100010000601.07.2022 O Y Y 2001.07.202200088.0000000.0000000.00 5001.07.2022SUBSEQUENT CONSULTATION - A one-on-one subsequent consultation in the 5001.07.2022treatment of work-related injuries or conditions. The first six (6) 5001.07.2022consultations (including initial consultation) are pre-approved, provided the 5001.07.2022injuries or conditions have not previously been treated by an allied health 5001.07.2022provider. If additional treatment is required, submit a Provider Management 5001.07.2022Plan (PMP) by the 6th subsequent treatment consultation. The PMP should 5001.07.2022include a comprehensive treatment plan containing: expected functional gains, 5001.07.2022transition of care to self-management; and treatment timeframes. Services to 5001.07.2022be conducted in accordance with the Clinical Framework for the Delivery of 5001.07.2022Health Services. Subsequent consultation may include: ongoing assessment 5001.07.2022(subjective and objective) intervention/treatment setting expectations of 5001.07.2022recovery and return to work clinical recording communication with the insurer 5001.07.2022of any relevant information for the workers rehabilitation. 100010002101.07.2022 O Y Y 2001.07.202200117.0000000.0000000.00 5001.07.2022INITIAL CONSULTATION - A one-on-one initial consultation for the treatment of 5001.07.2022work-related injuries or conditions, or the first consultation in a new 5001.07.2022episode of care for the same work-related injuries or conditions. Services to 5001.07.2022be conducted in accordance with the Clinical Framework for the Delivery of 5001.07.2022Health Services. Initial consultation may include: subjective assessment 5001.07.2022objective assessment treatment/service tailored goal setting and treatment 5001.07.2022planning setting expectations of recovery and return to work clinical 5001.07.2022recording communication with the insurer of any relevant information for the 5001.07.2022workers rehabilitation. 100010010601.07.2022 O Y Y 2001.07.202200050.0000000.0000000.00 5001.07.2022GROUP EXERCISE SESSIONS - Prior approval required before providing this 5001.07.2022service. A session where a common program is delivered to more than one 5001.07.2022individual at the same time. The group can consist of a maximum of eight (8) 5001.07.2022persons. The group session must be attended, conducted, and supervised by a 5001.07.2022physiotherapist. 100010022601.07.2022 H Y Y 2001.07.202200246.0000000.0000000.00 5001.07.2022INDEPENDENT CASE REVIEW - An independent physiotherapy examination and report 5001.07.2022on a worker. It is not carried out by the treating physiotherapist. The review 5001.07.2022is requested by the insurer where progress of treatment and/or rehabilitation 5001.07.2022falls outside the plan or expected course of injury management. The 5001.07.2022examination and report provide the insurer with an assessment and 5001.07.2022recommendations for ongoing treatment and prognosis. 100010028701.07.2022 H Y Y 2001.07.202200197.0000000.0000000.00 5001.07.2022SPECIALISED HAND/UPPER LIMB CONSULTATION - Prior approval is required before 5001.07.2022providing this service, unless referred by a medical specialist, then the 5001.07.2022first six (6) consultations are pre-approved. A one-on-one consultation and 5001.07.2022treatment for workers with hand and upper limb work-related injuries or 5001.07.2022conditions (below shoulder level). Treatment offered is considered specialist 5001.07.2022hand therapy provided by a qualified physiotherapist. Further details are 5001.07.2022provided below the tables. Consultations may include: ongoing assessment 5001.07.2022(subjective and objective) intervention/treatment setting expectations of 5001.07.2022recovery and return to work clinical recording communication with the insurer 5001.07.2022of any relevant information for the workers rehabilitation. A Provider 5001.07.2022Management Plan (PMP) is to be submitted following the initial assessment. The 5001.07.2022PMP should include an updated comprehensive treatment plan containing: 5001.07.2022expected functional gains, transition of care to self-management; and 5001.07.2022treatment timeframes. Maximum one (1) hour. 100010031401.07.2022 H Y Y 2001.07.202200197.0000000.0000000.00 5001.07.2022INITIAL CONSULTATION - WORK SPECIFIC FUNCTIONAL EXERCISE PROGRAM - Prior 5001.07.2022approval is required before providing this service. Development and 5001.07.2022instruction of a gym/pool-based exercise program focused on improving function 5001.07.2022of the work-related injury or condition, relevant to the work role. The aim of 5001.07.2022this program is for a successful transition of the workers program to a 5001.07.2022gym/pool-based setting in order to meet their work specific functional goals. 5001.07.2022This service may only be charged once. Refer to Item Number 300228 for Gym and 5001.07.2022Pool Entry Fees. Services to be conducted in accordance with the Clinical 5001.07.2022Framework for the Delivery of Health Services. The entire consultation must be 5001.07.2022one-on-one with the worker. Maximum one (1) hour. 100010040201.07.2022 H Y Y 2001.07.202200197.0000000.0000000.00 5001.07.2022SUBSEQUENT CONSULTATION - WORK SPECIFIC FUNCTIONAL EXERCISE PROGRAM - Prior 5001.07.2022approval is required before providing this service. The insurer may request 5001.07.2022justification and will consider seeking an independent opinion if more than 5001.07.2022six (6) consultations are requested per episode of care. A one-on-one 5001.07.2022consultation with the worker for ongoing monitoring, review and progression of 5001.07.2022a gym/pool-based exercise program as developed during initial consultation 5001.07.2022(100314). The focus must be on improving function of the work-related injury 5001.07.2022or condition relevant to the work role and include education and progression 5001.07.2022to self-management. Services to be conducted in accordance with the Clinical 5001.07.2022Framework for the Delivery of Health Services. A Provider Management Plan 5001.07.2022(PMP) is to be submitted for approval following the initial consultation 5001.07.2022(100314) and before any treatment commences. The PMP should include a 5001.07.2022comprehensive treatment plan containing: expected functional gains, transition 5001.07.2022of care to self-management; and treatment timeframes. Maximum one (1) hour. 100010040601.07.2022 H Y Y 2001.07.202200197.0000000.0000000.00 5001.07.2022SPECIFIC PHYSIOTHERAPY ASSESSMENT - Prior approval is required before 5001.07.2022providing this service and justification may be requested by the insurer. A 5001.07.2022one-on-one assessment used for specific conditions that cannot be adequately 5001.07.2022assessed, due to the complexity of the condition, within an initial 5001.07.2022consultation (100021, 100313 for multiple injuries or conditions, and 100314 5001.07.2022for work specific functional exercise program). These may include, but are not 5001.07.2022limited to: extensive burns acquired brain injuries severe spinal cord 5001.07.2022injuries multiple orthopaedic fractures limb amputations crush injuries. This 5001.07.2022service can also be used for the assessment (only) of suitability for entry 5001.07.2022into a Multi-Disciplinary Program or Pain Management Program. The service may 5001.07.2022only be used once by the physiotherapist in the treatment of a work-related 5001.07.2022injury or condition, or the first consultation in a new episode of care for 5001.07.2022the same work-related injury or condition. Maximum one (1) hour. 100010040701.07.2022 H Y Y 2001.07.202200197.0000000.0000000.00 5001.07.2022SPECIFIC PHYSIOTHERAPY CONSULTATION - Prior approval is required before 5001.07.2022providing this service. The insurer may request justification and will 5001.07.2022consider seeking an independent opinion if more than six (6) consultations are 5001.07.2022requested per episode of care. A one-on-one consultation for recommended 5001.07.2022interventions identified during a Specific Physiotherapy Assessment (100406). 5001.07.2022These may include, but are not limited to: extensive burns acquired brain 5001.07.2022injuries severe spinal cord injuries multiple orthopaedic fractures limb 5001.07.2022amputations crush injuries. Please note: This service is not to be used for 5001.07.2022consultations within a Multi-Disciplinary Program or Pain Management Program 5001.07.2022and must not be already classified elsewhere in this table. A Provider 5001.07.2022Management Plan (PMP) is to be submitted following the initial assessment 5001.07.2022(100406). The PMP should include an updated comprehensive treatment plan 5001.07.2022containing: expected functional gains, transition of care to self-management; 5001.07.2022and treatment timeframes. Maximum one (1) hour. 100010055501.07.2022 O Y Y 2001.07.202200117.0000000.0000000.00 5001.07.2022REASSESSMENT OR PROGRAM REVIEW - A one-on-one comprehensive assessment used 5001.07.2022when: the worker has been in active rehabilitation for at least six weeks and 5001.07.2022further treatment is likely; and/or there are new clinical findings that might 5001.07.2022affect ongoing treatment; and/or there is a rapid change in worker's status 5001.07.2022and/or there is no response to current therapeutic interventions. It should 5001.07.2022include: all components of initial consultation a review of the workers 5001.07.2022progress based on established objective measures a recommendation for future 5001.07.2022treatment and management strategies to assist the worker to return to work. It 5001.07.2022may include referral recommendations to other providers, a change in therapy 5001.07.2022or outcome direction requiring a new return to work goal. Following 5001.07.2022reassessment submit a Provider Management Plan (PMP) with an updated 5001.07.2022comprehensive treatment plan containing: expected functional gains, transition 5001.07.2022of care to self-management; and treatment timeframes. 100020001101.07.2022 O Y Y 5001.07.2022COMPREHENSIVE ORAL EXAMINATION (ADA 011) - Evaluation of all teeth, their 5001.07.2022supporting tissues, and the oral tissues in order to record the current 5001.07.2022condition of these structures. This evaluation includes recording an 5001.07.2022appropriate oral and medical history and any other relevant information. Usual 5001.07.2022practice fee applies. 