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Changes to medical fees for 1 December 2016

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WorkCover Queensland has reviewed and updated the medical fees applicable for workers’ compensation in Queensland. This will affect the medical schedule of fees and supplementary table of costs for GPs and specialists.

The majority of fees have increased to align with the current Australian Medical Association (AMA) List of Medical Services and Fees and the Medicare Benefits Schedule (MBS). The new fees will apply from 1 December 2016.

You can access the updated fees on our Medical fees page. If you have any queries, please call us on 1300 362 128. For individual workers’ compensation questions, such as payment of invoices, please contact the relevant insurer (WorkCover or the self-insurer).

Updates to supplementary table of costs

The supplementary table of costs for both GPs and specialists provide for item codes that fall outside the MBS and are utilised by workers’ compensation insurers, such as independent medical examination (IME) fees. The following are some key changes that have been made in the GP and specialist table of costs for 1 December 2016.

Permanent impairment (PI) Assessments

Item code 100803 (Specialist) and 100210 (GP) have been included within the table of costs for PI reports that are received by the insurer after 10 working days. The reduced fee is in line with other report request item codes and the Queensland Guide, 2nd edition paragraph 1.51, which states: “Reports are to be provided within ten working days of the assessment being completed, or as agreed between the referrer and the assessor”. Further information is provided in the details section of the table of costs.

Item 100209 / 100802 – Permanent Impairment (PI) Assessment: Received by insurer within 10 working days - $784.00

Item 100210 / 100803 – Permanent Impairment (PI) Assessment: Received by insurer after 10 working days - $392.00

Psychiatrist Telehealth Consultations

Separate item codes have been included within the Specialist Supplementary services table of costs for telehealth consultations that are associated with a  report. Insurer prior approval is required and is intended for the introduction of Independent Medical Examination (IME) consultations conducted by telehealth, specifically in circumstances where there is lack of access to local psychiatrists.

Item 100369: Psychiatrist – telehealth consultation between 45-75 mins - $405.00

Item 100302: Psychiatrist – telehealth consultation more than 75 mins - $511.00

Last updated
29 May 2017