100010000601.07.2021 O Y Y 2001.07.202100080.0000000.0000000.00 5001.07.2021SUBSEQUENT CONSULTATION - A one-on-one subsequent consultation in the 5001.07.2021treatment of one work-related injury or condition only. The first five (5) 5001.07.2021consultations (including initial consultation) are pre-approved, provided the 5001.07.2021injury or condition has not previously been treated by an allied health 5001.07.2021provider. If additional treatment is required, submit a Provider Management 5001.07.2021Plan3 (PMP) by the 6th subsequent treatment consultation. The PMP should 5001.07.2021include a comprehensive treatment plan containing: expected functional gains, 5001.07.2021transition of care to self-management; and treatment timeframes. Services to 5001.07.2021be conducted in accordance with the Clinical Framework for the Delivery of 5001.07.2021Health Services2. Subsequent consultation may include: ongoing assessment 5001.07.2021(subjective and objective) intervention/treatment setting expectations of 5001.07.2021recovery and return to work clinical recording communication with the insurer 5001.07.2021of any relevant information for the workers rehabilitation. 100010002101.07.2021 O Y Y 2001.07.202100090.0000000.0000000.00 5001.07.2021INITIAL CONSULTATION - A one-on-one initial consultation for the treatment of 5001.07.2021a work-related injury or condition, or the first consultation in a new episode 5001.07.2021of care for the same work-related injury or condition. Services to be 5001.07.2021conducted in accordance with the Clinical Framework for the Delivery of Health 5001.07.2021Services2. Initial consultation may include: subjective assessment objective 5001.07.2021assessment treatment/service tailored goal setting and treatment planning 5001.07.2021setting expectations of recovery and return to work clinical recording 5001.07.2021communication with the insurer of any relevant information for the workers 5001.07.2021rehabilitation. 100010010201.07.2021 O Y Y 2001.07.202100153.0000000.0000000.00 5001.07.2021SUBSEQUENT CONSULTATION - MULTIPLE INJURIES OR CONDITIONS - A one-on-one 5001.07.2021subsequent consultation with the worker in the treatment of two or more 5001.07.2021entirely separate work-related injuries or conditions. The first five (5) 5001.07.2021consultations (including initial consultation) are pre-approved, provided the 5001.07.2021injury or condition has not previously been treated by an allied health 5001.07.2021provider. If additional treatment is required, submit a Provider Management 5001.07.2021Plan3 (PMP) by the 6th subsequent treatment consultation. The PMP should 5001.07.2021include a comprehensive treatment plan containing: expected functional gains, 5001.07.2021transition of care to self-management; and treatment timeframes. Services to 5001.07.2021be conducted in accordance with the Clinical Framework for the Delivery of 5001.07.2021Health Services2. Subsequent consultation may include: ongoing assessment 5001.07.2021(subjective and objective) intervention/treatment setting expectations of 5001.07.2021recovery and return to work clinical recording communication with the insurer 5001.07.2021of any relevant information for the workers rehabilitation 100010010601.07.2021 O Y Y 2001.07.202100048.0000000.0000000.00 5001.07.2021GROUP EXERCISE SESSIONS - Prior approval required before providing this 5001.07.2021service. A session where a common program is delivered to more than one 5001.07.2021individual at the same time. The group can consist of a maximum of eight (8) 5001.07.2021persons. The group session must be attended, conducted, and supervised by a 5001.07.2021physiotherapist. 100010022601.07.2021 H Y Y 2001.07.202100236.0000000.0000000.00 5001.07.2021INDEPENDENT CASE REVIEW - An independent physiotherapy examination and report 5001.07.2021on a worker. It is not carried out by the treating physiotherapist. The review 5001.07.2021is requested by the insurer where progress of treatment and/or rehabilitation 5001.07.2021falls outside the plan or expected course of injury management. The 5001.07.2021examination and report provide the insurer with an assessment and 5001.07.2021recommendations for ongoing treatment and prognosis. 100010028701.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021SPECIALISED HAND/UPPER LIMB CONSULTATION - Prior approval is required before 5001.07.2021providing this service, unless referred by a medical specialist, then the 5001.07.2021first five (5) consultations are pre-approved. A one-on-one consultation and 5001.07.2021treatment for workers with hand and upper limb work-related injuries or 5001.07.2021conditions (below shoulder level). Treatment offered is considered specialist 5001.07.2021hand therapy provided by a qualified physiotherapist. Further details are 5001.07.2021provided below the tables. Consultations may include: ongoing assessment 5001.07.2021(subjective and objective) intervention/treatment setting expectations of 5001.07.2021recovery and return to work clinical recording communication with the insurer 5001.07.2021of any relevant information for the workers rehabilitation. A Provider 5001.07.2021Management Plan3 (PMP) is to be submitted following the initial assessment. 5001.07.2021The PMP should include an updated comprehensive treatment plan containing: 5001.07.2021expected functional gains, transition of care to self-management; and 5001.07.2021treatment timeframes. Maximum one (1) hour. 100010031301.07.2021 O Y Y 2001.07.202100134.0000000.0000000.00 5001.07.2021INITIAL CONSULTATION - MULTIPLE INJURIES OR CONDITIONS - A one-on-one initial 5001.07.2021consultation in the treatment of two or more entirely separate work-related 5001.07.2021injuries or conditions, or the first consultation in a new episode of care for 5001.07.2021the same two or more entirely separate work-related injuries or conditions. 5001.07.2021Please note: this does not include an injury or condition with referred pain 5001.07.2021to another area, and the work-related injuries or conditions to be treated 5001.07.2021must all be accepted by the insurer. Please check directly with the insurer 5001.07.2021for any clarification. Services to be conducted in accordance with the 5001.07.2021Clinical Framework for the Delivery of Health Services2. Initial consultation 5001.07.2021may include: subjective assessment objective assessment treatment/service 5001.07.2021tailored goal setting and treatment planning setting expectations of recovery 5001.07.2021and return to work clinical recording communication with the insurer of any 5001.07.2021relevant information for the workers rehabilitation. 100010031401.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021INITIAL CONSULTATION - WORK SPECIFIC FUNCTIONAL EXERCISE PROGRAM - Prior 5001.07.2021approval is required before providing this service. Development and 5001.07.2021instruction of a gym/pool-based exercise program focused on improving function 5001.07.2021of the work-related injury or condition, relevant to the work role. The aim of 5001.07.2021this program is for a successful transition of the workers program to a 5001.07.2021gym/pool-based setting in order to meet their work specific functional goals. 5001.07.2021This service may only be charged once. Refer to Item Number 300228 for Gym and 5001.07.2021Pool Entry Fees. Services to be conducted in accordance with the Clinical 5001.07.2021Framework for the Delivery of Health Services2. The entire consultation must 5001.07.2021be one-on-one with the worker. Maximum one (1) hour. 100010040201.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021SUBSEQUENT CONSULTATION - WORK SPECIFIC FUNCTIONAL EXERCISE PROGRAM - Prior 5001.07.2021approval is required before providing this service. The insurer may request 5001.07.2021justification and will consider seeking an independent opinion if more than 5001.07.2021six (6) consultations are requested per episode of care. A one-on-one 5001.07.2021consultation with the worker for ongoing monitoring, review and progression of 5001.07.2021a gym/pool-based exercise program as developed during initial consultation 5001.07.2021(100314). The focus must be on improving function of the work-related injury 5001.07.2021or condition relevant to the work role and include education and progression 5001.07.2021to self-management. Services to be conducted in accordance with the Clinical 5001.07.2021Framework for the Delivery of Health Services2. A Provider Management Plan 5001.07.2021(PMP) is to be submitted for approval following the initial consultation 5001.07.2021(100314) and before any treatment commences. The PMP should include a 5001.07.2021comprehensive treatment plan containing: expected functional gains, transition 5001.07.2021of care to self-management; and treatment timeframes. Maximum one (1) hour. 100010040601.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021SPECIFIC PHYSIOTHERAPY ASSESSMENT - Prior approval is required before 5001.07.2021providing this service and justification may be requested by the insurer. A 5001.07.2021one-on-one assessment used for specific conditions that cannot be adequately 5001.07.2021assessed, due to the complexity of the condition, within an initial 5001.07.2021consultation (100021, 100313 for multiple injuries or conditions, and 100314 5001.07.2021for work specific functional exercise program). These may include, but are not 5001.07.2021limited to: extensive burns acquired brain injuries severe spinal cord 5001.07.2021injuries multiple orthopaedic fractures limb amputations crush injuries. This 5001.07.2021service can also be used for the assessment (only) of suitability for entry 5001.07.2021into a Multi-Disciplinary Program or Pain Management Program. The service may 5001.07.2021only be used once by the physiotherapist in the treatment of a work-related 5001.07.2021injury or condition, or the first consultation in a new episode of care for 5001.07.2021the same work-related injury or condition. Maximum one (1) hour. 100010040701.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021SPECIFIC PHYSIOTHERAPY CONSULTATION - Prior approval is required before 5001.07.2021providing this service. The insurer may request justification and will 5001.07.2021consider seeking an independent opinion if more than six (6) consultations are 5001.07.2021requested per episode of care. A one-on-one consultation for recommended 5001.07.2021interventions identified during a Specific Physiotherapy Assessment (100406). 5001.07.2021These may include, but are not limited to: extensive burns acquired brain 5001.07.2021injuries severe spinal cord injuries multiple orthopaedic fractures limb 5001.07.2021amputations crush injuries. Please note: This service is not to be used for 5001.07.2021consultations within a Multi-Disciplinary Program or Pain Management Program 5001.07.2021and must not be already classified elsewhere in this table. A Provider 5001.07.2021Management Plan3 (PMP) is to be submitted following the initial assessment 5001.07.2021(100406). The PMP should include an updated comprehensive treatment plan 5001.07.2021containing: expected functional gains, transition of care to self-management; 5001.07.2021and treatment timeframes. Maximum one (1) hour. 100010055501.07.2021 O Y Y 2001.07.202100111.0000000.0000000.00 5001.07.2021REASSESSMENT OR PROGRAM REVIEW - A one-on-one comprehensive assessment used 5001.07.2021when: the worker has been in active rehabilitation for at least six weeks and 5001.07.2021further treatment is likely; and/or there are new clinical findings that might 5001.07.2021affect ongoing treatment; and/or there is a rapid change in worker's status 5001.07.2021and/or there is no response to current therapeutic interventions. It should 5001.07.2021include: all components of initial consultation a review of the workers 5001.07.2021progress based on established objective measures a recommendation for future 5001.07.2021treatment and management strategies to assist the worker to return to work. It 5001.07.2021may include referral recommendations to other providers, a change in therapy 5001.07.2021or outcome direction requiring a new return to work goal. Following 5001.07.2021reassessment submit a Provider Management Plan3 (PMP) with an updated 5001.07.2021comprehensive treatment plan containing: expected functional gains, transition 5001.07.2021of care to self-management; and treatment timeframes. 