100020001201.07.2022 O Y Y 5001.07.2022PERIODIC ORAL EXAMINATION (ADA 012) - An evaluation performed on a patient of 5001.07.2022record to determine any changes in the patient's oral and medical health 5001.07.2022status since a previous comprehensive or periodic examination. Usual practice 5001.07.2022fee applies. 100020001301.07.2022 O Y Y 5001.07.2022ORAL EXAMINATION - LIMITED (ADA 013) - A limited evaluation of the dentition, 5001.07.2022mouth and associated structures performed on a patient. This may be for a 5001.07.2022specific oral health problem or complaint. This evaluation includes recording 5001.07.2022an appropriate oral and medical history and any other relevant information. 5001.07.2022Usual practice fee applies. 100020001401.07.2022 O Y Y 5001.07.2022CONSULTATION (<30 MINUTES) (ADA 014) - A consultation to seek advice or 5001.07.2022discuss treatment options regarding a specific dental or oral condition. This 5001.07.2022consultation includes recording an appropriate medical history and any other 5001.07.2022relevant information. Usual practice fee applies. 100020001501.07.2022 O Y Y 5001.07.2022CONSULTATION - EXTENDED (30 MINUTES) (ADA 015) - An extended consultation to 5001.07.2022seek advice or discuss treatment options about a specific dental or oral 5001.07.2022complaint. This consultation includes recording an appropriate medical history 5001.07.2022and any other relevant information. Usual practice fee applies. 100020002201.07.2022 O Y Y 5001.07.2022INTRAORAL PERIAPICAL OR BITEWING RADIOGRAPH (ADA 022) - Taking and 5001.07.2022interpreting a radiograph made with the film inside the mouth. Usual practice 5001.07.2022fee per exposure applies. 100020002501.07.2022 O Y Y 5001.07.2022INTRAORAL RADIOGRAPH - OCCLUSAL, MAXILLARY, MANDIBULAR (ADA 025) - Taking and 5001.07.2022interpreting an occlusal, maxillary, or mandibular intraoral radiograph. This 5001.07.2022radiograph shows a more extensive view of teeth and maxillary or mandibular 5001.07.2022bone. Usual practice fee per exposure applies 100020003701.07.2022 O Y Y 5001.07.2022PANORAMIC RADIOGRAPH (OPG) (ADA 037) - Taking and interpreting an extraoral 5001.07.2022radiograph presenting a panoramic view of part or all of the mandible and/or 5001.07.2022the maxilla and/or adjacent structures. Usual practice fee per exposure 5001.07.2022applies. 100020007101.07.2022 O Y Y 5001.07.2022DIAGNOSTIC MODEL (ADA 071) - The preparation of a model from an impression or 5001.07.2022digital data. The model is used for examination and treatment planning 5001.07.2022procedures. This item should not be used to describe a working model. Usual 5001.07.2022practice fee per model applies. 100020031101.07.2022 O Y Y 5001.07.2022REMOVAL OF A TOOTH OR PART(S) THEREOF (ADA 311) - A procedure consisting of 5001.07.2022the removal of a tooth or part(s) thereof. Usual practice fee applies. 100020031401.07.2022 O Y Y 5001.07.2022SECTIONAL REMOVAL OF A TOOTH OR PART(S) THEREOF (ADA 314) - The removal of a 5001.07.2022tooth or part(s) thereof in sections. Bone removal may be necessary. Usual 5001.07.2022practice fee applies. 100020032201.07.2022 O Y Y 5001.07.2022SURGICAL REMOVAL OF A TOOTH OR FRAGMENT NOT REQUIRING REMOVAL OF BONE OR TOOTH 5001.07.2022DIVISION (ADA 322) - Removal of a tooth or tooth fragment where an incision 5001.07.2022and the raising of a mucoperiosteal flap are required, but where removal of 5001.07.2022bone or sectioning of the tooth is not necessary to remove the tooth. Usual 5001.07.2022practice fee applies. 100020032301.07.2022 O Y Y 5001.07.2022SURGICAL REMOVAL OF A TOOTH OR TOOTH FRAGMENT REQUIRING REMOVAL OF BONE (ADA 5001.07.2022323) - Removal of a tooth or tooth fragment where removal of bone is required 5001.07.2022after an incision and the raising of a mucoperiosteal flap. 100020035201.07.2022 O Y Y 5001.07.2022FRACTURE OF MAXILLA OR MANDIBLE - NOT REQUIRING FIXATION (ADA 352) - 5001.07.2022Conservative treatment of a fracture of the maxilla or mandible where there is 5001.07.2022no marked displacement or mobility of the fragments. No physical reduction or 5001.07.2022fixation is required. Usual practice fee applies. 100020038701.07.2022 O Y Y 5001.07.2022REPLANTATION AND SPLINTING OF A TOOTH (ADA 387) - Replantation of a tooth that 5001.07.2022has been avulsed or intentionally removed. It may be held in the correct 5001.07.2022position by splinting. Usual practice fee applies per tooth. 100020039901.07.2022 O Y Y 5001.07.2022CONTROL OF REACTIONARY OR SECONDARY POST-OPERATIVE HAEMORRHAGE (ADA 399) - 5001.07.2022This procedure describes the control of reactionary or secondary 5001.07.2022post-operative haemorrhage. Usual practice fee applies. 100020041101.07.2022 O Y Y 5001.07.2022DIRECT PULP CAPPING (ADA 411) - A procedure where an exposed pulp is directly 5001.07.2022covered with a protective dressing or cement. Usual practice fee applies. 100020041901.07.2022 O Y Y 5001.07.2022EXTIRPATION OF PULP OR DEBRIDEMENT OF ROOT CANAL(S) - EMERGENCY OR PALLIATIVE 5001.07.2022(ADA 419) - The partial or thorough removal of pulp and/or debris from the 5001.07.2022root canal system of a tooth. This is an emergency or palliative procedure 5001.07.2022distinct from visits for scheduled endodontic treatment. Temporisation, other 5001.07.2022than the closure of an access cavity, should be itemised separately. Usual 5001.07.2022practice fee applies. 100020045501.07.2022 O Y Y 5001.07.2022ADDITIONAL VISIT FOR IRRIGATION AND/OR DRESSING OF THE ROOT CANAL SYSTEM (ADA 5001.07.2022455) - Additional debridement irrigation and short-term dressing required 5001.07.2022where evidence of infection or inflammation persists following prior opening 5001.07.2022of the root canal and removal of its contents. Usual practice fee applies per 5001.07.2022tooth. 100020051101.07.2022 O Y Y 5001.07.2022METALLIC RESTORATION - ONE SURFACE - DIRECT (ADA 511) - Direct metallic 5001.07.2022restoration involving one surface of a tooth. Usual practice fee applies. 100020051201.07.2022 O Y Y 5001.07.2022METALLIC RESTORATION - TWO SURFACES - DIRECT (ADA 512) - Direct metallic 5001.07.2022restoration involving two surfaces of a tooth. Usual practice fee applies. 100020051301.07.2022 O Y Y 5001.07.2022ANY PROSTHODONTIC SERVICE (ADA 611-ADA 779) - Provision of any service from 5001.07.2022the Prosthodontics chapter of The Australian Schedule of Dental Services and 5001.07.2022Glossary 13th edition. Usual practice fee applies. 100020071101.07.2022 O Y Y 5001.07.2022COMPLETE MAXILLARY DENTURE (ADA 711) - Provision of a patient removable dental 5001.07.2022prosthesis replacing the natural teeth and adjacent tissues in the maxilla. 5001.07.2022Usual practice fee applies. 100020071201.07.2022 O Y Y 5001.07.2022COMPLETE MANDIBULAR DENTURE (ADA 712) - Provision of a patient removable 5001.07.2022dental prosthesis replacing the natural teeth and adjacent tissues in the 5001.07.2022mandible. Usual practice fee applies. 100020072101.07.2022 O Y Y 5001.07.2022PARTIAL MAXILLARY DENTURE - RESIN BASE (ADA 721) - Provision of a resin base 5001.07.2022for a patient removable dental prosthesis for the maxilla where some natural 5001.07.2022teeth remain. Other components of the denture such as teeth, rests, retainers, 5001.07.2022and immediate tooth replacements should be appropriately itemised. Usual 5001.07.2022practice fee applies. 100020072201.07.2022 O Y Y 5001.07.2022PARTIAL MANDIBULAR DENTURE - RESIN BASE (ADA 722) - Provision of a resin base 5001.07.2022for a patient removable dental prosthesis for the mandible where some natural 5001.07.2022teeth remain. Other components of the denture such as teeth, rests, retainers, 5001.07.2022and immediate tooth replacements should be appropriately itemised. Usual 5001.07.2022practice fee applies. 100020072801.07.2022 O Y Y 5001.07.2022PARTIAL MANDIBULAR DENTURE - CAST METAL FRAMEWORK (ADA 728) - Provision of the 5001.07.2022framework for a patient removable dental prosthesis made with a cast metal on 5001.07.2022which to replace teeth from the mandible where some natural teeth remain. 5001.07.2022Other components of the denture such as teeth, rests, retainers, and immediate 5001.07.2022tooth replacements should be appropriately itemised. Usual practice fee 5001.07.2022applies. 100020073101.07.2022 O Y Y 5001.07.2022RETAINER (ADA 731) - A retainer or attachment fitted to a tooth to aid 5001.07.2022retention of a partial denture. The number of retainers should be indicated. 5001.07.2022Usual practice fee per tooth applies. 100020073201.07.2022 O Y Y 5001.07.2022OCCLUSAL REST (ADA 732) - A unit of partial denture that rests upon a tooth 5001.07.2022surface to provide support for the denture. The number of rests used should be 5001.07.2022indicated. Usual practice fee per rest applies. 100020073301.07.2022 O Y Y 5001.07.2022TOOTH/TEETH (PARTIAL DENTURE) (ADA 733) - An item to describe each tooth added 5001.07.2022to the base of new partial denture. The number of teeth should be indicated. 5001.07.2022Usual practice fee applies. 100020076401.07.2022 O Y Y 5001.07.2022REPAIRING BROKEN BASE OF A PARTIAL DENTURE (ADA 764) - Repair, insertion, and 5001.07.2022adjustment of a broken resin partial denture base. Usual practice fee applies. 100020076801.07.2022 O Y Y 5001.07.2022ADDING TOOTH TO PARTIAL DENTURE TO REPLACE AN EXTRACTED OR DECORONATED TOOTH 5001.07.2022(ADA 768) - Modification, insertion, and adjustment of a partial denture 5001.07.2022involving an addition to accommodate the loss of a natural tooth or its 5001.07.2022coronal section. Usual practice fee per tooth applies. 100020077601.07.2022 O Y Y 5001.07.2022IMPRESSION - DENTAL APPLIANCE REPAIR/ MODIFICATION (ADA 776) - An item to 5001.07.2022describe taking an impression where required for the repair or modification of 5001.07.2022a dental appliance. Usual practice fee applies. 100020091101.07.2022 O Y Y 5001.07.2022PALLIATIVE CARE (ADA 911) - An item to describe interim care to relieve pain, 5001.07.2022infection, bleeding, or other problems not associated with other treatment. 