Workers' Compensation and Injury Management (Scales of Fees) Amendment Regulations 2009 (WA)
!200900196GG!
WESTERN 4343 AUSTRALIAN GOVERNMENT
| ISSN 1448-949X | PRINT POST APPROVED PP665002/00041 |
PERTH, FRIDAY, 30 OCTOBER 2009 No. 196 SPECIAL PUBLISHED BY AUTHORITY JOHN A. STRIJK, GOVERNMENT PRINTER AT 3.45 PM
© STATE OF WESTERN AUSTRALIA
WORKERS’ COMPENSATION AND INJURY MANAGEMENT
ACT 1981
_________
WORKERS’ COMPENSATION AND INJURY MANAGEMENT
(SCALES OF FEES)
AMENDMENT
REGULATIONS 2009
30 October 2009 GOVERNMENT GAZETTE, WA 4345
Workers’ Compensation and Injury Management Act 1981
Workers’ Compensation and Injury
Management (Scales of Fees) Amendment
Regulations 2009
Made by the Governor in Executive Council, on the recommendation of
WorkCover WA, under section 292 of the Act.1. Citation
These regulations are the Workers’ Compensation and Injury Management (Scales of Fees) Amendment Regulations 2009.
2. Commencement
These regulations come into operation as follows —
(a) regulations 1 and 2 — on the day on which these regulations are published in the Gazette; (b) the rest of the regulations — on 1 November 2009.
3. Regulations amended
These regulations amend the Workers’ Compensation and Injury
Management (Scales of Fees) Regulations 1998.
4. Regulation 6 amended
In regulation 6(1) delete “$187.70” and insert:
$196.35
4346 GOVERNMENT GAZETTE, WA 30 October 2009 Workers’ Compensation and Injury Management (Scales of Fees)
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5. Regulation 6A amended
In regulation 6A delete “$187.70” and insert:
$196.35
6. Regulation 7A amended
In regulation 7A delete “$59.40” and insert:
$62.15
7. Regulation 8 amended
In regulation 8 delete “$140.20” and insert:
$146.65
8. Schedule 1 amended
(1) In Schedule 1 Part 1 delete the passage that begins with
“GENERAL PRACTITIONER” and ends immediately before
“ANAESTHETISTS” and insert:GENERAL PRACTITIONER
CONSULTATIONS Surgery Consultation in hours
Content based
Minor or Specific Service (Level A or B) $61.05 Extended Service (Level C) $111.55
30 October 2009 GOVERNMENT GAZETTE, WA 4347 Workers’ Compensation and Injury Management (Scales of Fees)
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Comprehensive Service (Level D) $171.45 Time based
up to 5 minutes $36.40 more than 5 minutes to 15 minutes $47.50 more than 15 minutes to 30 minutes $91.65 more than 30 minutes to 45 minutes $138.60 more than 45 minutes to 60 minutes $187.85
Surgery Consultations
out of hours
For attendances between the hours of 6 p.m. and 8 a.m. on a weekday or between 12 noon on Saturday and 8 a.m. on the following Monday, and Public Holiday.
Content based
Minor Service (Level A) $45.80 Specific Service (Level B) $91.65 Extended Service (Level C) $166.85 Comprehensive Service (Level D) $258.30
Time based
up to 5 minutes $72.55 more than 5 minutes to 15 minutes $78.70 more than 15 minutes to 30 minutes $122.05 more than 30 minutes $166.85
VISITS
Consultations at a place other than the Consulting Rooms
in hours
Minor Service (Level A) $76.40
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Specific Service (Level B) $104.45 Extended Service (Level C) $155.00 Comprehensive Service (Level D) $216.05
out of hours
Minor Service (Level A) $91.65 Specific Service (Level B) $136.25 Extended Service (Level C) $209.05 Comprehensive Service (Level D) $305.35
TELEPHONE CONSULTATIONS
Time based
up to 5 minutes $20.40 more than 5 minutes to 15 minutes $25.50 more than 15 minutes to 30 minutes $53.40 more than 30 minutes $80.00
CASE CONFERENCES, discussions with employers/insurers,
rehabilitation providers, workplace assessments, etc.