100020001101.07.2021 O Y Y 5001.07.2021COMPREHENSIVE ORAL EXAMINATION (ADA 011) - Evaluation of all teeth, their 5001.07.2021supporting tissues, and the oral tissues in order to record the current 5001.07.2021condition of these structures. This evaluation includes recording an 5001.07.2021appropriate oral and medical history and any other relevant information. Usual 5001.07.2021practice fee applies. 100020001201.07.2021 O Y Y 5001.07.2021PERIODIC ORAL EXAMINATION (ADA 012) - An evaluation performed on a patient of 5001.07.2021record to determine any changes in the patient's oral and medical health 5001.07.2021status since a previous comprehensive or periodic examination. Usual practice 5001.07.2021fee applies. 100020001301.07.2021 O Y Y 5001.07.2021ORAL EXAMINATION - LIMITED (ADA 013) - A limited evaluation of the dentition, 5001.07.2021mouth and associated structures performed on a patient. This may be for a 5001.07.2021specific oral health problem or complaint. This evaluation includes recording 5001.07.2021an appropriate oral and medical history and any other relevant information. 5001.07.2021Usual practice fee applies. 100020001401.07.2021 O Y Y 5001.07.2021CONSULTATION (<30 MINUTES) (ADA 014) - A consultation to seek advice or 5001.07.2021discuss treatment options regarding a specific dental or oral condition. This 5001.07.2021consultation includes recording an appropriate medical history and any other 5001.07.2021relevant information. Usual practice fee applies. 100020001501.07.2021 O Y Y 5001.07.2021CONSULTATION - EXTENDED (30 MINUTES) (ADA 015) - An extended consultation to 5001.07.2021seek advice or discuss treatment options about a specific dental or oral 5001.07.2021complaint. This consultation includes recording an appropriate medical history 5001.07.2021and any other relevant information. Usual practice fee applies. 100020002201.07.2021 O Y Y 5001.07.2021INTRAORAL PERIAPICAL OR BITEWING RADIOGRAPH (ADA 022) - Taking and 5001.07.2021interpreting a radiograph made with the film inside the mouth. Usual practice 5001.07.2021fee per exposure applies. 100020002501.07.2021 O Y Y 5001.07.2021INTRAORAL RADIOGRAPH - OCCLUSAL, MAXILLARY, MANDIBULAR (ADA 025) - Taking and 5001.07.2021interpreting an occlusal, maxillary, or mandibular intraoral radiograph. This 5001.07.2021radiograph shows a more extensive view of teeth and maxillary or mandibular 5001.07.2021bone. Usual practice fee per exposure applies 100020003701.07.2021 O Y Y 5001.07.2021PANORAMIC RADIOGRAPH (OPG) (ADA 037) - Taking and interpreting an extraoral 5001.07.2021radiograph presenting a panoramic view of part or all of the mandible and/or 5001.07.2021the maxilla and/or adjacent structures. Usual practice fee per exposure 5001.07.2021applies. 100020007101.07.2021 O Y Y 5001.07.2021DIAGNOSTIC MODEL (ADA 071) - The preparation of a model from an impression or 5001.07.2021digital data. The model is used for examination and treatment planning 5001.07.2021procedures. This item should not be used to describe a working model. Usual 5001.07.2021practice fee per model applies. 100020031101.07.2021 O Y Y 5001.07.2021REMOVAL OF A TOOTH OR PART(S) THEREOF (ADA 311) - A procedure consisting of 5001.07.2021the removal of a tooth or part(s) thereof. Usual practice fee applies. 100020031401.07.2021 O Y Y 5001.07.2021SECTIONAL REMOVAL OF A TOOTH OR PART(S) THEREOF (ADA 314) - The removal of a 5001.07.2021tooth or part(s) thereof in sections. Bone removal may be necessary. Usual 5001.07.2021practice fee applies. 100020032201.07.2021 O Y Y 5001.07.2021SURGICAL REMOVAL OF A TOOTH OR FRAGMENT NOT REQUIRING REMOVAL OF BONE OR TOOTH 5001.07.2021DIVISION (ADA 322) - Removal of a tooth or tooth fragment where an incision 5001.07.2021and the raising of a mucoperiosteal flap are required, but where removal of 5001.07.2021bone or sectioning of the tooth is not necessary to remove the tooth. Usual 5001.07.2021practice fee applies. 100020032301.07.2021 O Y Y 5001.07.2021SURGICAL REMOVAL OF A TOOTH OR TOOTH FRAGMENT REQUIRING REMOVAL OF BONE (ADA 5001.07.2021323) - Removal of a tooth or tooth fragment where removal of bone is required 5001.07.2021after an incision and the raising of a mucoperiosteal flap. 100020035201.07.2021 O Y Y 5001.07.2021FRACTURE OF MAXILLA OR MANDIBLE - NOT REQUIRING FIXATION (ADA 352) - 5001.07.2021Conservative treatment of a fracture of the maxilla or mandible where there is 5001.07.2021no marked displacement or mobility of the fragments. No physical reduction or 5001.07.2021fixation is required. Usual practice fee applies. 100020038701.07.2021 O Y Y 5001.07.2021REPLANTATION AND SPLINTING OF A TOOTH (ADA 387) - Replantation of a tooth that 5001.07.2021has been avulsed or intentionally removed. It may be held in the correct 5001.07.2021position by splinting. Usual practice fee applies per tooth. 100020039901.07.2021 O Y Y 5001.07.2021CONTROL OF REACTIONARY OR SECONDARY POST-OPERATIVE HAEMORRHAGE (ADA 399) - 5001.07.2021This procedure describes the control of reactionary or secondary 5001.07.2021post-operative haemorrhage. Usual practice fee applies. 100020041101.07.2021 O Y Y 5001.07.2021DIRECT PULP CAPPING (ADA 411) - A procedure where an exposed pulp is directly 5001.07.2021covered with a protective dressing or cement. Usual practice fee applies. 100020041901.07.2021 O Y Y 5001.07.2021EXTIRPATION OF PULP OR DEBRIDEMENT OF ROOT CANAL(S) - EMERGENCY OR PALLIATIVE 5001.07.2021(ADA 419) - The partial or thorough removal of pulp and/or debris from the 5001.07.2021root canal system of a tooth. This is an emergency or palliative procedure 5001.07.2021distinct from visits for scheduled endodontic treatment. Temporisation, other 5001.07.2021than the closure of an access cavity, should be itemised separately. Usual 5001.07.2021practice fee applies. 100020045501.07.2021 O Y Y 5001.07.2021ADDITIONAL VISIT FOR IRRIGATION AND/OR DRESSING OF THE ROOT CANAL SYSTEM (ADA 5001.07.2021455) - Additional debridement irrigation and short-term dressing required 5001.07.2021where evidence of infection or inflammation persists following prior opening 5001.07.2021of the root canal and removal of its contents. Usual practice fee applies per 5001.07.2021tooth. 100020051101.07.2021 O Y Y 5001.07.2021METALLIC RESTORATION - ONE SURFACE - DIRECT (ADA 511) - Direct metallic 5001.07.2021restoration involving one surface of a tooth. Usual practice fee applies. 100020051201.07.2021 O Y Y 5001.07.2021METALLIC RESTORATION - TWO SURFACES - DIRECT (ADA 512) - Direct metallic 5001.07.2021restoration involving two surfaces of a tooth. Usual practice fee applies. 100020071101.07.2021 O Y Y 5001.07.2021COMPLETE MAXILLARY DENTURE (ADA 711) - Provision of a patient removable dental 5001.07.2021prosthesis replacing the natural teeth and adjacent tissues in the maxilla. 5001.07.2021Usual practice fee applies. 100020071201.07.2021 O Y Y 5001.07.2021COMPLETE MANDIBULAR DENTURE (ADA 712) - Provision of a patient removable 5001.07.2021dental prosthesis replacing the natural teeth and adjacent tissues in the 5001.07.2021mandible. Usual practice fee applies. 100020072101.07.2021 O Y Y 5001.07.2021PARTIAL MAXILLARY DENTURE - RESIN BASE (ADA 721) - Provision of a resin base 5001.07.2021for a patient removable dental prosthesis for the maxilla where some natural 5001.07.2021teeth remain. Other components of the denture such as teeth, rests, retainers, 5001.07.2021and immediate tooth replacements should be appropriately itemised. Usual 5001.07.2021practice fee applies. 100020072201.07.2021 O Y Y 5001.07.2021PARTIAL MANDIBULAR DENTURE - RESIN BASE (ADA 722) - Provision of a resin base 5001.07.2021for a patient removable dental prosthesis for the mandible where some natural 5001.07.2021teeth remain. Other components of the denture such as teeth, rests, retainers, 5001.07.2021and immediate tooth replacements should be appropriately itemised. Usual 5001.07.2021practice fee applies. 100020072801.07.2021 O Y Y 5001.07.2021PARTIAL MANDIBULAR DENTURE - CAST METAL FRAMEWORK (ADA 728) - Provision of the 5001.07.2021framework for a patient removable dental prosthesis made with a cast metal on 5001.07.2021which to replace teeth from the mandible where some natural teeth remain. 5001.07.2021Other components of the denture such as teeth, rests, retainers, and immediate 5001.07.2021tooth replacements should be appropriately itemised. Usual practice fee 5001.07.2021applies. 100020073101.07.2021 O Y Y 5001.07.2021RETAINER (ADA 731) - A retainer or attachment fitted to a tooth to aid 5001.07.2021retention of a partial denture. The number of retainers should be indicated. 5001.07.2021Usual practice fee per tooth applies. 100020073201.07.2021 O Y Y 5001.07.2021OCCLUSAL REST (ADA 732) - A unit of partial denture that rests upon a tooth 5001.07.2021surface to provide support for the denture. The number of rests used should be 5001.07.2021indicated. Usual practice fee per rest applies. 100020073301.07.2021 O Y Y 5001.07.2021TOOTH/TEETH (PARTIAL DENTURE) (ADA 733) - An item to describe each tooth added 5001.07.2021to the base of new partial denture. The number of teeth should be indicated. 5001.07.2021Usual practice fee applies. 100020076401.07.2021 O Y Y 5001.07.2021REPAIRING BROKEN BASE OF A PARTIAL DENTURE (ADA 764) - Repair, insertion, and 5001.07.2021adjustment of a broken resin partial denture base. Usual practice fee applies. 100020076801.07.2021 O Y Y 5001.07.2021ADDING TOOTH TO PARTIAL DENTURE TO REPLACE AN EXTRACTED OR DECORONATED TOOTH 5001.07.2021(ADA 768) - Modification, insertion, and adjustment of a partial denture 5001.07.2021involving an addition to accommodate the loss of a natural tooth or its 5001.07.2021coronal section. Usual practice fee per tooth applies. 100020077601.07.2021 O Y Y 5001.07.2021IMPRESSION - DENTAL APPLIANCE REPAIR/ MODIFICATION (ADA 776) - An item to 5001.07.2021describe taking an impression where required for the repair or modification of 5001.07.2021a dental appliance. Usual practice fee applies. 100020091101.07.2021 O Y Y 5001.07.2021PALLIATIVE CARE (ADA 911) - An item to describe interim care to relieve pain, 5001.07.2021infection, bleeding, or other problems not associated with other treatment. 5001.07.2021Usual practice fee applies. 100020092701.07.2021 O Y Y 5001.07.2021PROVISION OF MEDICATION/MEDICAMENT (ADA 927) - An additional item to describe 5001.07.2021the actual supply, prescription or administration of appropriate medications 5001.07.2021and medicaments required for dental treatments. Usual practice fee applies. 