5001.07.2022Usual practice fee applies. 100020092701.07.2022 O Y Y 5001.07.2022PROVISION OF MEDICATION/MEDICAMENT (ADA 927) - An additional item to describe 5001.07.2022the actual supply, prescription or administration of appropriate medications 5001.07.2022and medicaments required for dental treatments. Usual practice fee applies. 100021000101.07.2022 O Y Y 5001.07.2022COMPLETE FORMS (SENT WITH REQUEST) - FOR TREATING DENTAL PRACTITIONERS TO 5001.07.2022PROVIDE BASIC INFORMATION - Complete forms (sent with request) for treating 5001.07.2022dental practitioners to provide basic information as set out in forms provided 5001.07.2022by the insurer. The treating dental practitioner is to indicate the need for 5001.07.2022phone contact or a full report if additional pertinent information is 5001.07.2022available. Basic fee payable for each form completed. Usual practice fee 5001.07.2022applies. 100021000201.07.2022 O Y Y 5001.07.2022SHORT REPORT - A short report written in response to a request for specific 5001.07.2022information e.g. a statement of attendance, history, diagnosis, record of 5001.07.2022visits, including results of an investigation. These reports should only 5001.07.2022address the information requested but should include any comments necessary to 5001.07.2022make the position clear to a lay person. Expected length is half a page to one 5001.07.2022(1) page. Received by insurer within 10 working days. Usual practice fee 5001.07.2022applies. 100021000501.07.2022 O Y Y 5001.07.2022BASIC REPORT - A basic report includes summing up and an opinion helpful to 5001.07.2022the insurer. A basic report should include all of the relevant items listed in 5001.07.2022the outline for the short report and also a case summary. Details would only 5001.07.2022be given where this assists in determining the merits of a claim, establishing 5001.07.2022a need for a particular line of treatment or rehabilitation, understanding the 5001.07.2022development of the condition and the prognosis, or clarifying early treatment 5001.07.2022and return to work goals. Expected length is one (1) to two (2) pages. 5001.07.2022Received by insurer within 10 working days. Usual practice fee applies. 100021000801.07.2022 O Y Y 5001.07.2022SUBSTANTIAL REPORT - A substantial report includes extensive research or case 5001.07.2022discussion and opinion helpful to the insurer or assessment of impairment on 5001.07.2022request; or if the claim is rejected, to compensate for clinical input to the 5001.07.2022report. To qualify as substantial, a report must include, in addition to the 5001.07.2022case summary and comments required for a basic report, at least one of the 5001.07.2022following: - an assessment of impairment at the insurer's request - a report 5001.07.2022on a work-related injury or condition where the claim is subsequently rejected 5001.07.2022as a result of the report - evidence of extensive research into clinical, 5001.07.2022technical, or scientific papers - considerable case discussion outlining the 5001.07.2022merits of the claim - or advice on the future management of the case which 5001.07.2022assists the insurer and/or rehabilitation providers to manage the claim. 5001.07.2022Received by insurer within 10 working days. Usual practice fee applies. 100021001101.07.2022 O Y Y 5001.07.2022EXPERT SPECIALIST OPINION - An expert specialist opinion includes the above 5001.07.2022elements essential to the insurer in determining or managing claims. To 5001.07.2022attract the fee for an expert specialist report there should be evidence of 5001.07.2022two or more of the requirements for a substantial report, or the preparation 5001.07.2022of a report of a medico-legal standard for use by a medical assessment 5001.07.2022tribunal or a court. Expected length is three (3) or more pages. Note: only to 5001.07.2022be paid to specialists. Received by insurer within 10 working days. Usual 5001.07.2022practice fee applies. 100030000401.07.2022 O Y Y 2001.07.202200117.0000000.0000000.00 5001.07.2022INITIAL CONSULTATION - A one-on-one initial consultation for acupuncture in 5001.07.2022the treatment of work-related injuries or conditions, or the first 5001.07.2022consultation in a new episode of care for the same work-related injuries or 5001.07.2022conditions. Services to be conducted in accordance with the Clinical Framework 5001.07.2022for the Delivery of Health Services. Initial consultation may include: 5001.07.2022subjective assessment objective assessment treatment/service tailored goal 5001.07.2022setting and treatment planning setting expectations of recovery and return to 5001.07.2022work clinical recording communication (with referrer) any relevant information 5001.07.2022for the workers rehabilitation to the insurer. 100030000501.07.2022 O Y Y 2001.07.202200088.0000000.0000000.00 5001.07.2022SUBSEQUENT CONSULTATION - A one-on-one subsequent consultation for acupuncture 5001.07.2022in the treatment of work-related injuries or conditions. The first six (6) 5001.07.2022consultations (including initial consultation) are pre-approved, provided the 5001.07.2022injuries have not previously been treated by an allied health provider. If 5001.07.2022additional treatment is required, submit a Provider Management Plan (PMP) by 5001.07.2022the 6th subsequent treatment consultation. The PMP should include a 5001.07.2022comprehensive treatment plan containing: expected functional gains, transition 5001.07.2022of care to self-management; and treatment timeframes. Services to be conducted 5001.07.2022in accordance with the Clinical Framework for the Delivery of Health Services 5001.07.2022Subsequent consultation may include: ongoing assessment (subjective and 5001.07.2022objective) intervention/treatment setting expectations of recovery and return 5001.07.2022to work clinical recording communication with the insurer of any relevant 5001.07.2022information for the workers rehabilitation. 100030001401.07.2022 H Y Y 2001.07.202200078.0000000.0000000.00 5001.07.2022HOME NURSING SERVICES BY A REGISTERED NURSE - Home Nursing Services by a 5001.07.2022Registered Nurse-Prior approval is required before providing this service. 5001.07.2022Home nursing services such as dressing of wounds and assistance with daily 5001.07.2022care. The insurer will not pay for home nursing services in excess of four (4) 5001.07.2022weeks without a treating medical practitioner review. NB: must be referred by 5001.07.2022a medical practitioner. Day and evening rate: $78. Weekend rate: $101. 100030007901.07.2022 O Y Y 2001.07.202200033.0000000.0000000.00 5001.07.2022COMMUNICATION - 3 TO 10 MINS - Communication-3 to 10 mins-Direct communication 5001.07.2022between treating provider and insurer, employer, insurer referred allied 5001.07.2022health provider and doctors to assist with faster and more effective 5001.07.2022rehabilitation and return to work for a worker. Excludes communication with a 5001.07.2022worker, and of a general administrative nature or conveying non-specific 5001.07.2022information. Must be more than three (3) minutes. Refer to details below the 5001.07.2022tables for a list of exclusions before using this item number. Treating 5001.07.2022providers are expected to keep a written record of the details of 5001.07.2022communication including date, time, and duration. The insurer may request 5001.07.2022evidence of communication at any time. 100030008101.07.2022 O Y Y 2001.07.202200043.0000000.0000000.00 5001.07.2022GENERAL MEDICAL PROCEDURES - Payable where a patient is seen by an advanced 5001.07.2022practice registered nurse (i.e. a nurse practitioner or rural and isolated 5001.07.2022practice nurse) and performs straightforward medical procedures that would 5001.07.2022normally be payable as part of a doctor's MBS attendance fee i.e. suturing a 5001.07.2022wound or removal of a superficial foreign body. This also includes outpatient 5001.07.2022care in hospitals. 100030008201.07.2022 H Y Y 2001.07.202200197.0000000.0000000.00 5001.07.2022CASE CONFERENCE - Prior approval is required before providing the service. 5001.07.2022Face-to-face or phone communication involving the treating provider, insurer 5001.07.2022and one or more of the following: treating medical practitioner or specialist 5001.07.2022employer or employee representative worker allied health providers; or other. 100030008401.07.2022 O Y Y 2001.07.202200066.0000000.0000000.00 5001.07.2022UPDATED SUITABLE DUTIES PROGRAM (SDP) - Documentation of an updated or further 5001.07.2022suitable duties plan for a worker, detailing specific information necessary 5001.07.2022for a safe and effective return to the workplace. For WorkCover Queensland 5001.07.2022claims, only an approved RTW Services provider can provide this service.** 100030008601.07.2022 O Y Y 2001.07.202200066.0000000.0000000.00 5001.07.2022PROGRESS REPORT - A written report providing a brief summary of the worker's 5001.07.2022progress towards recovery and return to work. 100030008701.07.2022 O Y Y 2001.07.202200132.0000000.0000000.00 5001.07.2022PUBLIC HOSPITAL EMERGENCY NURSE SERVICES - To be billed where a worker 5001.07.2022receives primary emergency services provided by nursing staff only. This code 5001.07.2022is used if the care is of an emergency nature only and the hospital is not 5001.07.2022considered to have a recognised emergency department as per the Public Health 5001.07.2022Services Table of Costs. 100030008801.07.2022 O Y Y 2001.07.202200167.0000000.0000000.00 5001.07.2022STANDARD REPORT - A written report used for conveying relevant information 5001.07.2022about a worker's work-related injury or condition where the case or treatment 5001.07.2022is not extremely complex or where responses to a limited number of questions 5001.07.2022have been requested by the insurer. 100030008901.07.2022 O Y Y 2001.07.202200043.0000000.0000000.00 5001.07.2022ASSISTING DOCTOR IN MINOR SURGERY - This item will be payable only if the 5001.07.2022procedure attracts an MBS assistance fee and there is no other doctor 5001.07.2022available to assist. 100030009001.07.2022 H Y Y 2001.07.202200197.0000000.0000000.00 5001.07.2022COMPREHENSIVE REPORT - A written report only used where the case and treatment 5001.07.2022is extremely complex. Hours to be negotiated with the insurer prior to 5001.07.2022providing the report. 