Changes to Medical items table of costs - effective 1 December 2019
WorkCover Queensland has reviewed and updated the table of costs for medical treatment applicable for workers’ compensation in Queensland. The changes are effective 1 December 2019 and impact the Medical items table of costs and the Supplementary services table of costs for GPs and Specialists.
Details of the updated Medical items table of costs are as follows:
MBS item numbers and fees
The Medical Benefits Schedule (MBS) item numbers, explanations, definitions, rules and conditions for services provided by medical practitioners have been adopted and fees have been indexed in line with CPI and Wage Index increases.
Supplementary services table of costs
The supplementary services table of costs for both general practitioners and specialists have also been reviewed for accuracy and appropriateness. These supplementary services table of costs provide for item numbers that fall outside the MBS but are used by workers’ compensation insurers specifically for referred services such as independent medical examinations, case conferences, medical reports and other communication.
Optimising treating services - diagnostic imaging fees
Following extensive research and analysis across jurisdictions, workshops and stakeholder consultations, we have identified a need to review our treating services model to ensure alignment with schemes across Australia to not only deliver better outcomes for our customers, but also to sustain an equitable and viable scheme in Queensland.
Initial investigations have focused on diagnostic imaging and we are consulting with the relevant stakeholders and industry bodies to ensure a fair and equitable fee schedule.
In the meantime, diagnostic imaging fees (x-ray, USS, nuclear imaging, CT and MRI) will temporarily remain unchanged for this 1 December 2019 release. We will update the fee schedule as we progress our research and stakeholder consultation.
Research and analysis will also continue across other medical and allied health services to identify further improvements and we will continue to work with the relevant professional bodies to implement change.
Rules for use
- For spinal surgery: 100% for the item with the greatest WorkCover fee; plus 50% for the item with the next greatest WorkCover fee; plus 25% for each other item (previously 100% / 75% / 75%)
- For hand surgery: 100% for the item with the greatest WorkCover fee; plus 75% for the item with the next greatest WorkCover fee; plus 75% for each other item (previously 100% / 50% / 25%)
Assistance at operations
- Perioperative Nurse Surgical Assistants (PNSA) who are a member of the Australian Association of Nurse Surgical Assistants (AANSA Inc.) can invoice a 15% assistant's fee based on the rules for 'Assistance at operations'.
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
- 21 November 2019