100021000101.07.2021 O Y Y 5001.07.2021COMPLETE FORMS (SENT WITH REQUEST) - FOR TREATING DENTAL PRACTITIONERS TO 5001.07.2021PROVIDE BASIC INFORMATION - Complete forms (sent with request) for treating 5001.07.2021dental practitioners to provide basic information as set out in forms provided 5001.07.2021by the insurer. The treating dental practitioner is to indicate the need for 5001.07.2021phone contact or a full report if additional pertinent information is 5001.07.2021available. Basic fee payable for each form completed. Usual practice fee 5001.07.2021applies. 100021000201.07.2021 O Y Y 5001.07.2021SHORT REPORT - A short report written in response to a request for specific 5001.07.2021information e.g. a statement of attendance, history, diagnosis, record of 5001.07.2021visits, including results of an investigation. These reports should only 5001.07.2021address the information requested but should include any comments necessary to 5001.07.2021make the position clear to a lay person. Expected length is half a page to one 5001.07.2021(1) page. Received by insurer within 10 working days. Usual practice fee 5001.07.2021applies. 100021000501.07.2021 O Y Y 5001.07.2021BASIC REPORT - A basic report includes summing up and an opinion helpful to 5001.07.2021the insurer. A basic report should include all of the relevant items listed in 5001.07.2021the outline for the short report and also a case summary. Details would only 5001.07.2021be given where this assists in determining the merits of a claim, establishing 5001.07.2021a need for a particular line of treatment or rehabilitation, understanding the 5001.07.2021development of the condition and the prognosis, or clarifying early treatment 5001.07.2021and return to work goals. Expected length is one (1) to two (2) pages. 5001.07.2021Received by insurer within 10 working days. Usual practice fee applies. 100021000801.07.2021 O Y Y 5001.07.2021SUBSTANTIAL REPORT - A substantial report includes extensive research or case 5001.07.2021discussion and opinion helpful to the insurer or assessment of impairment on 5001.07.2021request; or if the claim is rejected, to compensate for clinical input to the 5001.07.2021report. To qualify as substantial, a report must include, in addition to the 5001.07.2021case summary and comments required for a basic report, at least one of the 5001.07.2021following: - an assessment of impairment at the insurer's request - a report 5001.07.2021on a work-related injury or condition where the claim is subsequently rejected 5001.07.2021as a result of the report - evidence of extensive research into clinical, 5001.07.2021technical, or scientific papers - considerable case discussion outlining the 5001.07.2021merits of the claim - or advice on the future management of the case which 5001.07.2021assists the insurer and/or rehabilitation providers to manage the claim. 5001.07.2021Received by insurer within 10 working days. Usual practice fee applies. 100021001101.07.2021 O Y Y 5001.07.2021EXPERT SPECIALIST OPINION - An expert specialist opinion includes the above 5001.07.2021elements essential to the insurer in determining or managing claims. To 5001.07.2021attract the fee for an expert specialist report there should be evidence of 5001.07.2021two or more of the requirements for a substantial report, or the preparation 5001.07.2021of a report of a medico-legal standard for use by a medical assessment 5001.07.2021tribunal or a court. Expected length is three (3) or more pages. Note: only to 5001.07.2021be paid to specialists. Received by insurer within 10 working days. Usual 5001.07.2021practice fee applies. 100030000401.07.2021 O Y Y 2001.07.202100090.0000000.0000000.00 5001.07.2021INITIAL CONSULTATION - A one-on-one initial consultation for acupuncture in 5001.07.2021the treatment of a work-related injury or condition, or the first consultation 5001.07.2021in a new episode of care for the same work-related injury or condition. 5001.07.2021Services to be conducted in accordance with the Clinical Framework for the 5001.07.2021Delivery of Health Services2. Initial consultation may include: subjective 5001.07.2021assessment objective assessment treatment/service tailored goal setting and 5001.07.2021treatment planning setting expectations of recovery and return to work 5001.07.2021clinical recording communication (with referrer) any relevant information for 5001.07.2021the workers rehabilitation to the insurer. 100030000501.07.2021 O Y Y 2001.07.202100080.0000000.0000000.00 5001.07.2021SUBSEQUENT CONSULTATION - A one-on-one subsequent consultation for acupuncture 5001.07.2021in the treatment of a work-related injury or condition. The first five (5) 5001.07.2021consultations (including initial consultation) are pre-approved, provided the 5001.07.2021injury has not previously been treated by an allied health provider. If 5001.07.2021additional treatment is required, submit a Provider Management Plan3 (PMP) by 5001.07.2021the 6th subsequent treatment consultation. The PMP should include a 5001.07.2021comprehensive treatment plan containing: expected functional gains, transition 5001.07.2021of care to self-management; and treatment timeframes. Services to be conducted 5001.07.2021in accordance with the Clinical Framework for the Delivery of Health Services2 5001.07.2021Subsequent consultation may include: ongoing assessment (subjective and 5001.07.2021objective) intervention/treatment setting expectations of recovery and return 5001.07.2021to work clinical recording communication with the insurer of any relevant 5001.07.2021information for the workers rehabilitation. 100030001401.07.2021 H Y Y 2001.07.202100075.0000000.0000000.00 5001.07.2021HOME NURSING SERVICES BY A REGISTERED NURSE - Prior approval is required 5001.07.2021before providing this service. Home nursing services such as dressing of 5001.07.2021wounds and assistance with daily care. The insurer will not pay for home 5001.07.2021nursing services in excess of four (4) weeks without a treating medical 5001.07.2021practitioner review. NB: must be referred by a medical practitioner. Day and 5001.07.2021evening rate: $75. Weekend rate: $97. 100030007901.07.2021 O Y Y 2001.07.202100032.0000000.0000000.00 5001.07.2021COMMUNICATION - 3 TO 10 MINS - Direct communication between treating provider 5001.07.2021and insurer, employer, insurer referred allied health provider and doctors to 5001.07.2021assist with faster and more effective rehabilitation and return to work for a 5001.07.2021worker. Excludes communication with a worker, and of a general administrative 5001.07.2021nature or conveying non-specific information. Must be more than three (3) 5001.07.2021minutes. Refer to details below the tables for list of exclusions before using 5001.07.2021this item number. Treating providers are expected to keep a written record of 5001.07.2021the details of communication, including date, time, and duration. The insurer 5001.07.2021may request evidence of communication at any time. 100030008101.07.2021 O Y Y 2001.07.202100041.0000000.0000000.00 5001.07.2021GENERAL MEDICAL PROCEDURES - Payable where a patient is seen by an advanced 5001.07.2021practice registered nurse (i.e. a nurse practitioner or rural and isolated 5001.07.2021practice nurse) and performs straightforward medical procedures that would 5001.07.2021normally be payable as part of a doctor's MBS attendance fee i.e. suturing a 5001.07.2021wound or removal of a superficial foreign body. This also includes outpatient 5001.07.2021care in hospitals. 100030008201.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021CASE CONFERENCE - Prior approval is required before providing the service. 5001.07.2021Face-to-face or phone communication involving the treating provider, insurer 5001.07.2021and one or more of the following: treating medical practitioner or specialist 5001.07.2021employer or employee representative worker allied health providers; or other. 100030008401.07.2021 O Y Y 2001.07.202100063.0000000.0000000.00 5001.07.2021UPDATED SUITABLE DUTIES PROGRAM (SDP) - Documentation of an updated or further 5001.07.2021suitable duties plan for a worker, detailing specific information necessary 5001.07.2021for a safe and effective return to the workplace. For WorkCover Queensland 5001.07.2021claims, only an approved RTW Services provider can provide this service.** 100030008601.07.2021 O Y Y 2001.07.202100063.0000000.0000000.00 5001.07.2021PROGRESS REPORT - A written report providing a brief summary of the worker's 5001.07.2021progress towards recovery and return to work. 100030008701.07.2021 O Y Y 2001.07.202100126.0000000.0000000.00 5001.07.2021PUBLIC HOSPITAL EMERGENCY NURSE SERVICES - To be billed where a worker 5001.07.2021receives primary emergency services provided by nursing staff only. This code 5001.07.2021is used if the care is of an emergency nature only and the hospital is not 5001.07.2021considered to have a recognised emergency department as per the Public Health 5001.07.2021Services Table of Costs. 100030008801.07.2021 O Y Y 2001.07.202100160.0000000.0000000.00 5001.07.2021STANDARD REPORT - A written report used for conveying relevant information 5001.07.2021about a worker's work-related injury or condition where the case or treatment 5001.07.2021is not extremely complex or where responses to a limited number of questions 5001.07.2021have been requested by the insurer. 100030008901.07.2021 O Y Y 2001.07.202100041.0000000.0000000.00 5001.07.2021ASSISTING DOCTOR IN MINOR SURGERY - This item will be payable only if the 5001.07.2021procedure attracts an MBS assistance fee and there is no other doctor 5001.07.2021available to assist. 100030009001.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021COMPREHENSIVE REPORT - A written report only used where the case and treatment 5001.07.2021is extremely complex. Hours to be negotiated with the insurer prior to 5001.07.2021providing the report. 100030009101.07.2021 H Y Y 2001.07.202100140.0000000.0000000.00 5001.07.2021TRAVEL - RTW - Prior approval is required for travel >1 hour. Travel charges 5001.07.2021are applicable when the provider is required to leave their normal place of 5001.07.2021practice to provide services to a worker at a: rehabilitation facility 5001.07.2021hospital workplace, or their place of residence (worker must be certified 5001.07.2021unable to travel). Note: Where multiple workers are being provided services in 5001.07.2021the same visit to a facility, or in the same geographical area on the same 5001.07.2021day, travel must be divided evenly between those workers. Travel is not 5001.07.2021payable where: the provider does not have (or is employed by a business that 5001.07.2021does not have) a commercial place of business for the delivery of services 5001.07.2021(e.g. mobile practice) the travel is between clinics owned and/or operated by 5001.07.2021the provider or their employer a provider or their employer have multiple 5001.07.2021clinics, travel is only payable from the clinic closest to the location of 5001.07.2021services. For WCQ claims, only an approved RTW Services provider can provide 5001.07.2021this service.