100030009101.07.2022 H Y Y 2001.07.202200146.0000000.0000000.00 5001.07.2022TRAVEL - RTW - Travel charges are applicable when the provider is required to 5001.07.2022leave their normal place of practice to treat a worker at a: rehabilitation 5001.07.2022facility hospital workplace their place of residence, or community-based 5001.07.2022setting. Travel is not payable where: the travel is between clinics or 5001.07.2022facilities owned and/or operated by the provider or their employer. the travel 5001.07.2022is for services delivered at an external facility where treatment at these 5001.07.2022external facilities is a regular part of that providers approach and there 5001.07.2022exists a contractual arrangement and/or agreement to use that external 5001.07.2022facility. Please see explanatory notes for further information. For WorkCover 5001.07.2022Queensland claims, only an approved RTW Services provider can provide this 5001.07.2022service.** 100030009201.07.2022 H Y Y 2001.07.202200140.0000000.0000000.00 5001.07.2022TRAVEL - TREATMENT - Travel - Prior approval is required for travel of more 5001.07.2022than one (1) hour. Travel charges are applicable when the provider is required 5001.07.2022to leave their normal place of practice to treat a worker at a: rehabilitation 5001.07.2022facility hospital workplace their place of residence, or community-based 5001.07.2022setting. Travel is not payable where: the travel is between clinics or 5001.07.2022facilities owned and/or operated by the provider or their employer. the travel 5001.07.2022is for services delivered at an external facility where treatment at these 5001.07.2022external facilities is a regular part of that providers approach and there 5001.07.2022exists a contractual arrangement and/or agreement to use that external 5001.07.2022facility. Please see explanatory notes for further information. 100030009301.07.2022 O Y Y 2001.07.202200027.0000000.0000000.00 5001.07.2022COPIES OF PATIENT RECORDS RELATING TO CLAIM - Copies of patient records 5001.07.2022relating to the worker's compensation claim including file notes, results of 5001.07.2022relevant tests e.g. pathology, diagnostic imaging, and reports from 5001.07.2022specialists. Paid at $27 flat fee plus $1 per page. 100030009401.07.2022 O Y Y 2001.07.202200075.0000000.0000000.00 5001.07.2022INCIDENTAL EXPENSES - Reasonable charges for incidental items required by the 5001.07.2022worker to assist in their recovery and which they take home with them 5001.07.2022following their treatment. Pharmacy items and consumables used by a provider 5001.07.2022during a consultation are not included. For further clarification refer to the 5001.07.2022information provided below the tables. * Payment will be made up to $75 in 5001.07.2022total for incidental expenses and up to $220 in total for supportive devices, 5001.07.2022per claim (not per consultation), without prior approval. Approval from the 5001.07.2022insurer must be obtained for items exceeding the pre-approved value. Hire of 5001.07.2022equipment to be negotiated with insurer. All expenses must be itemised on the 5001.07.2022invoice. Please note: This item number is not to be used for admission fees to 5001.07.2022external facilities such as gyms and pools. 100030010001.07.2022 O Y Y 2001.07.202200066.0000000.0000000.00 5001.07.2022COMMUNICATION - 11 TO 20 MINS - Communication-11 to 20 mins-Direct 5001.07.2022communication between treating provider and insurer, employer, insurer 5001.07.2022referred allied health provider and doctors to assist with faster and more 5001.07.2022effective rehabilitation and return to work for a worker. Excludes 5001.07.2022communication with a worker, and of a general administrative nature or 5001.07.2022conveying non-specific information. Must be more than ten (10) minutes. Refer 5001.07.2022to details below the tables for a list of exclusions before using this item 5001.07.2022number. Treating providers are expected to keep a written record of the 5001.07.2022details of communication including date, time, and duration. The insurer may 5001.07.2022request evidence of communication at any time. 100030010201.07.2022 O Y Y 2001.07.202200098.0000000.0000000.00 5001.07.2022INITIAL SUITABLE DUTIES PROGRAM (SDP) - Documentation of suitable duties for a 5001.07.2022worker, detailing specific information necessary for a safe and effective 5001.07.2022return to the workplace. For WorkCover Queensland claims, only an approved RTW 5001.07.2022Services provider can provide this service.** 100030015801.07.2022 H Y Y 2001.07.202200197.0000000.0000000.00 5001.07.2022WORKPLACE EVALUATION/ASSESSMENT - Systematic process using the workplace to 5001.07.2022estimate work potential and work behaviour. Includes ergonomic assessments. 5001.07.2022For WorkCover Queensland claims, only an approved RTW Services provider can 5001.07.2022provide this service.** 100030015901.07.2022 H Y Y 2001.07.202200197.0000000.0000000.00 5001.07.2022ACTIVITIES OF DAILY LIVING ASSESSMENT - A series of standardised tests and 5001.07.2022measures to assess a worker's activities of daily living and mobility 5001.07.2022(including Modified Barthel Index assessments for registered occupational 5001.07.2022therapy only). Service includes assessment and report, noting that WorkCover 5001.07.2022Queenslands template for Modified Barthel Index is to be used (for WorkCover 5001.07.2022claims). 100030016001.07.2022 H Y Y 2001.07.202200197.0000000.0000000.00 5001.07.2022FUNCTIONAL CAPACITY EVALUATION (FCE) - Systematic assessment using a series of 5001.07.2022standardised tests and work specific simulation activities to assess a 5001.07.2022worker's functional capacity for work or potential to return to suitable work; 5001.07.2022includes assessment and report. For WorkCover Queensland claims, only an 5001.07.2022approved RTW Services provider can provide this service.** 100030016101.07.2022 H Y Y 2001.07.202200197.0000000.0000000.00 5001.07.2022DRIVING ASSESSMENT - Off-road and on-road driving assessments of cognitive, 5001.07.2022psychological, and physical capacity to drive. Assessments must be conducted 5001.07.2022by a qualified driving assessor. Service includes assessment and report. 5001.07.2022Driving instructor is also required for on-road assessment component and fees 5001.07.2022are paid separately. 100030016201.07.2022 H Y Y 2001.07.202200197.0000000.0000000.00 5001.07.2022VOCATIONAL ASSESSMENT AND REPORT* - Assessment of realistic vocational options 5001.07.2022in the current job market for a worker using integrated clinical and 5001.07.2022standardised assessment procedures and instruments; includes assessment and 5001.07.2022report. For WorkCover Queensland claims, only an approved RTW Services 5001.07.2022provider can provide this service.** 100030016401.07.2022 H Y Y 2001.07.202200197.0000000.0000000.00 5001.07.2022RETURN TO WORK FACILITATION - Communication with a worker and employer to 5001.07.2022establish an updated suitable duties program where no worksite assessment or 5001.07.2022job placement services are required, or other service item number applies. 5001.07.2022Also used where there are significant barriers preventing a worker 5001.07.2022participating in a return to work program and the provider delivers strategies 5001.07.2022to overcome the barriers. Includes communication between the worker, employer, 5001.07.2022and insurer (does not include general communication relating to a suitable 5001.07.2022duties program or job placement or where another number applies). May include 5001.07.2022face-to-face or electronic file reviews for the insurer. For WorkCover 5001.07.2022Queensland claims, only an approved RTW Services provider can provide this 5001.07.2022service.** 100030016601.07.2022 H Y Y 2001.07.202200197.0000000.0000000.00 5001.07.2022JOB SEEKING SKILLS ASSESSMENT - INITIAL* - Identify a worker's transferable 5001.07.2022skills and abilities for a new job/career or host placement; may involve the 5001.07.2022development of a vocational preparation action plan with the worker. For 5001.07.2022WorkCover Queensland claims, only an approved RTW Services provider can 5001.07.2022provide this service.** 100030016801.07.2022 H Y Y 2001.07.202200197.0000000.0000000.00 5001.07.2022JOB PREPARATION SERVICES* - Prepare the worker to find suitable employment. 5001.07.2022Services will be based on the needs of the worker and may include development 5001.07.2022of or updating a resume and/or cover letter, interview preparation skills and 5001.07.2022career counselling. For WorkCover Queensland claims, only an approved RTW 5001.07.2022Services provider can provide this service.** 100030018601.07.2022 H Y Y 2001.07.202200197.0000000.0000000.00 5001.07.2022INITIAL CONSULTATION - WORK SPECIFIC FUNCTIONAL EXERCISE PROGRAM - Initial 5001.07.2022development and instruction of an exercise program focused on improving 5001.07.2022function of the work-related injuries or conditions, relevant to their work 5001.07.2022role. This service may only be charged once for development of an exercise 5001.07.2022program to meet the workers work specific functional goals. Refer item number 5001.07.2022300228 for Gym and Pool Entry Fees. The exercise physiologist is then expected 5001.07.2022to submit a Provider Management Plan (PMP) following the initial consultation 5001.07.2022for approval before any treatment commences. The PMP should include a 5001.07.2022comprehensive treatment plan containing: expected functional gains, transition 5001.07.2022of care to self-management; and treatment timeframes. The PMP form is 5001.07.2022available on the Workers Compensation Regulatory Services website 5001.07.2022(www.worksafe.qld.gov.au). The insurer will not pay for the preparation or 5001.07.2022completion of a Provider Management Plan. The entire consultation must be 1 on 5001.07.20221 with the worker. Maximum of one (1) hour. 100030018701.07.2022 H Y Y 2001.07.202200197.0000000.0000000.00 5001.07.2022SUBSEQUENT CONSULTATION - WORK SPECIFIC FUNCTIONAL EXERCISE PROGRAM - Prior 5001.07.2022approval is required before providing this service. The insurer may request 5001.07.2022justification and will consider seeking an independent opinion if more than 6 5001.07.2022consultations are requested per episode of care. A one-on-one consultation 5001.07.2022with the worker for ongoing monitoring, review and progression of a 5001.07.2022work-specific functional exercise program as developed during initial 5001.07.2022consultation (300186). The focus must be on improving function of the 5001.07.2022work-related injuries or conditions relevant to the work role and include 5001.07.2022education and progression to self-management. Services to be conducted in 5001.07.2022accordance with the Clinical Framework for the Delivery of Health Services. A 5001.07.2022Provider Management Plan (PMP) is to be submitted for approval following the 5001.07.2022initial consultation (300186), before any further treatment commences. The PMP 5001.07.2022should include a comprehensive treatment plan containing: expected functional 5001.07.2022gains, transition of care to self-management; and treatment timeframes. 