per hour $229.65 TRAVELLING FEES
Rate per kilometre $4.10
30 October 2009 GOVERNMENT GAZETTE, WA 4349 Workers’ Compensation and Injury Management (Scales of Fees)
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PHYSICIANS, OCCUPATIONAL & REHABILITATION
PHYSICIANS
PHYSICIANS
CONSULTATIONS
Professional attendance at consulting rooms and issue of certificate (if required) et al
first attendance $231.85 subsequent attendances $116.00 VISITS
Professional attendance at a place other than consulting rooms and issue of certificate (if required) et al
first attendance $277.70 subsequent attendances $160.25 REHABILITATION PHYSICIANS
CONSULTATIONS
Professional attendance at consulting rooms and issue of certificate (if required) et al
first attendance $231.85 subsequent attendances $116.00 VISITS
Professional attendance at a place other than consulting rooms and issue of certificate (if required) et al
first attendance $277.70 subsequent attendances $160.25
4350 GOVERNMENT GAZETTE, WA 30 October 2009 Workers’ Compensation and Injury Management (Scales of Fees)
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CONSULTATIONS
Professional attendance at consulting rooms and issue of certificate (if required) et al
first attendance $235.70 subsequent attendances $116.00 VISITS
Professional attendance at a place other than consulting rooms and issue of certificate (if required) et al
first attendance $277.70 subsequent attendances $160.25 TELEPHONE CONSULTATIONS
Time based
up to 5 minutes $30.45 more than 5 minutes to 15 minutes $37.55 more than 15 minutes to 30 minutes $78.45 more than 30 minutes $118.45
CASE CONFERENCES, discussions with employers/insurers,
rehabilitation providers, workplace assessments, etc.
per hour $340.55 TRAVELLING FEES
Rate per kilometre $4.10
30 October 2009 GOVERNMENT GAZETTE, WA 4351 Workers’ Compensation and Injury Management (Scales of Fees)
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CONSULTANT PSYCHIATRISTS
CONSULTATIONS
Professional attendance at consulting rooms and issue of certificate (if required) et al
Time based
up to 15 minutes $68.00 more than 15 minutes to 30 minutes $135.70 more than 30 minutes to 45 minutes $203.25 more than 45 minutes to 60 minutes $271.90 more than 60 minutes to 75 minutes $307.70 more than 75 minutes $343.45
VISITS
Professional attendance at a place other than consulting
rooms and issue of certificate (if required) et alVisits include both attendance at hospitals and home visits
Time based
up to 15 minutes $111.65 more than 15 minutes to 30 minutes $180.35 more than 30 minutes to 45 minutes $246.10 more than 45 minutes to 75 minutes $314.85 more than 75 minutes $379.35
TELEPHONE CONSULTATIONS
Time based
up to 45 minutes $90.20 more than 45 minutes $197.00
CASE CONFERENCES, discussions with employers/insurers,
rehabilitation providers, workplace assessments, etc.
per hour $340.55
4352 GOVERNMENT GAZETTE, WA 30 October 2009 Workers’ Compensation and Injury Management (Scales of Fees)
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Rate per kilometre $4.10 SPECIALISTS
SURGEONS
CONSULTATIONS
Professional attendance at consulting rooms and issue of certificate (if required) et al
first attendance $131.85 subsequent attendances $68.75 VISITS
Professional attendance at a place other than consulting rooms and issue of certificate (if required) et al
first attendance $177.70 subsequent attendances $113.25 DERMATOLOGISTS
CONSULTATIONS
Professional attendance at consulting rooms and issue of certificate (if required) et al
first attendance $131.85 subsequent attendances $68.75 VISITS
Professional attendance at a place other than consulting rooms and issue of certificate (if required) et al
first attendance $177.40 subsequent attendances $113.05
30 October 2009 GOVERNMENT GAZETTE, WA 4353 Workers’ Compensation and Injury Management (Scales of Fees)
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TELEPHONE CONSULTATIONS
Time based
up to 5 minutes $30.45 more than 5 minutes to 15 minutes $37.55 more than 15 minutes to 30 minutes $78.45 more than 30 minutes $118.45
CASE CONFERENCES, discussions with employers/insurers,
rehabilitation providers, workplace assessments, etc.
per hour $340.55 TRAVELLING FEES
Rate per kilometre $4.10 (2) In Schedule 1 Part 1 in the item headed “ANAESTHETISTS”
delete “$65.55” and insert:$68.55 (3) Delete Schedule 1 Parts 2 and 3 and insert: Part 2 — Medical procedures
Type of procedure Fee
$GENERAL Localised burns 50.90 Localised burns, including dressing of, under general anaesthetic 144.85 Extensive burns 87.80 Extensive burns, including dressing of, under general anaesthetic 306.55
4354 GOVERNMENT GAZETTE, WA 30 October 2009 Workers’ Compensation and Injury Management (Scales of Fees)
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Type of procedure Fee
$
Dressing of wounds, under general anaesthetic 144.85 Acupuncture, including consultation 67.55 DISLOCATIONS
closed reduction means non-operative reduction of the dislocation, and included percutaneous fixation and/or external splintage by cast or splint.
open reduction means treatment by either closed
reduction and intra-medullary fixation or treatment
by operative exposure of the dislocation includinginternal or external fixation.
other means treatment by any other method and
includes the use of external splintage.