** 100030009201.07.2021 H Y Y 2001.07.202100134.0000000.0000000.00 5001.07.2021TRAVEL - TREATMENT - Prior approval is required for travel of more than one 5001.07.2021(1) hour. Travel charges are applicable when the provider is required to leave 5001.07.2021their normal place of practice to treat a worker at a: rehabilitation facility 5001.07.2021(including a gym or pool) hospital workplace, or their place of residence 5001.07.2021(worker must be certified unable to travel). Please note: Where multiple 5001.07.2021workers are being treated in the same visit to a facility, or in the same 5001.07.2021geographical area on the same day, travel must be divided evenly between those 5001.07.2021workers. Travel is not payable where: the provider does not have (or is 5001.07.2021employed by a business that does not have) a commercial place of business for 5001.07.2021the delivery of treatment services (e.g. mobile provider practice) the travel 5001.07.2021is between clinics owned and/or operated by the provider or their employer a 5001.07.2021provider or their employer have multiple clinics, travel is only payable from 5001.07.2021the clinic closest to the location of treatment. 100030009301.07.2021 O Y Y 2001.07.202100026.0000000.0000000.00 5001.07.2021COPIES OF PATIENT RECORDS RELATING TO CLAIM - Copies of patient records 5001.07.2021relating to the worker's compensation claim including file notes, results of 5001.07.2021relevant tests e.g. pathology, diagnostic imaging, and reports from 5001.07.2021specialists. Paid at $26 flat fee plus $1 per page. 100030009401.07.2021 O Y Y 2001.07.202100058.0000000.0000000.00 5001.07.2021INCIDENTAL EXPENSES - Reasonable charges for incidental items required by the 5001.07.2021worker to assist in their recovery and which they take home with them 5001.07.2021following their treatment. Pharmacy items and consumables used by a provider 5001.07.2021during a consultation are not included. For further clarification refer to the 5001.07.2021information provided below the tables. Payment will be made up to $58 in total 5001.07.2021for incidental expenses and up to $203 in total for supportive devices, per 5001.07.2021claim (not per consultation), without prior approval. Approval from the 5001.07.2021insurer must be obtained for items exceeding the pre-approved value. Hire of 5001.07.2021equipment to be negotiated with insurer. All expenses must be itemised on the 5001.07.2021invoice. Please note: This item number is not to be used for admission fees to 5001.07.2021external facilities such as gyms and pools. 100030010001.07.2021 O Y Y 2001.07.202100063.0000000.0000000.00 5001.07.2021COMMUNICATION - 11 TO 20 MINS - Direct communication between treating provider 5001.07.2021and insurer, employer, insurer referred allied health provider and doctors to 5001.07.2021assist with faster and more effective rehabilitation and return to work for a 5001.07.2021worker. Excludes communication with a worker, and of a general administrative 5001.07.2021nature or conveying non-specific information. Must be more than ten (10) 5001.07.2021minutes. Refer to details below the tables for list of exclusions before using 5001.07.2021this item number). Treating provider are expected to keep a written record of 5001.07.2021the details of communication, including date, time, and duration. The insurer 5001.07.2021may request evidence of communication at any time. 100030010201.07.2021 O Y Y 2001.07.202100094.0000000.0000000.00 5001.07.2021INITIAL SUITABLE DUTIES PROGRAM (SDP) - Documentation of suitable duties for a 5001.07.2021worker, detailing specific information necessary for a safe and effective 5001.07.2021return to the workplace. For WorkCover Queensland claims, only an approved RTW 5001.07.2021Services provider can provide this service.** 100030015801.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021WORKPLACE EVALUATION/ASSESSMENT - Systematic process using the workplace to 5001.07.2021estimate work potential and work behaviour. Includes ergonomic assessments. 5001.07.2021For WorkCover Queensland claims, only an approved RTW Services provider can 5001.07.2021provide this service.** 100030015901.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021ACTIVITIES OF DAILY LIVING ASSESSMENT - A series of standardised tests and 5001.07.2021measures to assess a worker's activities of daily living and mobility 5001.07.2021(including Modified Barthel Index assessments for registered occupational 5001.07.2021therapy only). Service includes assessment and report, noting that WorkCover 5001.07.2021Queenslands template for Modified Barthel Index is to be used (for WorkCover 5001.07.2021claims). 100030016001.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021FUNCTIONAL CAPACITY EVALUATION (FCE) - Systematic assessment using a series of 5001.07.2021standardised tests and work specific simulation activities to assess a 5001.07.2021worker's functional capacity for work or potential to return to suitable work; 5001.07.2021includes assessment and report. For WorkCover Queensland claims, only an 5001.07.2021approved RTW Services provider can provide this service.** 100030016101.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021DRIVING ASSESSMENT - Off-road and on-road driving assessments of cognitive, 5001.07.2021psychological, and physical capacity to drive. Assessments must be conducted 5001.07.2021by a qualified driving assessor. Service includes assessment and report. 5001.07.2021Driving instructor is also required for on-road assessment component and fees 5001.07.2021are paid separately. 100030016201.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021VOCATIONAL ASSESSMENT AND REPORT* - Assessment of realistic vocational options 5001.07.2021in the current job market for a worker using integrated clinical and 5001.07.2021standardised assessment procedures and instruments; includes assessment and 5001.07.2021report. For WorkCover Queensland claims, only an approved RTW Services 5001.07.2021provider can provide this service.** 100030016401.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021RETURN TO WORK FACILITATION - Communication with a worker and employer to 5001.07.2021establish an updated suitable duties program where no worksite assessment or 5001.07.2021job placement services are required, or other service item number applies. 5001.07.2021Also used where there are significant barriers preventing a worker 5001.07.2021participating in a return to work program and the provider delivers strategies 5001.07.2021to overcome the barriers. Includes communication between the worker, employer, 5001.07.2021and insurer (does not include general communication relating to a suitable 5001.07.2021duties program or job placement or where another number applies). May include 5001.07.2021face-to-face or electronic file reviews for the insurer. For WorkCover 5001.07.2021Queensland claims, only an approved RTW Services provider can provide this 5001.07.2021service.** 100030016601.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021JOB SEEKING SKILLS ASSESSMENT - INITIAL* - Identify a worker's transferable 5001.07.2021skills and abilities for a new job/career or host placement; may involve the 5001.07.2021development of a vocational preparation action plan with the worker. For 5001.07.2021WorkCover Queensland claims, only an approved RTW Services provider can 5001.07.2021provide this service.** 100030016801.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021JOB PREPARATION SERVICES* - Prepare the worker to find suitable employment. 5001.07.2021Services will be based on the needs of the worker and may include development 5001.07.2021of or updating a resume and/or cover letter, interview preparation skills and 5001.07.2021career counselling. For WorkCover Queensland claims, only an approved RTW 5001.07.2021Services provider can provide this service.** 100030018601.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021INITIAL CONSULTATION - WORK SPECIFIC FUNCTIONAL EXERCISE PROGRAM - IInitial 5001.07.2021development and instruction of an exercise program focused on improving 5001.07.2021function of the work-related injury or condition, relevant to their work role. 5001.07.2021This service may only be charged once for development of an exercise program 5001.07.2021to meet the workers work specific functional goals. Refer item number 300228 5001.07.2021for Gym and Pool Entry Fees. The exercise physiologist is then expected to 5001.07.2021submit a Provider Management Plan (PMP) following the initial consultation for 5001.07.2021approval before any treatment commences. The PMP should include a 5001.07.2021comprehensive treatment plan containing: expected functional gains, transition 5001.07.2021of care to self-management; and treatment timeframes. The PMP form is 5001.07.2021available on the Workers Compensation Regulatory Services website 5001.07.2021(www.worksafe.qld.gov.au). The insurer will not pay for the preparation or 5001.07.2021completion of a Provider Management Plan. The entire consultation must be 1 on 5001.07.20211 with the worker. Maximum of one (1) hour. 100030018701.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021SUBSEQUENT CONSULTATION - WORK SPECIFIC FUNCTIONAL EXERCISE PROGRAM - Prior 5001.07.2021approval is required before providing this service. The insurer may request 5001.07.2021justification and will consider seeking an independent opinion if more than 6 5001.07.2021consultations are requested per episode of care. A one-on-one consultation 5001.07.2021with the worker for ongoing monitoring, review and progression of a 5001.07.2021work-specific functional exercise program as developed during initial 5001.07.2021consultation (300186). The focus must be on improving function of the 5001.07.2021work-related injury or condition relevant to the work role and include 5001.07.2021education and progression to self-management. Services to be conducted in 5001.07.2021accordance with the Clinical Framework for the Delivery of Health Services2. A 5001.07.2021Provider Management Plan3 (PMP) is to be submitted for approval following the 5001.07.2021initial consultation (300186), before any further treatment commences. The PMP 5001.07.2021should include a comprehensive treatment plan containing: expected functional 5001.07.2021gains, transition of care to self-management; and treatment timeframes. 5001.07.2021Maximum 1 hour. 100030018801.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021ADJUSTMENT COUNSELLING - INITIAL CONSULTATION - Undertaken where possible to 5001.07.2021clarify the presence of possible adjustment to injury issues and set goals of 5001.07.2021therapy to optimise rehabilitation outcomes; performed where worker is 5001.07.2021displaying psychological, social, cognitive, emotional, and behavioural 5001.07.2021problems after a work-related incident or injury. The purpose of the 5001.07.2021consultation is to identify appropriate interventions/treatments to optimise 5001.07.2021rehabilitation outcomes. Services to be conducted in accordance with the 5001.07.2021Clinical Framework for the Delivery of Health Services.2 Initial consultation 5001.07.2021may include: history taking assessment diagnostic formulation 5001.07.2021treatment/service tailored goal setting and treatment planning setting 5001.07.2021expectations of recovery and return to work clinical recording communication 5001.07.2021with the insurer of any relevant information for the workers rehabilitation 5001.07.2021Maximum one (1) hour. 100030019001.07.2021 O Y Y 2001.07.202100115.0000000.0000000.00 5001.07.2021DIETARY ASSESSMENT - Consultation to evaluate dietary issues and objective 5001.07.2021tests to formulate an intervention plan focused on a return to work goal. 5001.07.2021Prior approval required before providing service. Services must be provided by 5001.07.2021a person with a tertiary degree in dietetics. 