5001.07.2022Maximum 1 hour. 100030018801.07.2022 H Y Y 2001.07.202200208.0000000.0000000.00 5001.07.2022ADJUSTMENT COUNSELLING - INITIAL CONSULTATION - Undertaken where possible to 5001.07.2022clarify the presence of possible adjustment to injury issues and set goals of 5001.07.2022therapy to optimise rehabilitation outcomes; performed where worker is 5001.07.2022displaying psychological, social, cognitive, emotional, and behavioural 5001.07.2022problems after a work-related incident or injury. The purpose of the 5001.07.2022consultation is to identify appropriate interventions/treatments to optimise 5001.07.2022rehabilitation outcomes. Services to be conducted in accordance with the 5001.07.2022Clinical Framework for the Delivery of Health Services. Initial consultation 5001.07.2022may include: history taking assessment diagnostic formulation 5001.07.2022treatment/service tailored goal setting and treatment planning setting 5001.07.2022expectations of recovery and return to work clinical recording communication 5001.07.2022with the insurer of any relevant information for the workers rehabilitation 5001.07.2022Maximum one (1) hour. 100030019001.07.2022 O Y Y 2001.07.202200120.0000000.0000000.00 5001.07.2022DIETARY ASSESSMENT - Consultation to evaluate dietary issues and objective 5001.07.2022tests to formulate an intervention plan focused on a return to work goal. 5001.07.2022Prior approval required before providing service. Services must be provided by 5001.07.2022a person with a tertiary degree in dietetics. 100030019801.07.2022 H Y Y 2001.07.202200053.0000000.0000000.00 5001.07.2022PERSONAL CARE ASSISTANCE - Prior approval is required before providing this 5001.07.2022service Provided through an agency - includes services for injury/wound care, 5001.07.2022personal hygiene and grooming etc. where the worker is living at home and has 5001.07.2022been assessed as incapable (for physical, cognitive or emotional reasons) of 5001.07.2022undertaking these tasks and has no family or other social support network. Day 5001.07.2022rate: $53 per hour. Weekend rate: $75 per hour. 100030020001.07.2022 H Y Y 2001.07.202200047.0000000.0000000.00 5001.07.2022DIVERSIONAL THERAPY PROGRAM - Prior approval is required before providing this 5001.07.2022service Services to be provided by a diversional therapist at a nursing home 5001.07.2022including therapeutic activities. Services must be provided by a person with a 5001.07.2022minimum of an Associate Diploma in Diversional Therapy. The service should 5001.07.2022only be used under the supervision of an occupational therapist, who has 5001.07.2022recommended therapeutic activities as part of the overall treatment program. 100030020101.07.2022 H Y Y 2001.07.202200044.0000000.0000000.00 5001.07.2022DOMESTIC ASSISTANCE - Prior approval is required before providing this service 5001.07.2022Provided through an agency - includes cleaning, shopping and washing etc. 5001.07.2022where the worker is living at home and has been assessed by an occupational 5001.07.2022therapist as incapable of undertaking these tasks (for physical, cognitive or 5001.07.2022emotional reasons) of undertaking these tasks, and has no family or other 5001.07.2022social support network. Note: weekend and public holiday rates may be 5001.07.2022negotiated with the insurer. 100030020201.07.2022 O Y Y 5001.07.2022LITERACY SKILLS - Prior approval is required before providing this service 5001.07.2022Private tutoring by a qualified tutor to improve literacy skills for job 5001.07.2022placement prospects. Program should be limited to achieving a base level of 5001.07.2022competency up to four (4) to six (6) weeks. Typically, literacy services are 5001.07.2022provided through the local TAFE or appropriately qualified private literacy 5001.07.2022services. 100030021001.07.2022 O Y Y 2001.07.202200033.0000000.0000000.00 5001.07.2022RTW COMMUNICATION - 3 TO 10 MINS - Communication by a RTW Services provider 5001.07.2022who has received a referral from an insurer for the following services: 5001.07.2022worksite assessment/evaluation development of suitable duties program or 5001.07.2022updated program monitoring of suitable duties programs communication with 5001.07.2022relevant stakeholders about a worker's progress or issues related to an 5001.07.2022existing suitable duties program functional capacity evaluation vocational 5001.07.2022assessment job seeking, job preparation or job placement services. Direct 5001.07.2022communication between a RTW Services provider and the following: insurer 5001.07.2022employer worker insurer referred providers; and treating providers to assist 5001.07.2022with faster, more effective rehabilitation and return to work for a worker. 5001.07.2022Refer to the exclusions listed below these tables before using this item 5001.07.2022number. For WorkCover Queensland claims, only an approved RTW Services 5001.07.2022provider can provide this service.** 100030021101.07.2022 O Y Y 2001.07.202200066.0000000.0000000.00 5001.07.2022RTW COMMUNICATION - 11 TO 20 MINS - Communication by a RTW Services provider 5001.07.2022who has received a referral from an insurer for the following services: 5001.07.2022worksite assessment/evaluation development of suitable duties program or 5001.07.2022updated program monitoring of suitable duties programs communication with 5001.07.2022relevant stakeholders about a worker's progress or issues related to an 5001.07.2022existing suitable duties program functional capacity evaluation vocational 5001.07.2022assessment job seeking, job preparation or job placement services. Direct 5001.07.2022communication between a RTW Services provider and the following: insurer 5001.07.2022employer worker insurer referred providers; and treating providers to assist 5001.07.2022with faster, more effective rehabilitation and return to work for a worker. 5001.07.2022Must be more than ten (10) minutes. Refer to the exclusions listed below these 5001.07.2022tables before using this item number. For WorkCover Queensland claims, only an 5001.07.2022approved RTW Services provider can provide this service.** 100030021201.07.2022 H Y Y 2001.07.202200197.0000000.0000000.00 5001.07.2022JOB PLACEMENT SERVICES - NEW EMPLOYER* - The process of actively sourcing and 5001.07.2022placing a worker in a host placement or for WorkCover also includes placing a 5001.07.2022worker in a Recover at Work program with a view to a durable return to work 5001.07.2022outcome. Also includes seeking new employment with/for the worker. Includes 5001.07.2022employer and worker liaison, job application and coaching. For WorkCover 5001.07.2022Queensland claims, only an approved RTW Services provider can provide this 5001.07.2022service.** 100030021301.07.2022 H Y Y 2001.07.202200197.0000000.0000000.00 5001.07.2022JOB PLACEMENT SERVICES - WORK HARDENING PROGRAM* - The process of actively 5001.07.2022sourcing and placing a worker in a host placement or for WorkCover also 5001.07.2022includes placing a worker in a Recover at Work program where the worker has a 5001.07.2022job to return to. Includes employer and worker liaison, job application and 5001.07.2022coaching. For WorkCover Queensland claims, only an approved RTW Services 5001.07.2022provider can provide this service.** 100030022801.07.2022 O Y Y 5001.07.2022GYM AND POOL ENTRY FEES - Prior approval is required before providing this 5001.07.2022service. The insurer may request justification and will consider seeking a 5001.07.2022second opinion if more than three (3) months facility membership is requested 5001.07.2022per episode of care. Entry fee for the worker to attend a gym or pool for 5001.07.2022assessment and treatment (up to a maximum three-month membership). Entry fees 5001.07.2022will be paid for the worker, only where the facility is not owned or operated 5001.07.2022by the provider, their employer, or where either party contracts their 5001.07.2022services to the facility. Entry fees will not be paid for providers. The 5001.07.2022provider is then expected to submit Provider Management Plan (PMP) for 5001.07.2022approval before any treatment commences. 100030028501.07.2022 H Y Y 2001.07.202200208.0000000.0000000.00 5001.07.2022ADJUSTMENT COUNSELLING - SUBSEQUENT CONSULTATION - Prior approval required 5001.07.2022before providing this service. Ongoing treatment of work-related components of 5001.07.2022presenting adjustment to injury issues; intervention would be based on 5001.07.2022treatment formulated from the initial consultation (300188). The provider is 5001.07.2022expected to submit a Provider Management Plan (PMP) after the Adjustment 5001.07.2022Counselling - Initial Consultation is completed. The PMP should include a 5001.07.2022comprehensive treatment plan containing: expected functional gains, transition 5001.07.2022of care to self-management; and treatment timeframes. Maximum treatment time 5001.07.2022of one (1) hour per day Services to be conducted in accordance with the 5001.07.2022Clinical Framework for the Delivery of Health Services. Subsequent 5001.07.2022consultation may include: ongoing assessment (subjective and objective) 5001.07.2022intervention/treatment setting expectations of recovery and return to work 5001.07.2022clinical recording communication with the insurer of any relevant information 5001.07.2022for the workers rehabilitation. 