterile pack incl. gauze) Sterile instruments (scissors and tweezers) 5001.07.2023Stitch cutters (for suture removal) Saline solution (for wound irrigation) 5001.07.2023Peroxide Betadine Chlorohexidine (for wound irrigation) 100100025801.07.2023 O Y Y 2001.07.202300160.0000000.0000000.00 5001.07.2023INCIDENTAL EXPENSES HAND THERAPY - Reasonable charges for incidental items 5001.07.2023required by the worker to assist in their recovery and which they take home 5001.07.2023with them following their treatment. Pharmacy items and consumables used by a 5001.07.2023provider during a consultation are not included. For further clarification 5001.07.2023refer to the information provided below the tables. * Payment will be made up 5001.07.2023to $160 in total for incidental expenses and up to $265 in total for 5001.07.2023supportive devices, per claim (not per consultation), without prior approval. 5001.07.2023Approval from the insurer must be obtained for items exceeding the 5001.07.2023pre-approved value. Hire of equipment to be negotiated with insurer. All 5001.07.2023expenses must be itemised on the invoice. Please note: This item number is not 5001.07.2023to be used for admission fees to external facilities such as gyms and pools.