100030019801.07.2021 H Y Y 2001.07.202100051.0000000.0000000.00 5001.07.2021PERSONAL CARE ASSISTANCE - Prior approval is required before providing this 5001.07.2021service Provided through an agency - includes services for injury/wound care, 5001.07.2021personal hygiene and grooming etc. where the worker is living at home and has 5001.07.2021been assessed as incapable (for physical, cognitive or emotional reasons) of 5001.07.2021undertaking these tasks and has no family or other social support network. Day 5001.07.2021rate: $51 per hour. Weekend rate: $72 per hour. 100030020001.07.2021 H Y Y 2001.07.202100045.0000000.0000000.00 5001.07.2021DIVERSIONAL THERAPY PROGRAM - Prior approval is required before providing this 5001.07.2021service Services to be provided by a diversional therapist at a nursing home 5001.07.2021including therapeutic activities. Services must be provided by a person with a 5001.07.2021minimum of an Associate Diploma in Diversional Therapy. The service should 5001.07.2021only be used under the supervision of an occupational therapist, who has 5001.07.2021recommended therapeutic activities as part of the overall treatment program. 100030020101.07.2021 H Y Y 2001.07.202100042.0000000.0000000.00 5001.07.2021DOMESTIC ASSISTANCE - Prior approval is required before providing this service 5001.07.2021Provided through an agency - includes cleaning, shopping and washing etc. 5001.07.2021where the worker is living at home and has been assessed by an occupational 5001.07.2021therapist as incapable of undertaking these tasks (for physical, cognitive or 5001.07.2021emotional reasons) of undertaking these tasks, and has no family or other 5001.07.2021social support network. Note: weekend and public holiday rates may be 5001.07.2021negotiated with the insurer. 100030020201.07.2021 O Y Y 5001.07.2021LITERACY SKILLS - Prior approval is required before providing this service 5001.07.2021Private tutoring by a qualified tutor to improve literacy skills for job 5001.07.2021placement prospects. Program should be limited to achieving a base level of 5001.07.2021competency up to four (4) to six (6) weeks. Typically, literacy services are 5001.07.2021provided through the local TAFE or appropriately qualified private literacy 5001.07.2021services. 100030021001.07.2021 O Y Y 2001.07.202100032.0000000.0000000.00 5001.07.2021RTW COMMUNICATION - 3 TO 10 MINS - Communication by a provider who has 5001.07.2021received a referral from an insurer for the following services: - worksite 5001.07.2021assessment/evaluation - development of suitable duties program or updated 5001.07.2021program - functional capacity evaluation - vocational assessment - job 5001.07.2021seeking, job preparation or - job placement services. Direct communication 5001.07.2021between a provider and insurer, employer, insurer referred allied health 5001.07.2021provider and doctors to assist with faster, more effective rehabilitation and 5001.07.2021return to work for a worker. Excludes communication with a worker, and of a 5001.07.2021general administrative nature or conveying non-specific information. Must be 5001.07.2021more than 3 minutes. Refer to the exclusions listed below these tables before 5001.07.2021using this item number. A written record of the communication details 5001.07.2021including date, time, and duration should be kept. The insurer may request 5001.07.2021evidence at any time. For WorkCover Queensland claims, only an approved RTW 5001.07.2021Services provider can provide this service.** 100030021101.07.2021 O Y Y 2001.07.202100063.0000000.0000000.00 5001.07.2021RTW COMMUNICATION - 11 TO 20 MINS - Communication by a provider who has 5001.07.2021received a referral from an insurer for RTW services: - worksite 5001.07.2021assessment/evaluation - development of SDP or updated program - functional 5001.07.2021capacity evaluation - vocational assessment - job seeking, job preparation or 5001.07.2021- job placement services. Direct communication between a provider and insurer, 5001.07.2021employer, insurer referred provider and doctors to assist with faster, more 5001.07.2021effective rehabilitation and RTW for a worker including the monitoring of 5001.07.2021SDPs, communication with relevant stakeholders about a worker's progress or 5001.07.2021issues related to an existing SDP. Excludes communication with a worker, and 5001.07.2021of a general administrative nature or conveying non-specific information. Must 5001.07.2021be > 10 minutes. Refer to exclusions listed below. A written record of the 5001.07.2021communication details including date, time and duration should be kept. The 5001.07.2021insurer may request evidence at any time. For WCQ claims, only an approved RTW 5001.07.2021Services provider can provide this service.** 100030021201.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021JOB PLACEMENT SERVICES - NEW EMPLOYER* - The process of actively sourcing and 5001.07.2021placing a worker in a host placement or for WorkCover also includes placing a 5001.07.2021worker in a Recover at Work program with a view to a durable return to work 5001.07.2021outcome. Also includes seeking new employment with/for the worker. Includes 5001.07.2021employer and worker liaison, job application and coaching. For WorkCover 5001.07.2021Queensland claims, only an approved RTW Services provider can provide this 5001.07.2021service.** 100030021301.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021JOB PLACEMENT SERVICES - WORK HARDENING PROGRAM* - The process of actively 5001.07.2021sourcing and placing a worker in a host placement or for WorkCover also 5001.07.2021includes placing a worker in a Recover at Work program where the worker has a 5001.07.2021job to return to. Includes employer and worker liaison, job application and 5001.07.2021coaching. For WorkCover Queensland claims, only an approved RTW Services 5001.07.2021provider can provide this service.** 100030022801.07.2021 O Y Y 5001.07.2021GYM AND POOL ENTRY FEES - Prior approval is required before providing this 5001.07.2021service. The insurer may request justification and will consider seeking a 5001.07.2021second opinion if more than three (3) months facility membership is requested 5001.07.2021per episode of care. Entry fee for the worker to attend a gym or pool for 5001.07.2021assessment and treatment (up to a maximum three-month membership). Entry fees 5001.07.2021will be paid for the worker, only where the facility is not owned or operated 5001.07.2021by the provider, their employer, or where either party contracts their 5001.07.2021services to the facility. Entry fees will not be paid for providers. The 5001.07.2021provider is then expected to submit Provider Management Plan (PMP) for 5001.07.2021approval before any treatment commences. 100030028501.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021ADJUSTMENT COUNSELLING - SUBSEQUENT CONSULTATION - Prior approval required 5001.07.2021before providing this service. Ongoing treatment of work-related components of 5001.07.2021presenting adjustment to injury issues; intervention would be based on 5001.07.2021treatment formulated from the initial consultation (300188) The provider is 5001.07.2021expected to submit a Provider Management Plan3 (PMP) after the Adjustment 5001.07.2021Counselling - Initial Consultation is completed. The PMP should include a 5001.07.2021comprehensive treatment plan containing: expected functional gains, transition 5001.07.2021of care to self-management; and treatment timeframes. Maximum treatment time 5001.07.2021of one (1) hour per day Services to be conducted in accordance with the 5001.07.2021Clinical Framework for the Delivery of Health Services2. Subsequent 5001.07.2021consultation may include: ongoing assessment (subjective and objective) 5001.07.2021intervention/treatment setting expectations of recovery and return to work 5001.07.2021clinical recording communication with the insurer of any relevant information 5001.07.2021for the workers rehabilitation. 100030029501.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021EXTERNAL CASE MANAGEMENT - Includes an initial needs assessment and report; 5001.07.2021should outline a case management plan indicating the goals of the program, 5001.07.2021services required, timeframes and costs. Insurer request only. 100030030901.07.2021 O Y Y 5001.07.2021AMBULANCE TRANSPORT - NON QAS - INITIAL TRANSPORTATION - Transport provided 5001.07.2021immediately after the work-related injury or condition is sustained. 100030031001.07.2021 O Y Y 5001.07.2021AMBULANCE TRANSPORT - NON QAS - SUBSEQUENT TRANSPORTATION - Subsequent 5001.07.2021transport must be certified in writing by a doctor as necessary because of the 5001.07.2021worker's physical condition resulting from a work-related injury or condition. 100030040101.07.2021 O Y Y 2001.07.202100048.0000000.0000000.00 5001.07.2021GROUP EXERCISE SESSIONS - PPrior approval is required before providing this 5001.07.2021service. A group session where a common exercise programs is delivered to more 5001.07.2021than one individual at the same time. The group can consist of a maximum of 5001.07.2021eight (8) persons. The group session must be attended, conducted, and 5001.07.2021supervised by an exercise physiologist. 100040008801.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021INITIAL CONSULTATION - The initial consultation in the treatment of possible 5001.07.2021psychological, social, cognitive, emotional, and behavioural problems 5001.07.2021occurring after a work-related injury or condition. The purpose of the 5001.07.2021assessment is to identify appropriate interventions/treatments to optimise 5001.07.2021rehabilitation outcomes (maximum two (2) hours direct contact and test scoring 5001.07.2021time). Services to be conducted in accordance with the Clinical Framework for 5001.07.2021the Delivery of Health Services2. Initial consultation may include: history 5001.07.2021taking assessment diagnostic formulation treatment/service tailored goal 5001.07.2021setting and treatment planning setting expectations of recovery and return to 5001.07.2021work clinical recording communication with the insurer of any relevant 5001.07.2021information for the workers rehabilitation. The entire consultation must be 5001.07.2021one-on-one with the worker. 100040009101.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021NEUROPSYCHOLOGICAL ASSESSMENT - An assessment to clarify the presence of 5001.07.2021possible acquired brain injury or brain dysfunction where possible 5001.07.2021psychological, social, cognitive, emotional, and behavioural problems are 5001.07.2021occurring after a work-related injury or condition (four to five (4-5) hours 5001.07.2021direct contact and test scoring time). 100040009501.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021SUBSEQUENT CONSULTATION - A one on one subsequent consultation with the worker 5001.07.2021in the ongoing management and treatment of their work-related psychological 5001.07.2021issues. Intervention is based on treatment formulated in the initial 5001.07.2021consultation. The first 6 hours (including initial) are pre-approved provided 5001.07.2021this condition has not previously been treated by an allied health provider. 