100030029501.07.2022 H Y Y 2001.07.202200197.0000000.0000000.00 5001.07.2022EXTERNAL CASE MANAGEMENT - Includes an initial needs assessment and report; 5001.07.2022should outline a case management plan indicating the goals of the program, 5001.07.2022services required, timeframes and costs. Insurer request only. 100030030901.07.2022 O Y Y 5001.07.2022AMBULANCE TRANSPORT - NON QAS - INITIAL TRANSPORTATION - Transport provided 5001.07.2022immediately after the work-related injury or condition is sustained. 100030031001.07.2022 O Y Y 5001.07.2022AMBULANCE TRANSPORT - NON QAS - SUBSEQUENT TRANSPORTATION - Subsequent 5001.07.2022transport must be certified in writing by a doctor as necessary because of the 5001.07.2022worker's physical condition resulting from a work-related injury or condition. 100030040101.07.2022 O Y Y 2001.07.202200050.0000000.0000000.00 5001.07.2022GROUP EXERCISE SESSIONS - Prior approval is required before providing this 5001.07.2022service. A group session where a common exercise programs is delivered to more 5001.07.2022than one individual at the same time. The group can consist of a maximum of 5001.07.2022eight (8) persons. The group session must be attended, conducted, and 5001.07.2022supervised by an exercise physiologist. 100040008801.07.2022 H Y Y 2001.07.202200208.0000000.0000000.00 5001.07.2022INITIAL CONSULTATION - The initial consultation in the treatment of possible 5001.07.2022psychological, social, cognitive, emotional, and behavioural problems 5001.07.2022occurring after a work-related injury or condition. The purpose of the 5001.07.2022assessment is to identify appropriate interventions/treatments to optimise 5001.07.2022rehabilitation outcomes (maximum two (2) hours direct contact and test scoring 5001.07.2022time). Services to be conducted in accordance with the Clinical Framework for 5001.07.2022the Delivery of Health Services. Initial consultation may include: history 5001.07.2022taking assessment diagnostic formulation treatment/service tailored goal 5001.07.2022setting and treatment planning setting expectations of recovery and return to 5001.07.2022work clinical recording communication with the insurer of any relevant 5001.07.2022information for the workers rehabilitation. The entire consultation must be 5001.07.2022one-on-one with the worker. 100040009101.07.2022 H Y Y 2001.07.202200208.0000000.0000000.00 5001.07.2022NEUROPSYCHOLOGICAL ASSESSMENT - An assessment to clarify the presence of 5001.07.2022possible acquired brain injury or brain dysfunction where possible 5001.07.2022psychological, social, cognitive, emotional, and behavioural problems are 5001.07.2022occurring after a work-related injury or condition (four to five (4-5) hours 5001.07.2022direct contact and test scoring time). 100040009501.07.2022 H Y Y 2001.07.202200208.0000000.0000000.00 5001.07.2022SUBSEQUENT CONSULTATION - A one on one subsequent consultation with the worker 5001.07.2022in the ongoing management and treatment of their work-related psychological 5001.07.2022issues. Intervention is based on treatment formulated in the initial 5001.07.2022consultation. The first 6 hours (including initial) are pre-approved provided 5001.07.2022this condition has not previously been treated by an allied health provider. 5001.07.2022If additional treatment is required, submit a Provider Management Plan (PMP) 5001.07.2022within 6 hours of consultations, including a comprehensive treatment plan 5001.07.2022containing: expected functional gains, transition to self-care management; and 5001.07.2022treatment timeframes. Services to be conducted in accordance with the Clinical 5001.07.2022Framework for the Delivery of Health Services. Subsequent consultation may 5001.07.2022include: ongoing assessment intervention/treatment setting expectations of 5001.07.2022recovery and return to work clinical recording communication with the insurer 5001.07.2022of any relevant information for the workers rehabilitation. Max 2 hours on any 5001.07.2022one day. 100040010101.07.2022 H Y Y 2001.07.202200154.0000000.0000000.00 5001.07.2022INITIAL ASSESSMENT - A one-on-one initial consultation where possible 5001.07.2022psychological, social, cognitive, emotional, and behavioural problems are 5001.07.2022occurring after a work-related injury or condition. The purpose of the 5001.07.2022assessment is to identify appropriate interventions/treatments to optimise 5001.07.2022rehabilitation outcomes (maximum two (2) hours direct contact and test scoring 5001.07.2022time). Services to be conducted in accordance with the Clinical Framework for 5001.07.2022the Delivery of Health Services. Initial consultation may include: history 5001.07.2022taking assessment diagnostic formulation treatment/service tailored goal 5001.07.2022setting and treatment planning setting expectations of recovery and return to 5001.07.2022work clinical recording communication with the insurer of any relevant 5001.07.2022information for the workers rehabilitation. 100040010201.07.2022 H Y Y 2001.07.202200154.0000000.0000000.00 5001.07.2022SUBSEQUENT CONSULTATION - A one-on-one subsequent consultation with the worker 5001.07.2022in their ongoing management and treatment. Intervention is based on treatment 5001.07.2022formulated in the initial consultation. The first six (6) hours (including 5001.07.2022initial consultation) are pre-approved, provided this issue has not previously 5001.07.2022been treated by an allied health provider, with a maximum of two (2) hours on 5001.07.2022any one day. If additional treatment is required, submit a Provider Management 5001.07.2022Plan (PMP) within six (6) hours of consultations which includes a 5001.07.2022comprehensive treatment plan containing: expected functional gains, transition 5001.07.2022to self-care management; and treatment timeframes. Services to be conducted in 5001.07.2022accordance with the Clinical Framework for the Delivery of Health Services. 5001.07.2022Subsequent consultation may include: ongoing assessment intervention/treatment 5001.07.2022setting expectations of recovery and return to work clinical recording 5001.07.2022communication with the insurer of any relevant information for the workers 5001.07.2022rehabilitation. 100040018401.07.2022 H Y Y 2001.07.202200208.0000000.0000000.00 5001.07.2022CRITICAL INCIDENT DEBRIEFING SESSIONS - A process where, following exposure to 5001.07.2022a critical incident, an individual or group of workers are debriefed by a 5001.07.2022psychologist to assist them to deal more effectively with their experience. 5001.07.2022Approval required after the first two (2) pre-approved sessions. 100040022601.07.2022 H Y Y 2001.07.202200246.0000000.0000000.00 5001.07.2022INDEPENDENT CASE REVIEW - An independent psychologist examination and report 5001.07.2022of a worker (not by the treating psychologist). Only provided following a 5001.07.2022request from the insurer. The review is requested by the insurer where 5001.07.2022progress of treatment and/or rehabilitation falls outside the plan or expected 5001.07.2022course of injury management. The examination and report provide the insurer 5001.07.2022with an assessment and recommendations for ongoing treatment and prognosis. 100050000601.07.2022 O Y Y 2001.07.202200088.0000000.0000000.00 5001.07.2022SUBSEQUENT CONSULTATION - A one-on-one subsequent consultation in the 5001.07.2022treatment of work-related injuries or conditions. The first six (6) 5001.07.2022consultations (including initial consultation) are pre-approved, provided the 5001.07.2022injuries or conditions have not previously been treated by an allied health 5001.07.2022provider. If additional treatment is required, submit a Provider Management 5001.07.2022Plan (PMP) by the 6th subsequent treatment consultation. The PMP should 5001.07.2022include a comprehensive treatment plan containing: expected functional gains, 5001.07.2022transition of care to self-management; and treatment timeframes. Services to 5001.07.2022be conducted in accordance with the Clinical Framework for the Delivery of 5001.07.2022Health Services. Subsequent consultation may include: ongoing assessment 5001.07.2022(subjective and objective) intervention/treatment setting expectations of 5001.07.2022recovery and return to work clinical recording communication with the insurer 5001.07.2022of any relevant information for the workers rehabilitation. 100050002101.07.2022 O Y Y 2001.07.202200117.0000000.0000000.00 5001.07.2022INITIAL CONSULTATION - A one-on-one initial consultation in the treatment of 5001.07.2022work-related injuries or conditions, or the first consultation in a new 5001.07.2022episode of care for the same work-related injuries or conditions. Services to 5001.07.2022be conducted in accordance with the Clinical Framework for the Delivery of 5001.07.2022Health Services. Initial consultation may include: subjective assessment 5001.07.2022objective assessment treatment/service tailored goal setting and treatment 5001.07.2022planning setting expectations of recovery and return to work clinical 5001.07.2022recording communication with the insurer of any relevant information for the 5001.07.2022workers rehabilitation. 100050005501.07.2022 O Y Y 2001.07.202200117.0000000.0000000.00 5001.07.2022REASSESSMENT OR PROGRAM REVIEW - A comprehensive assessment used when: the 5001.07.2022worker has been in active rehabilitation for at least six weeks and further 5001.07.2022treatment is likely; and/or there are new clinical findings that might affect 5001.07.2022ongoing treatment; and/or there is a rapid change in worker's status and/or 5001.07.2022there is no response to current therapeutic interventions. It should include: 5001.07.2022all components of initial consultation a review of the workers progress based 5001.07.2022on established objective measures a recommendation for future treatment and 5001.07.2022management strategies to assist the worker to return to work. It may include 5001.07.2022referral recommendations to other providers, a change in therapy or outcome 5001.07.2022direction requiring a new return to work goal. Following reassessment submit a 5001.07.2022Provider Management Plan3 (PMP) with an updated comprehensive treatment plan 5001.07.2022containing: expected functional gains, transition of care to self-management; 5001.07.2022and treatment timeframes. 