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Changes to medical fees for 1 December 2018

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WorkCover Queensland has reviewed and updated the medical fees applicable for workers’ compensation in Queensland. The changes are effective 1 December 2018 and impact the Medical table of costs and the Supplementary services table of costs for GPs and Specialists.

In this review, WorkCover has taken into account the evidence-based recommendations published by Choosing Wisely Australia and developed by Australia’s peak colleges, societies and associations.

Details of the updated Medical table of costs are as follows:

  • The majority of fees have been increased to align with the current Australian Medical Association (AMA) List of Medical Services and Fees and the Medicare Benefits Schedule (MBS).
  • Fees are indexed according to the AMA Medical Fees Index (MFI) with a loading applied to all MBS codes that do not have a corresponding AMA code.
  • For consistency, fees above the AMA fees list have been realigned where a corresponding AMA service fee is available.
  • The new MBS Spinal Surgery codes released by MBS effective 1 November 2018 have been incorporated in this current release of the Medical table of costs.
  • The ‘Rules for use', updated with key messages and additional information are now available as a stand-alone document. For consistency in methodology, the Multiple Operation Rule has been amended and is now in line with the AMA ruling as follows:
    For surgical procedures: 100 per cent for the item with the greatest WorkCover fee; plus 50 per cent for the item with the next greatest WorkCover fee; plus 25 per cent for each other item.
    For all orthopaedic procedures: 100 per cent for the item with the greatest WorkCover fee; plus 75 per cent of each other item.

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).

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Last updated
28 November 2018