5001.07.2021If additional treatment is required, submit a Provider Management Plan3 (PMP) 5001.07.2021within 6 hours of consultations, including a comprehensive treatment plan 5001.07.2021containing: expected functional gains, transition to self-care management; and 5001.07.2021treatment timeframes. Services to be conducted in accordance with the Clinical 5001.07.2021Framework for the Delivery of Health Services2. Subsequent consultation may 5001.07.2021include: ongoing assessment intervention/treatment setting expectations of 5001.07.2021recovery and return to work clinical recording communication with the insurer 5001.07.2021of any relevant information for the workers rehabilitation. Max 2 hours on any 5001.07.2021one day. 100040010101.07.2021 H Y Y 2001.07.202100140.0000000.0000000.00 5001.07.2021INITIAL ASSESSMENT - A one-on-one initial consultation where possible 5001.07.2021psychological, social, cognitive, emotional, and behavioural problems are 5001.07.2021occurring after a work-related injury or condition. The purpose of the 5001.07.2021assessment is to identify appropriate interventions/treatments to optimise 5001.07.2021rehabilitation outcomes (maximum two (2) hours direct contact and test scoring 5001.07.2021time). Services to be conducted in accordance with the Clinical Framework for 5001.07.2021the Delivery of Health Services2. Initial consultation may include: history 5001.07.2021taking assessment diagnostic formulation treatment/service tailored goal 5001.07.2021setting and treatment planning setting expectations of recovery and return to 5001.07.2021work clinical recording communication with the insurer of any relevant 5001.07.2021information for the workers rehabilitation. 100040010201.07.2021 H Y Y 2001.07.202100140.0000000.0000000.00 5001.07.2021SUBSEQUENT CONSULTATION - A one-on-one subsequent consultation with the worker 5001.07.2021in their ongoing management and treatment. Intervention is based on treatment 5001.07.2021formulated in the initial consultation. The first six (6) hours (including 5001.07.2021initial consultation) are pre-approved, provided this issue has not previously 5001.07.2021been treated by an allied health provider, with a maximum of two (2) hours on 5001.07.2021any one day. If additional treatment is required, submit a Provider Management 5001.07.2021Plan3 (PMP) within six (6) hours of consultations which includes a 5001.07.2021comprehensive treatment plan containing: expected functional gains, transition 5001.07.2021to self-care management; and treatment timeframes. Services to be conducted in 5001.07.2021accordance with the Clinical Framework for the Delivery of Health Services2. 5001.07.2021Subsequent consultation may include: ongoing assessment intervention/treatment 5001.07.2021setting expectations of recovery and return to work clinical recording 5001.07.2021communication with the insurer of any relevant information for the workers 5001.07.2021rehabilitation. 100040018401.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021CRITICAL INCIDENT DEBRIEFING SESSIONS - A process where, following exposure to 5001.07.2021a critical incident, an individual or group of workers are debriefed by a 5001.07.2021psychologist to assist them to deal more effectively with their experience. 5001.07.2021Approval required after the first two (2) pre-approved sessions. 100040022601.07.2021 H Y Y 2001.07.202100236.0000000.0000000.00 5001.07.2021INDEPENDENT CASE REVIEW - An independent psychologist examination and report 5001.07.2021of a worker (not by the treating psychologist). Only provided following a 5001.07.2021request from the insurer. The review is requested by the insurer where 5001.07.2021progress of treatment and/or rehabilitation falls outside the plan or expected 5001.07.2021course of injury management. The examination and report provide the insurer 5001.07.2021with an assessment and recommendations for ongoing treatment and prognosis. 100050000601.07.2021 O Y Y 2001.07.202100080.0000000.0000000.00 5001.07.2021SUBSEQUENT CONSULTATION - A one-on-one subsequent consultation in the 5001.07.2021treatment of one work-related injury or condition only. The first five (5) 5001.07.2021consultations (including initial consultation) are pre-approved, provided the 5001.07.2021injury or condition has not previously been treated by an allied health 5001.07.2021provider. If additional treatment is required, submit a Provider Management 5001.07.2021Plan3 (PMP) by the 6th subsequent treatment consultation. The PMP should 5001.07.2021include a comprehensive treatment plan containing: expected functional gains, 5001.07.2021transition of care to self-management; and treatment timeframes. Services to 5001.07.2021be conducted in accordance with the Clinical Framework for the Delivery of 5001.07.2021Health Services2. Subsequent consultation may include: ongoing assessment 5001.07.2021(subjective and objective) intervention/treatment setting expectations of 5001.07.2021recovery and return to work clinical recording communication with the insurer 5001.07.2021of any relevant information for the workers rehabilitation. 100050002101.07.2021 O Y Y 2001.07.202100090.0000000.0000000.00 5001.07.2021INITIAL CONSULTATION - A one-on-one initial consultation in the treatment of a 5001.07.2021work-related injury or condition, or the first consultation in a new episode 5001.07.2021of care for the same work-related injury or condition. Services to be 5001.07.2021conducted in accordance with the Clinical Framework for the Delivery of Health 5001.07.2021Services2. Initial consultation may include: subjective assessment objective 5001.07.2021assessment treatment/service tailored goal setting and treatment planning 5001.07.2021setting expectations of recovery and return to work clinical recording 5001.07.2021communication with the insurer of any relevant information for the workers 5001.07.2021rehabilitation. 100050005501.07.2021 O Y Y 2001.07.202100111.0000000.0000000.00 5001.07.2021REASSESSMENT OR PROGRAM REVIEW - A comprehensive assessment used when: the 5001.07.2021worker has been in active rehabilitation for at least six weeks and further 5001.07.2021treatment is likely; and/or there are new clinical findings that might affect 5001.07.2021ongoing treatment; and/or there is a rapid change in worker's status and/or 5001.07.2021there is no response to current therapeutic interventions. It should include: 5001.07.2021all components of initial consultation a review of the workers progress based 5001.07.2021on established objective measures a recommendation for future treatment and 5001.07.2021management strategies to assist the worker to return to work. It may include 5001.07.2021referral recommendations to other providers, a change in therapy or outcome 5001.07.2021direction requiring a new return to work goal. Following reassessment submit a 5001.07.2021Provider Management Plan3 (PMP) with an updated comprehensive treatment plan 5001.07.2021containing: expected functional gains, transition of care to self-management; 5001.07.2021and treatment timeframes. 100050010201.07.2021 O Y Y 2001.07.202100153.0000000.0000000.00 5001.07.2021SUBSEQUENT CONSULTATION - MULTIPLE INJURIES OR CONDITIONS - A one-on-one 5001.07.2021subsequent consultation with the worker in the treatment of two or more 5001.07.2021entirely separate work-related injuries or conditions. The first five (5) 5001.07.2021consultations (including initial consultation) are pre-approved, provided the 5001.07.2021injury or condition has not previously been treated by an allied health 5001.07.2021provider. If additional treatment is required, submit a Provider Management 5001.07.2021Plan3 (PMP) by the 6th subsequent treatment consultation. The PMP should 5001.07.2021include a comprehensive treatment plan containing: expected functional gains, 5001.07.2021transition of care to self-management; and treatment timeframes. Services to 5001.07.2021be conducted in accordance with the Clinical Framework for the Delivery of 5001.07.2021Health Services2. Subsequent consultation may include: ongoing assessment 5001.07.2021(subjective and objective) intervention/treatment setting expectations of 5001.07.2021recovery and return to work clinical recording communication with the insurer 5001.07.2021of any relevant information for the workers rehabilitation. 100050022601.07.2021 H Y Y 2001.07.202100236.0000000.0000000.00 5001.07.2021INDEPENDENT CASE REVIEW - An independent chiropractic examination and report 5001.07.2021on a worker and is not carried out by the treating chiropractor. The review is 5001.07.2021requested by the insurer where progress of treatment and/or rehabilitation 5001.07.2021falls outside the plan or expected course of injury management. The 5001.07.2021examination and report provide the insurer with an assessment and 5001.07.2021recommendations for ongoing treatment and prognosis. 100050031301.07.2021 O Y Y 2001.07.202100134.0000000.0000000.00 5001.07.2021INITIAL CONSULTATION - MULTIPLE INJURIES OR CONDITIONS - A one-on-one initial 5001.07.2021consultation in the treatment of two or more entirely separate work-related 5001.07.2021injuries or conditions, or the first consultation in a new episode of care for 5001.07.2021the same two or more entirely separate work-related injuries or conditions. 5001.07.2021Please note: this does not include an injury or condition with referred pain 5001.07.2021to another area, and a workers' compensation certificate detailing each 5001.07.2021work-related injury or condition to be treated is required. Services to be 5001.07.2021conducted in accordance with the Clinical Framework for the Delivery of Health 5001.07.2021Services2. Initial consultation may include: subjective assessment objective 5001.07.2021assessment treatment/service tailored goal setting and treatment planning 5001.07.2021setting expectations of recovery and return to work clinical recording 5001.07.2021communication with the insurer of any relevant information for the workers 5001.07.2021rehabilitation. 100055810001.07.2021 O Y Y 2001.07.202100187.0000000.0000000.00 5001.07.2021X-RAY - CERVICAL SPINE - X-Ray - Cervical Spine. Must be clinically 5001.07.2021justifiable. 100055810301.07.2021 O Y Y 2001.07.202100155.0000000.0000000.00 5001.07.2021X-RAY - THORACIC SPINE - X-Ray - Thoracic Spine. Must be clinically 5001.07.2021justifiable. 100055810601.07.2021 O Y Y 2001.07.202100217.0000000.0000000.00 5001.07.2021X-RAY - LUMBOSACRAL SPINE - X-Ray - Lumbosacral Spine. Must be clinically 5001.07.2021justifiable. 100055811201.07.2021 O Y Y 2001.07.202100273.0000000.0000000.00 5001.07.2021X-RAY - ANY TWO REGIONS OF THE SPINE - X-Ray - Any two regions of the spine. 5001.07.2021Must be clinically justifiable. 100055811501.07.2021 O Y Y 2001.07.202100375.0000000.0000000.00 5001.07.2021X-RAY - ANY THREE REGIONS OF THE SPINE - X-Ray - Any three regions of the 5001.07.2021spine. Must be clinically justifiable. 100060001501.07.2021 O Y Y 2001.07.202100090.0000000.0000000.00 5001.07.2021INITIAL CONSULTATION - A one-on-one initial consultation in the treatment of a 5001.07.2021work-related injury or condition, or the first consultation in a new episode 5001.07.2021of care for the same work-related injury or condition. Services to be 5001.07.2021conducted in accordance with the Clinical Framework for the Delivery of Health 5001.07.2021Services2. Initial consultation may include: subjective assessment objective 5001.07.2021assessment treatment/service tailored goal setting and treatment planning 5001.07.2021setting expectations of recovery and return to work clinical recording 5001.07.2021communication (with referrer) any relevant information for the workers 5001.07.2021rehabilitation to the insurer. 