100050022601.07.2022 H Y Y 2001.07.202200246.0000000.0000000.00 5001.07.2022INDEPENDENT CASE REVIEW - An independent chiropractic examination and report 5001.07.2022on a worker and is not carried out by the treating chiropractor. The review is 5001.07.2022requested by the insurer where progress of treatment and/or rehabilitation 5001.07.2022falls outside the plan or expected course of injury management. The 5001.07.2022examination and report provide the insurer with an assessment and 5001.07.2022recommendations for ongoing treatment and prognosis. 100055810001.07.2022 O Y Y 2001.07.202200195.0000000.0000000.00 5001.07.2022X-RAY - CERVICAL SPINE - X-Ray - Cervical Spine. Must be clinically 5001.07.2022justifiable. 100055810301.07.2022 O Y Y 2001.07.202200162.0000000.0000000.00 5001.07.2022X-RAY - THORACIC SPINE - X-Ray - Thoracic Spine. Must be clinically 5001.07.2022justifiable. 100055810601.07.2022 O Y Y 2001.07.202200227.0000000.0000000.00 5001.07.2022X-RAY - LUMBOSACRAL SPINE - X-Ray - Lumbosacral Spine. Must be clinically 5001.07.2022justifiable. 100055811201.07.2022 O Y Y 2001.07.202200285.0000000.0000000.00 5001.07.2022X-RAY - ANY TWO REGIONS OF THE SPINE - X-Ray - Any two regions of the spine. 5001.07.2022Must be clinically justifiable. 100055811501.07.2022 O Y Y 2001.07.202200392.0000000.0000000.00 5001.07.2022X-RAY - ANY THREE REGIONS OF THE SPINE - X-Ray - Any three regions of the 5001.07.2022spine. Must be clinically justifiable. 100060001501.07.2022 O Y Y 2001.07.202200117.0000000.0000000.00 5001.07.2022INITIAL CONSULTATION - A one-on-one initial consultation in the treatment of 5001.07.2022work-related injuries or conditions, or the first consultation in a new 5001.07.2022episode of care for the same work-related injuries or conditions. Services to 5001.07.2022be conducted in accordance with the Clinical Framework for the Delivery of 5001.07.2022Health Services. Initial consultation may include: subjective assessment 5001.07.2022objective assessment treatment/service tailored goal setting and treatment 5001.07.2022planning setting expectations of recovery and return to work clinical 5001.07.2022recording communication (with referrer) any relevant information for the 5001.07.2022workers rehabilitation to the insurer. 100060001601.07.2022 O Y Y 2001.07.202200088.0000000.0000000.00 5001.07.2022SUBSEQUENT CONSULTATION - A one-on-one subsequent consultation in the 5001.07.2022treatment of work-related injuries or conditions. The first six (6) 5001.07.2022consultations (including initial consultation) are pre-approved, provided the 5001.07.2022injury has not previously been treated by an allied health provider. If 5001.07.2022additional treatment is required, the provider is expected to submit a 5001.07.2022Provider Management Plan (PMP) by the 6th subsequent treatment consultation. 5001.07.2022The PMP should include a comprehensive treatment plan containing: expected 5001.07.2022functional gains, transition of care to self-management; and treatment 5001.07.2022timeframes. Services to be conducted in accordance with the Clinical Framework 5001.07.2022for the Delivery of Health Services. Subsequent consultation may include: 5001.07.2022ongoing assessment (subjective and objective) intervention/treatment setting 5001.07.2022expectations of recovery and return to work clinical recording communication 5001.07.2022with the insurer of any relevant information for the workers rehabilitation. 100060005501.07.2022 O Y Y 2001.07.202200117.0000000.0000000.00 5001.07.2022REASSESSMENT OR PROGRAM REVIEW - This reassessment or program review is 5001.07.2022indicated when: the worker has been in active rehabilitation for at least six 5001.07.2022weeks and further treatment is likely; and/or there are new clinical findings 5001.07.2022that might affect ongoing treatment; and/or there is a rapid change in 5001.07.2022worker's status and/or there is no response to current therapeutic 5001.07.2022interventions. A reassessment or program review is a comprehensive assessment 5001.07.2022including: all components of initial consultation a review of the workers 5001.07.2022progress based on established objective measures a recommendation for future 5001.07.2022treatment and management strategies to assist the worker to return to work. A 5001.07.2022reassessment or program review may include referral recommendations to other 5001.07.2022providers, a change in therapy direction or a change on outcome direction 5001.07.2022requiring a new return to work goal. The occupational therapist is expected to 5001.07.2022submit a Provider Management Plan (PMP) following the reassessment. 100060017001.07.2022 H Y Y 2001.07.202200197.0000000.0000000.00 5001.07.2022SPECIFIC OCCUPATIONAL THERAPY ASSESSMENT - Prior approval is required before 5001.07.2022providing this service and justification may be requested by the insurer. This 5001.07.2022service is to be used for assessing specific conditions that cannot be 5001.07.2022adequately assessed, due to the complexity of the condition, within an initial 5001.07.2022consultation 600015 and 600020 for multiple injuries or conditions. The entire 5001.07.2022consultation must be one-on-one with the worker. These may include, but are 5001.07.2022not limited to: extensive burns acquired brain injuries severe spinal cord 5001.07.2022injuries multiple orthopaedic fractures limb amputations crush injuries. This 5001.07.2022service can also be used for the assessment (only) of suitability for entry 5001.07.2022into a Multi-Disciplinary Program or Pain Management Program. The service may 5001.07.2022only be used once by the occupational therapist in the treatment of a 5001.07.2022work-related injury or condition, or the first consultation in a new episode 5001.07.2022of care for the same work-related injury or condition. Maximum one (1) hour. 100060022601.07.2022 H Y Y 2001.07.202200246.0000000.0000000.00 5001.07.2022INDEPENDENT CASE REVIEW - An independent occupational therapist examination 5001.07.2022and report on a worker and is not carried out by the treating occupational 5001.07.2022therapist. The review is requested by the insurer where progress of treatment 5001.07.2022and/or rehabilitation falls outside the plan or expected course of injury 5001.07.2022management. The examination and report provide the insurer with an assessment 5001.07.2022and recommendations for ongoing treatment and prognosis. 100060028701.07.2022 H Y Y 2001.07.202200197.0000000.0000000.00 5001.07.2022SPECIALISED HAND/UPPER LIMB THERAPY CONSULTATION - Prior approval is required 5001.07.2022before providing this service, unless referred by a medical specialist, then 5001.07.2022the first six (6) consultations are pre-approved. A one-on-one consultation 5001.07.2022and treatment for workers with hand and upper limb work-related injuries or 5001.07.2022conditions (below shoulder level). Treatment offered is considered specialist 5001.07.2022hand therapy provided by a qualified occupational therapist. Further details 5001.07.2022are provided below the tables. Consultations may include: ongoing assessment 5001.07.2022(subjective and objective) intervention/treatment setting expectations of 5001.07.2022recovery and return to work clinical recording communication with the insurer 5001.07.2022of any relevant information for the workers rehabilitation. The occupational 5001.07.2022therapist is expected to submit a Provider Management Plan (PMP) following the 5001.07.2022initial assessment. Maximum one (1) hour. 100060029201.07.2022 H Y Y 2001.07.202200197.0000000.0000000.00 5001.07.2022SPECIFIC OCCUPATIONAL THERAPY INTERVENTION - Prior approval is required before 5001.07.2022providing this service. The insurer may request justification and will 5001.07.2022consider seeking an independent opinion if more than six (6) consultations are 5001.07.2022requested per episode of care. A one-on-one consultation for recommended 5001.07.2022interventions identified during a Specific Occupational Therapist Assessment 5001.07.2022(600170). These may include, but are not limited to: extensive burns acquired 5001.07.2022brain injuries severe spinal cord injuries multiple orthopaedic fractures limb 5001.07.2022amputations crush injuries. Please note: This service is not to be used for 5001.07.2022ongoing consultations within a Multi-Disciplinary Program and/or Pain 5001.07.2022Management Program. This service must not be already classified elsewhere in 5001.07.2022this table of costs. A Provider Management Plan (PMP) is to be submitted 5001.07.2022following the initial assessment (600170). Maximum one (1) hour. 100070005101.07.2022 H Y Y 2001.07.202200197.0000000.0000000.00 5001.07.2022INITIAL CONSULTATION - A one-on-one initial consultation in the treatment of 5001.07.2022work-related injuries or conditions, or the first consultation in a new 5001.07.2022episode of care for the same work-related injuries or conditions. Services to 5001.07.2022be conducted in accordance with the Clinical Framework for the Delivery of 5001.07.2022Health Services. Initial consultation may include: subjective assessment 5001.07.2022objective assessment treatment/service tailored goal setting and treatment 5001.07.2022planning setting expectations of recovery and return to work clinical 5001.07.2022recording communication with the insurer of any relevant information for the 5001.07.2022workers rehabilitation. 