WorkCover Queensland now accepts the services of a Chinese Medicine Practitioner for acupuncture. Chinese Medicine Practitioners must be registered by the Chinese Medicine Board of Australia to be eligible to provide acupuncture services under WorkCover.
Acupuncture should be used with evidence of clinical and functional outcomes to ensure that the injured worker stays at work or returns to work as quickly as possible.
The initial consultation with a Chinese Medicine Practitioner can be billed without prior approval on an accepted and current claim. Any subsequent consultations with a Chinese Medicine Practitioner require prior approval from the insurer. WorkCover will require the practitioner to outline their treatment plan including the clinical and functional outcomes to be achieved by this course of treatment.
Acupuncture needles and accessories are considered items used in the normal course of treatment. They are consumables and will not be paid by WorkCover Queensland.
Other allied health practitioners (e.g. physiotherapists) may provide services that utilise needling techniques e.g. dry needling, trigger point release. These are services which can be incorporated as part of a normal consultation and are not billable separately or as acupuncture services.
Medical practitioners (e.g. GP) are able to bill for acupuncture services under the current Medicare Benefits Scheme.
Massage is widely used by physiotherapists as a therapeutic intervention. Physiotherapists may use massage as part of the normal treatment regime. Massage therapists, remedial massage therapists, and myotherapists are not registered providers in Queensland—therefore we do not pay for these services.
Massage should not be used as a stand-alone treatment and should be used with evidence of clinical and functional outcomes. WorkCover Queensland will pay for massage as part of a normal treatment session by physiotherapists. There are no individual item codes for massage under the table of costs. This must be charged under the standard consultation item codes as appropriate.
Massage oil and creams are considered items used in the normal course of treatment. They are consumables and will not be paid by WorkCover Queensland.
Pilates must be provided by a WorkCover Queensland registered provider or non-registered approved provider. This will include physiotherapists and exercise physiologists. Personal trainers or those accredited by pilates associations are not registered providers, therefore we will not pay for these services.
The registered provider or non-registered approved provider must be providing the service i.e. either individual sessions or as part of a group, where the registered provider or non-registered approved provider is running the group session. This does not include distant supervision for example, in the next room. The provider must supervise the group directly. There can be up to eight members in an exercise group. This may be charged under the standard physiotherapy and exercise physiology consultation item codes or group exercise session item codes as appropriate. This does not fall under initial program development and instruction or program instruction subsequent consultation item codes (100314 and 100402).
Under consultation with the customer advisor, the treating physiotherapist may use the Specific Physiotherapy Assessment item code (100406) to develop the initial pilates program. The use of this item code is not related to time. It is related to the complexity of the injured worker and the interventions required to manage their injury and rehabilitation. This would be appropriate when setting up the initial program where the worker’s injury is complex in nature i.e. multi-trauma, post-operative rehabilitation, chronic pain etc. The use of the specific physiotherapy assessment item code is strictly on a one-on-one basis only.
The Specific Physiotherapy Intervention item code (100407) may be used to provide the ongoing pilates sessions after consultation and approval from the customer advisor. Once again this would be appropriate where the worker’s injury is complex in nature i.e. multi-trauma, post-operative rehabilitation, chronic pain etc. The use of the specific physiotherapy intervention item code is strictly on a one-on-one basis only.
These prior approved clinic sessions must not be undertaken concurrently with pre-approved treatment sessions i.e. if the physiotherapist chooses to use prior approved item codes, they do not have access to the standard seven pre-approved sessions. This would cover the one-on-one sessions, subsequent consultations, and group pilates sessions, but all these sessions must be requested.
Both services require prior approval and the PMP must specify the exact time periods and number of sessions required to provide the service.
Individual treatment sessions with a physiotherapist and pilates sessions should not be provided on the same day (as a general rule). However there may be some travel and work related issues that require two services on the same day e.g. regional locations. If it is unclear whether this is the case, please contact us.
Real time ultrasound imaging (RTUI)
RTUI is a reliable and valid treatment used by physiotherapists to evaluate muscle structure and form, and to examine patterns of muscle activation.
Physiotherapists use RTUI in clinical practice to assess size and activation of deep trunk and neck muscles, and the pelvic floor and associated muscles. It allows for observation of muscle contraction and the resultant tensioning of the fasciae. The ultrasound image is also able to provide direct feedback to the patient on patterns of muscle activation and assist them in the correct activation of these muscles.
RTUI may be used as part of an assessment and as an addition to physiotherapy treatment. The treating physiotherapist may use the Specific Physiotherapy Assessment item code (100406) to provide the initial diagnostic ultrasound session. The treating physiotherapist may use the Specific Physiotherapy Intervention item code (100407) to provide the ongoing therapeutic diagnostic ultrasound sessions.
Both services require prior approval and the PMP must specify the exact time periods and number of sessions required to provide the service. The prior approved clinic sessions must not be undertaken concurrently with pre-approved treatment sessions. If the physiotherapist chooses to use prior approved item codes they do not have access to the standard seven pre-approved sessions. This means that all treatment sessions must be requested on a PMP.
Physiotherapists may choose not to specifically charge for the use of RTUI. In this case it will be covered under standard physiotherapy consultation item codes as appropriate. RTUI for assessment and/or treatment does not warrant the use of Level C or D consultation item codes (100101 /100102) unless it is two or more entirely separate injuries or conditions that are assessed and treated where treatment applied to one condition does not affect the symptoms of other injury. Please refer to the table of costs for the service descriptions.
- Last updated
- 04 November 2016
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