100060001601.07.2021 O Y Y 2001.07.202100080.0000000.0000000.00 5001.07.2021SUBSEQUENT CONSULTATION - A one-on-one subsequent consultation in the 5001.07.2021treatment of one work-related injury or condition only. The first five (5) 5001.07.2021consultations (including initial consultation) are pre-approved, provided the 5001.07.2021injury has not previously been treated by an allied health provider. If 5001.07.2021additional treatment is required, the provider is expected to submit a 5001.07.2021Provider Management Plan3 (PMP) by the 6th subsequent treatment consultation. 5001.07.2021The PMP should include a comprehensive treatment plan containing: expected 5001.07.2021functional gains, transition of care to self-management; and treatment 5001.07.2021timeframes. Services to be conducted in accordance with the Clinical Framework 5001.07.2021for the Delivery of Health Services2. Subsequent consultation may include: 5001.07.2021ongoing assessment (subjective and objective) intervention/treatment setting 5001.07.2021expectations of recovery and return to work clinical recording communication 5001.07.2021with the insurer of any relevant information for the workers rehabilitation. 100060002001.07.2021 O Y Y 2001.07.202100134.0000000.0000000.00 5001.07.2021INITIAL CONSULTATION (MULTIPLE AREAS) - A one-on-one initial consultation in 5001.07.2021the treatment of two or more entirely separate work-related injuries or 5001.07.2021conditions, or the first consultation in a new episode of care for the same 5001.07.2021two or more separate work-related injuries or conditions. Please note: 5001.07.2021Separate treatment applied to one condition does not affect the symptoms of 5001.07.2021the other injury; must relate to the work- related injury or condition; does 5001.07.2021not include a condition with referred pain to another area; and requires 5001.07.2021workers' compensation certificate detailing each work-related injury or 5001.07.2021condition to be treated. Services to be conducted in accordance with the 5001.07.2021Clinical Framework for Delivery of Health Services2. Initial consultation may 5001.07.2021include: subjective assessment objective assessment treatment/service tailored 5001.07.2021goal setting and treatment planning setting expectations of recovery and 5001.07.2021return to work clinical recording communication with the insurer of any 5001.07.2021relevant information for the workers rehabilitation. 100060005501.07.2021 O Y Y 2001.07.202100111.0000000.0000000.00 5001.07.2021REASSESSMENT OR PROGRAM REVIEW - This reassessment or program review is 5001.07.2021indicated when: the worker has been in active rehabilitation for at least six 5001.07.2021weeks and further treatment is likely; and/or there are new clinical findings 5001.07.2021that might affect ongoing treatment; and/or there is a rapid change in 5001.07.2021worker's status and/or there is no response to current therapeutic 5001.07.2021interventions. A reassessment or program review is a comprehensive assessment 5001.07.2021including: all components of initial consultation a review of the workers 5001.07.2021progress based on established objective measures a recommendation for future 5001.07.2021treatment and management strategies to assist the worker to return to work. A 5001.07.2021reassessment or program review may include referral recommendations to other 5001.07.2021providers, a change in therapy direction or a change on outcome direction 5001.07.2021requiring a new return to work goal. The occupational therapist is expected to 5001.07.2021submit a Provider Management Plan3 (PMP) following the reassessment. 100060017001.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021SPECIFIC OCCUPATIONAL THERAPY ASSESSMENT - Prior approval is required before 5001.07.2021providing this service and justification may be requested by the insurer. This 5001.07.2021service is to be used for assessing specific conditions that cannot be 5001.07.2021adequately assessed, due to the complexity of the condition, within an initial 5001.07.2021consultation 600015 and 600020 for multiple injuries or conditions. The entire 5001.07.2021consultation must be one-on-one with the worker. These may include, but are 5001.07.2021not limited to: extensive burns acquired brain injuries severe spinal cord 5001.07.2021injuries multiple orthopaedic fractures limb amputations crush injuries. This 5001.07.2021service can also be used for the assessment (only) of suitability for entry 5001.07.2021into a Multi-Disciplinary Program or Pain Management Program. The service may 5001.07.2021only be used once by the occupational therapist in the treatment of a 5001.07.2021work-related injury or condition, or the first consultation in a new episode 5001.07.2021of care for the same work-related injury or condition. Maximum one (1) hour. 100060022601.07.2021 H Y Y 2001.07.202100236.0000000.0000000.00 5001.07.2021INDEPENDENT CASE REVIEW - An independent occupational therapist examination 5001.07.2021and report on a worker and is not carried out by the treating occupational 5001.07.2021therapist. The review is requested by the insurer where progress of treatment 5001.07.2021and/or rehabilitation falls outside the plan or expected course of injury 5001.07.2021management. The examination and report provide the insurer with an assessment 5001.07.2021and recommendations for ongoing treatment and prognosis. 100060028701.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021SPECIALISED HAND/UPPER LIMB THERAPY CONSULTATION - Prior approval is required 5001.07.2021before providing this service, unless referred by a medical specialist, then 5001.07.2021the first five (5) consultations are pre-approved. A one-on-one consultation 5001.07.2021and treatment for workers with hand and upper limb work-related injuries or 5001.07.2021conditions (below shoulder level). Treatment offered is considered specialist 5001.07.2021hand therapy provided by a qualified occupational therapist. Further details 5001.07.2021are provided below the tables. Consultations may include: ongoing assessment 5001.07.2021(subjective and objective) intervention/treatment setting expectations of 5001.07.2021recovery and return to work clinical recording communication with the insurer 5001.07.2021of any relevant information for the workers rehabilitation. The occupational 5001.07.2021therapist is expected to submit a Provider Management Plan (PMP) following the 5001.07.2021initial assessment. Maximum one (1) hour. 100060028901.07.2021 O Y Y 2001.07.202100153.0000000.0000000.00 5001.07.2021SUBSEQUENT CONSULTATION - MULTIPLE INJURIES OR CONDITIONS - A one-on-one 5001.07.2021subsequent consultation in the treatment of two or more entirely separate 5001.07.2021work-related injuries or conditions. The first five (5) consultations 5001.07.2021(including initial consultation) are pre-approved, provided the injury has not 5001.07.2021previously been treated by an allied health provider. If additional treatment 5001.07.2021is required, the provider is expected to submit a Provider Management Plan3 5001.07.2021(PMP) by the 6th subsequent treatment consultation. The PMP should include a 5001.07.2021comprehensive treatment plan containing: expected functional gains, transition 5001.07.2021of care to self-management; and treatment timeframes. Services to be conducted 5001.07.2021in accordance with the Clinical Framework for the Delivery of Health 5001.07.2021Services2. Subsequent consultations may include: ongoing assessment 5001.07.2021(subjective and objective) intervention/treatment setting expectations of 5001.07.2021recovery and return to work clinical recording communication with the insurer 5001.07.2021of any relevant information for the workers rehabilitation. 100060029201.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021SPECIFIC OCCUPATIONAL THERAPY INTERVENTION - Prior approval is required before 5001.07.2021providing this service. The insurer may request justification and will 5001.07.2021consider seeking an independent opinion if more than six (6) consultations are 5001.07.2021requested per episode of care. A one-on-one consultation for recommended 5001.07.2021interventions identified during a Specific Occupational Therapist Assessment 5001.07.2021(600170). These may include, but are not limited to: extensive burns acquired 5001.07.2021brain injuries severe spinal cord injuries multiple orthopaedic fractures limb 5001.07.2021amputations crush injuries. Please note: This service is not to be used for 5001.07.2021ongoing consultations within a Multi-Disciplinary Program and/or Pain 5001.07.2021Management Program. This service must not be already classified elsewhere in 5001.07.2021this table of costs. A Provider Management Plan3 (PMP) is to be submitted 5001.07.2021following the initial assessment (600170). Maximum one (1) hour. 100070005101.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021INITIAL CONSULTATION - A one-on-one initial consultation in the treatment of a 5001.07.2021work-related injury or condition, or the first consultation in a new episode 5001.07.2021of care for the same work-related injury or condition. Services to be 5001.07.2021conducted in accordance with the Clinical Framework for the Delivery of Health 5001.07.2021Services2. Initial consultation may include: subjective assessment objective 5001.07.2021assessment treatment/service tailored goal setting and treatment planning 5001.07.2021setting expectations of recovery and return to work clinical recording 5001.07.2021communication with the insurer of any relevant information for the workers 5001.07.2021rehabilitation. 100070005301.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021SUBSEQUENT CONSULTATION - A one-on-one subsequent consultation in the 5001.07.2021treatment of a work-related injury or condition only. If additional treatment 5001.07.2021is required, the provider must submit a Provider Management Plan3 (PMP) after 5001.07.2021the initial consultation and before commencing any treatment consultations. 5001.07.2021The PMP should include a comprehensive treatment plan containing: expected 5001.07.2021functional gains, transition of care to self-management; and treatment 5001.07.2021timeframes. Services to be conducted in accordance with the Clinical Framework 5001.07.2021for the Delivery of Health Services2. Subsequent consultation may include: 5001.07.2021ongoing assessment (subjective and objective) intervention/treatment setting 5001.07.2021expectations of recovery and return to work clinical recording communication 5001.07.2021with the insurer of any relevant information for the workers rehabilitation. 5001.07.2021Maximum one (1) hour. 100070022601.07.2021 H Y Y 2001.07.202100236.0000000.0000000.00 5001.07.2021INDEPENDENT CASE REVIEW - An independent speech pathologist examination and 5001.07.2021report on a worker and is not carried out by the treating speech pathologist. 5001.07.2021The review is requested by the insurer where progress of treatment and/or 5001.07.2021rehabilitation falls outside the plan or expected course of injury management. 5001.07.2021The examination and report provide the insurer with an assessment and 5001.07.2021recommendations for ongoing treatment and prognosis. 