100070005301.07.2022 H Y Y 2001.07.202200197.0000000.0000000.00 5001.07.2022SUBSEQUENT CONSULTATION - A one-on-one subsequent consultation in the 5001.07.2022treatment of work-related injuries or conditions. If additional treatment is 5001.07.2022required, the provider must submit a Provider Management Plan (PMP) after the 5001.07.2022initial consultation and before commencing any treatment consultations. The 5001.07.2022PMP should include a comprehensive treatment plan containing: expected 5001.07.2022functional gains, transition of care to self-management; and treatment 5001.07.2022timeframes. Services to be conducted in accordance with the Clinical Framework 5001.07.2022for the Delivery of Health Services. Subsequent consultation may include: 5001.07.2022ongoing assessment (subjective and objective) intervention/treatment setting 5001.07.2022expectations of recovery and return to work clinical recording communication 5001.07.2022with the insurer of any relevant information for the workers rehabilitation. 5001.07.2022Maximum one (1) hour. 100070022601.07.2022 H Y Y 2001.07.202200246.0000000.0000000.00 5001.07.2022INDEPENDENT CASE REVIEW - An independent speech pathologist examination and 5001.07.2022report on a worker and is not carried out by the treating speech pathologist. 5001.07.2022The review is requested by the insurer where progress of treatment and/or 5001.07.2022rehabilitation falls outside the plan or expected course of injury management. 5001.07.2022The examination and report provide the insurer with an assessment and 5001.07.2022recommendations for ongoing treatment and prognosis. 100080002801.07.2022 O Y Y 2001.07.202200117.0000000.0000000.00 5001.07.2022INITIAL CONSULTATION - A one-one-one initial consultation in the treatment of 5001.07.2022work-related injuries or conditions, or the first consultation in a new 5001.07.2022episode of care for the same work-related injuries or conditions. Services to 5001.07.2022be conducted in accordance with the Clinical Framework for the Delivery of 5001.07.2022Health Services. Initial consultation may include: subjective assessment 5001.07.2022objective assessment treatment/service tailored goal setting and treatment 5001.07.2022planning setting expectations of recovery and return to work clinical 5001.07.2022recording communication (with referrer) any relevant information for the 5001.07.2022workers rehabilitation to the insurer. 100080002901.07.2022 O Y Y 2001.07.202200088.0000000.0000000.00 5001.07.2022SUBSEQUENT CONSULTATION - A one-on-one subsequent consultation in the 5001.07.2022treatment of work-related injuries or conditions. The first six (6) 5001.07.2022consultations (including initial consultation) are pre-approved, provided the 5001.07.2022injuries have not previously been treated by an allied health provider. If 5001.07.2022additional treatment is required, submit a Provider Management Plan (PMP) by 5001.07.2022the 6th subsequent treatment consultation. The PMP should include a 5001.07.2022comprehensive treatment plan containing: expected functional gains, transition 5001.07.2022of care to self-management; and treatment timeframes. Services to be conducted 5001.07.2022in accordance with the Clinical Framework for the Delivery of Health Services. 5001.07.2022Subsequent consultation may include: ongoing assessment (subjective and 5001.07.2022objective) intervention/treatment setting expectations of recovery and return 5001.07.2022to work clinical recording communication with the insurer of any relevant 5001.07.2022information for the workers rehabilitation. 100080003701.07.2022 O Y Y 2001.07.202200228.0000000.0000000.00 5001.07.2022ORTHOSES - Thermoplastic shell - Intrinsic fore/rearfoot post - single. Prior 5001.07.2022insurer approval is required. 100080003801.07.2022 O Y Y 2001.07.202200444.0000000.0000000.00 5001.07.2022ORTHOSES - Thermoplastic shell - Intrinsic fore/rearfoot post - pair. Prior 5001.07.2022approval from the insurer is required. 100080003901.07.2022 O Y Y 2001.07.202200038.0000000.0000000.00 5001.07.2022INSOLES - Plain - single. Prior insurer approval is required. 100080004001.07.2022 O Y Y 2001.07.202200069.0000000.0000000.00 5001.07.2022INSOLES - Plain - pair. Prior insurer approval is required. 100080004101.07.2022 O Y Y 2001.07.202200079.0000000.0000000.00 5001.07.2022INSOLES - Padded insole - single. Prior insurer approval is required. 100080004201.07.2022 O Y Y 2001.07.202200152.0000000.0000000.00 5001.07.2022INSOLES - Padded insole - pair. Prior insurer approval is required. 100080004301.07.2022 O Y Y 2001.07.202200195.0000000.0000000.00 5001.07.2022INSOLES - Balance inlay - single custom. Prior insurer approval is required. 100080004401.07.2022 O Y Y 2001.07.202200369.0000000.0000000.00 5001.07.2022INSOLES - Balance inlay - pair custom. Prior insurer approval is required. 100080004501.07.2022 O Y Y 2001.07.202200133.0000000.0000000.00 5001.07.2022INSOLES - Balance inlay - Thermo non-cast single. Prior insurer approval is 5001.07.2022required. 100080004601.07.2022 O Y Y 2001.07.202200214.0000000.0000000.00 5001.07.2022INSOLES - Balance inlay - Thermo non-cast pair. Prior insurer approval is 5001.07.2022required. 100080004701.07.2022 O Y Y 2001.07.202200032.0000000.0000000.00 5001.07.2022ORTHOSES - Heel lift - single. Prior insurer approval is required. 100080004801.07.2022 O Y Y 2001.07.202200030.0000000.0000000.00 5001.07.2022ORTHOSES - Extrinsic fore/rear foot post - single. Prior approval from the 5001.07.2022insurer is required. 100080004901.07.2022 O Y Y 2001.07.202200091.0000000.0000000.00 5001.07.2022CAST - Negative impression- single. Prior insurer approval is required. 100080005001.07.2022 O Y Y 2001.07.202200125.0000000.0000000.00 5001.07.2022CAST - Negative impression - pair. Prior insurer approval is required. 100080008401.07.2022 O Y Y 2001.07.202200073.0000000.0000000.00 5001.07.2022INSOLES - Soft tissue supplement - pair. Prior insurer approval is required. 100080022601.07.2022 H Y Y 2001.07.202200246.0000000.0000000.00 5001.07.2022INDEPENDENT CASE REVIEW - This is an independent podiatrist examination and 5001.07.2022report on a worker and is not carried out by the treating podiatrist. The 5001.07.2022review is requested by the insurer where progress of treatment and/or 5001.07.2022rehabilitation falls outside the plan or expected course of injury management. 5001.07.2022The examination and report provide the insurer with an assessment and 5001.07.2022recommendations for ongoing treatment and prognosis. 100080023201.07.2022 O Y Y 2001.07.202200057.0000000.0000000.00 5001.07.2022ORTHOSES - Extrinsic fore/rear foot post - pair. Prior insurer approval is 5001.07.2022required. 100080028301.07.2022 O Y Y 2001.07.202200039.0000000.0000000.00 5001.07.2022INSOLES - Covers - plain. Prior insurer approval is required. 100080028401.07.2022 H Y Y 2001.07.202200197.0000000.0000000.00 5001.07.2022NAIL REMOVAL - Nail removal under local anaesthetic. Prior insurer approval is 5001.07.2022required. 100090000601.07.2022 O Y Y 2001.07.202200088.0000000.0000000.00 5001.07.2022SUBSEQUENT CONSULTATION - A one-on-one subsequent consultation in the 5001.07.2022treatment of work-related injuries or conditions. The first six (6) 5001.07.2022consultations (including initial consultation) are pre-approved, provided the 5001.07.2022injuries or conditions have not previously been treated by an allied health 5001.07.2022provider. If additional treatment is required, submit a Provider Management 5001.07.2022Plan (PMP) by the 6th subsequent treatment consultation. The PMP should 5001.07.2022include a comprehensive treatment plan containing: expected functional gains, 5001.07.2022transition of care to self-management; and treatment timeframes. Services to 5001.07.2022be conducted in accordance with the Clinical Framework for the Delivery of 5001.07.2022Health Services. Subsequent consultation may include: ongoing assessment 5001.07.2022(subjective and objective) intervention/treatment setting expectations of 5001.07.2022recovery and return to work clinical recording communication with the insurer 5001.07.2022of any relevant information for the workers rehabilitation. 100090002101.07.2022 O Y Y 2001.07.202200117.0000000.0000000.00 5001.07.2022INITIAL CONSULTATION - A one-on-one initial consultation in the treatment of 5001.07.2022work-related injuries or conditions, or the first consultation in a new 5001.07.2022episode of care for the same work-related injuries or conditions. Services to 5001.07.2022be conducted in accordance with the Clinical Framework for the Delivery of 5001.07.2022Health Services. Initial consultation may include: subjective assessment 5001.07.2022objective assessment treatment/service tailored goal setting and treatment 5001.07.2022planning setting expectations of recovery and return to work clinical 5001.07.2022recording communication (with referrer) any relevant information for the 5001.07.2022workers rehabilitation to the insurer. 100090005501.07.2022 O Y Y 2001.07.202200117.0000000.0000000.00 5001.07.2022REASSESSMENT OR PROGRAM REVIEW - A one-one-one comprehensive assessment used 5001.07.2022when: the worker has been in active rehabilitation for at least six weeks and 5001.07.2022further treatment is likely; and/or there are new clinical findings that might 5001.07.2022affect ongoing treatment; and/or there is a rapid change in worker's status 5001.07.2022and/or there is no response to current therapeutic interventions. It should 5001.07.2022include: all components of initial consultation a review of the workers 5001.07.2022progress based on established objective measures a recommendation for future 5001.07.2022treatment and management strategies to assist the worker to return to work. It 5001.07.2022may include referral recommendations to other providers, a change in therapy 5001.07.2022or outcome direction requiring a new return to work goal. Following 5001.07.2022reassessment submit a Provider Management Plan3 (PMP) which should include an 5001.07.2022updated comprehensive treatment plan containing: expected functional gains, 5001.07.2022transition of care to self-management; and treatment timeframes. 100090022601.07.2022 H Y Y 2001.07.202200246.0000000.0000000.00 5001.07.2022INDEPENDENT CASE REVIEW - An independent osteopathy examination and report on 5001.07.2022a worker and is not carried out by the treating osteopath. The review is 5001.07.2022requested by the insurer where progress of treatment and/or rehabilitation 5001.07.2022falls outside the plan or expected course of injury management. The 5001.07.2022examination and report provide the insurer with an assessment and 5001.07.2022recommendations for ongoing treatment and prognosis.