100080002801.07.2021 O Y Y 2001.07.202100090.0000000.0000000.00 5001.07.2021INITIAL CONSULTATION - A one-one-one initial consultation in the treatment of 5001.07.2021a work-related injury or condition, or the first consultation in a new episode 5001.07.2021of care for the same work-related injury or condition. Services to be 5001.07.2021conducted in accordance with the Clinical Framework for the Delivery of Health 5001.07.2021Services2. Initial consultation may include: subjective assessment objective 5001.07.2021assessment treatment/service tailored goal setting and treatment planning 5001.07.2021setting expectations of recovery and return to work clinical recording 5001.07.2021communication (with referrer) any relevant information for the workers 5001.07.2021rehabilitation to the insurer. 100080002901.07.2021 O Y Y 2001.07.202100080.0000000.0000000.00 5001.07.2021SUBSEQUENT CONSULTATION - A one-on-one subsequent consultation in the 5001.07.2021treatment of one work-related injury or condition only. The first five (5) 5001.07.2021consultations (including initial consultation) are pre-approved, provided the 5001.07.2021injury has not previously been treated by an allied health provider. If 5001.07.2021additional treatment is required, submit a Provider Management Plan3 (PMP) by 5001.07.2021the 6th subsequent treatment consultation. The PMP should include a 5001.07.2021comprehensive treatment plan containing: expected functional gains, transition 5001.07.2021of care to self-management; and treatment timeframes. Services to be conducted 5001.07.2021in accordance with the Clinical Framework for the Delivery of Health 5001.07.2021Services2. Subsequent consultation may include: ongoing assessment (subjective 5001.07.2021and objective) intervention/treatment setting expectations of recovery and 5001.07.2021return to work clinical recording communication with the insurer of any 5001.07.2021relevant information for the workers rehabilitation. 100080003701.07.2021 O Y Y 2001.07.202100218.0000000.0000000.00 5001.07.2021ORTHOSES - Thermoplastic shell - Intrinsic fore/rearfoot post - single. Prior 5001.07.2021insurer approval is required. 100080003801.07.2021 O Y Y 2001.07.202100425.0000000.0000000.00 5001.07.2021ORTHOSES - Thermoplastic shell - Intrinsic fore/rearfoot post - pair. Prior 5001.07.2021approval from the insurer is required. 100080003901.07.2021 O Y Y 2001.07.202100036.0000000.0000000.00 5001.07.2021INSOLES - Plain - single. Prior insurer approval is required. 100080004001.07.2021 O Y Y 2001.07.202100066.0000000.0000000.00 5001.07.2021INSOLES - Plain - pair. Prior insurer approval is required. 100080004101.07.2021 O Y Y 2001.07.202100076.0000000.0000000.00 5001.07.2021INSOLES - Padded insole - single. Prior insurer approval is required. 100080004201.07.2021 O Y Y 2001.07.202100146.0000000.0000000.00 5001.07.2021INSOLES - Padded insole - pair. Prior insurer approval is required. 100080004301.07.2021 O Y Y 2001.07.202100187.0000000.0000000.00 5001.07.2021INSOLES - Balance inlay - single custom. Prior insurer approval is required. 100080004401.07.2021 O Y Y 2001.07.202100353.0000000.0000000.00 5001.07.2021INSOLES - Balance inlay - pair custom. Prior insurer approval is required. 100080004501.07.2021 O Y Y 2001.07.202100127.0000000.0000000.00 5001.07.2021INSOLES - Balance inlay - Thermo non-cast single. Prior insurer approval is 5001.07.2021required. 100080004601.07.2021 O Y Y 2001.07.202100205.0000000.0000000.00 5001.07.2021INSOLES - Balance inlay - Thermo non-cast pair. Prior insurer approval is 5001.07.2021required. 100080004701.07.2021 O Y Y 2001.07.202100031.0000000.0000000.00 5001.07.2021ORTHOSES - Heel lift - single. Prior insurer approval is required. 100080004801.07.2021 O Y Y 2001.07.202100029.0000000.0000000.00 5001.07.2021ORTHOSES - Extrinsic fore/rear foot post - single. Prior approval from the 5001.07.2021insurer is required. 100080004901.07.2021 O Y Y 2001.07.202100087.0000000.0000000.00 5001.07.2021CAST - Negative impression- single. Prior insurer approval is required. 100080005001.07.2021 O Y Y 2001.07.202100120.0000000.0000000.00 5001.07.2021CAST - Negative impression - pair. Prior insurer approval is required. 100080008401.07.2021 O Y Y 2001.07.202100070.0000000.0000000.00 5001.07.2021INSOLES - Soft tissue supplement - pair. Prior insurer approval is required. 100080022601.07.2021 H Y Y 2001.07.202100236.0000000.0000000.00 5001.07.2021INDEPENDENT CASE REVIEW - This is an independent podiatrist examination and 5001.07.2021report on a worker and is not carried out by the treating podiatrist. The 5001.07.2021review is requested by the insurer where progress of treatment and/or 5001.07.2021rehabilitation falls outside the plan or expected course of injury management. 5001.07.2021The examination and report provide the insurer with an assessment and 5001.07.2021recommendations for ongoing treatment and prognosis. 100080023201.07.2021 O Y Y 2001.07.202100055.0000000.0000000.00 5001.07.2021ORTHOSES - Extrinsic fore/rear foot post - pair. Prior insurer approval is 5001.07.2021required. 100080028301.07.2021 O Y Y 2001.07.202100037.0000000.0000000.00 5001.07.2021INSOLES - Covers - plain. Prior insurer approval is required. 100080028401.07.2021 H Y Y 2001.07.202100189.0000000.0000000.00 5001.07.2021NAIL REMOVAL - Nail removal under local anaesthetic. Prior insurer approval is 5001.07.2021required. 100090000601.07.2021 O Y Y 2001.07.202100080.0000000.0000000.00 5001.07.2021SUBSEQUENT CONSULTATION - A one-on-one subsequent consultation in the 5001.07.2021treatment of one work-related injury or condition only. The first five (5) 5001.07.2021consultations (including initial consultation) are pre-approved, provided the 5001.07.2021injury or condition has not previously been treated by an allied health 5001.07.2021provider. If additional treatment is required, submit a Provider Management 5001.07.2021Plan3 (PMP) by the 6th subsequent treatment consultation. The PMP should 5001.07.2021include a comprehensive treatment plan containing: expected functional gains, 5001.07.2021transition of care to self-management; and treatment timeframes. Services to 5001.07.2021be conducted in accordance with the Clinical Framework for the Delivery of 5001.07.2021Health Services2. Subsequent consultation may include: ongoing assessment 5001.07.2021(subjective and objective) intervention/treatment setting expectations of 5001.07.2021recovery and return to work clinical recording communication with the insurer 5001.07.2021of any relevant information for the workers rehabilitation. 100090002101.07.2021 O Y Y 2001.07.202100090.0000000.0000000.00 5001.07.2021INITIAL CONSULTATION - A one-on-one initial consultation in the treatment of a 5001.07.2021work-related injury or condition, or the first consultation in a new episode 5001.07.2021of care for the same work-related injury or condition. Services to be 5001.07.2021conducted in accordance with the Clinical Framework for the Delivery of Health 5001.07.2021Services2. Initial consultation may include: subjective assessment objective 5001.07.2021assessment treatment/service tailored goal setting and treatment planning 5001.07.2021setting expectations of recovery and return to work clinical recording 5001.07.2021communication (with referrer) any relevant information for the workers 5001.07.2021rehabilitation to the insurer. 100090005501.07.2021 O Y Y 2001.07.202100111.0000000.0000000.00 5001.07.2021REASSESSMENT OR PROGRAM REVIEW - A one-one-one comprehensive assessment used 5001.07.2021when: the worker has been in active rehabilitation for at least six weeks and 5001.07.2021further treatment is likely; and/or there are new clinical findings that might 5001.07.2021affect ongoing treatment; and/or there is a rapid change in worker's status 5001.07.2021and/or there is no response to current therapeutic interventions. It should 5001.07.2021include: all components of initial consultation a review of the workers 5001.07.2021progress based on established objective measures a recommendation for future 5001.07.2021treatment and management strategies to assist the worker to return to work. It 5001.07.2021may include referral recommendations to other providers, a change in therapy 5001.07.2021or outcome direction requiring a new return to work goal. Following 5001.07.2021reassessment submit a Provider Management Plan3 (PMP) which should include an 5001.07.2021updated comprehensive treatment plan containing: expected functional gains, 5001.07.2021transition of care to self-management; and treatment timeframes. 100090010201.07.2021 O Y Y 2001.07.202100153.0000000.0000000.00 5001.07.2021SUBSEQUENT CONSULTATION - MULTIPLE INJURIES OR CONDITIONS - A one-on-one 5001.07.2021subsequent consultation in the treatment of two or more entirely separate 5001.07.2021work-related injuries or conditions. The first five (5) consultations 5001.07.2021(including initial consultation) are pre-approved, provided the injury or 5001.07.2021condition has not previously been treated by an allied health provider. If 5001.07.2021additional treatment is required, submit a Provider Management Plan3 (PMP) by 5001.07.2021the 6th subsequent treatment consultation. The PMP should include a 5001.07.2021comprehensive treatment plan containing: expected functional gains, transition 5001.07.2021of care to self-management; and treatment timeframes. Services to be conducted 5001.07.2021in accordance with the Clinical Framework for the Delivery of Health 5001.07.2021Services2. Subsequent consultation may include: ongoing assessment (subjective 5001.07.2021and objective) intervention/treatment setting expectations of recovery and 5001.07.2021return to work clinical recording communication with the insurer of any 5001.07.2021relevant information for the workers rehabilitation. 100090022601.07.2021 H Y Y 2001.07.202100236.0000000.0000000.00 5001.07.2021INDEPENDENT CASE REVIEW - An independent osteopathy examination and report on 5001.07.2021a worker and is not carried out by the treating osteopath. The review is 5001.07.2021requested by the insurer where progress of treatment and/or rehabilitation 5001.07.2021falls outside the plan or expected course of injury management. The 5001.07.2021examination and report provide the insurer with an assessment and 5001.07.2021recommendations for ongoing treatment and prognosis. 100090031301.07.2021 O Y Y 2001.07.202100134.0000000.0000000.00 5001.07.2021INITIAL CONSULTATION- - MULTIPLE INJURIES OR CONDITIONS - A one-on-one initial 5001.07.2021consultation in the treatment of two or more entirely separate work-related 5001.07.2021injuries or conditions, or the first consultation in a new episode of care for 5001.07.2021the same two or more entirely separate work-related injuries or conditions. 5001.07.2021Please note: this does not include an injury or condition with referred pain 5001.07.2021to another area, and a workers' compensation certificate detailing each 5001.07.2021work-related injury or condition to be treated is required. Services to be 5001.07.2021conducted in accordance with the Clinical Framework for the Delivery of Health 5001.07.2021Services2. Initial consultation may include: subjective assessment objective 5001.07.2021assessment treatment/service tailored goal setting and treatment planning 5001.07.2021setting expectations of recovery and return to work clinical recording 5001.07.2021communication with the insurer of any relevant information for the workers 5001.07.2021rehabilitation.