[Where injuries are associated with a compound (open)
wound, an additional fee of 50% of the fee listed is toapply.]
Elbow, by closed reduction 273.10 Elbow, by open reduction 362.20 Interphalangeal joint, by closed reduction 117.10 Interphalangeal joint, by open reduction 156.10 Mandible, by closed reduction 97.60 Clavicle, by closed reduction 115.75 Clavicle, by open reduction 234.10 Shoulder, not requiring general anaesthetic 130.25 Shoulder, by open reduction, with general anaesthetic 466.85 Shoulder, other, with general anaesthetic 231.25 Metacarpophalangeal joint, by closed reduction 156.10 Metacarpophalangeal joint, by open reduction 209.05
30 October 2009 GOVERNMENT GAZETTE, WA 4355 Workers’ Compensation and Injury Management (Scales of Fees)
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Type of procedure Fee
$Patella, by closed reduction 175.50 Patella, by open reduction 234.10 Radioulnar joint, by closed reduction 273.10 Radioulnar joint, by open reduction 362.20 Toe, by closed reduction 97.60 Toe, by open reduction 129.60 REMOVAL OF FOREIGN BODIES — as independent procedure
42.45
superficial 189.45 deep tissue or muscle 529.55 ear, other than by syringing 136.50 nose, other than by simple probing 136.50 cornea or sclera, embedded 139.35 FRACTURES
closed reduction means non-operative reduction of
the fracture, and included percutaneous fixationand/or external splintage by cast or splint.
open reduction means treatment by either closed
reduction and intra-medullary fixation or treatment
by operative exposure of the fracture includinginternal or external fixation.
other means treatment by any other method and
includes the use of external splintage.
[Where injuries are associated with a compound (open)
wound, an additional fee of 50% of the fee listed is toapply.]
Distal phalanx of finger or thumb fracture, by closed reduction
175.50
4356 GOVERNMENT GAZETTE, WA 30 October 2009 Workers’ Compensation and Injury Management (Scales of Fees)
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Type of procedure Fee
$
fracture, intra-articular, by closed reduction 203.45 fracture, by open reduction 234.10 fracture, intra-articular, by open reduction 292.60 Middle phalanx of finger
fracture, by closed reduction 264.75 fracture, intra-articular, by closed reduction 299.50 fracture, by open reduction 348.30 fracture, intra-articular, by open reduction 438.85 Proximal phalanx of finger or thumb
fracture, by closed reduction 348.30 fracture, intra-articular, by closed reduction 410.90 fracture, by open reduction 466.85 fracture, intra-articular, by open reduction 585.20 Metacarpal
fracture, by closed reduction 348.30 fracture, intra-articular, by closed reduction 410.90 fracture, by open reduction 466.85 fracture, intra-articular, by open reduction 585.20 Carpal Scaphoid, by open reduction 780.25 Carpal Scaphoid, other 348.30 Carpus (excluding Scaphoid), by open reduction 487.60 Carpus (excluding Scaphoid), other 195.05 Radius by closed management 390.05 by open management 780.25
30 October 2009 GOVERNMENT GAZETTE, WA 4357 Workers’ Compensation and Injury Management (Scales of Fees)
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Type of procedure Fee
$Radius or Ulnar, distal end, (Colies’, Smith’s or
Barton’s)by closed reduction 585.20 by open reduction Ribs (1 or more), each attendance
780.25
89.30 Tibia, plateau of, medial or lateral by closed reduction
703.65
by open reduction Tibia, plateau of, medial and lateral
933.45
by closed reduction 1 170.30 by open reduction 1 567.40 SUTURES
face or neck, less than 7 cm, superficial 139.35 face or neck, less than 7 cm, deep 211.75 face or neck, more than 7 cm, superficial 211.75 face or neck, more than 7 cm, deep 362.20 except face or neck, less than 7 cm, superficial 105.85 except face or neck, less than 7 cm, deep 158.85 except face or neck, more than 7 cm, superficial 158.85 except face or neck, more than 7 cm, deep 348.30 AMPUTATIONS Hand, midcarpal or transmetacarpal 529.55 Hand, forearm or through arm 613.05
4358 GOVERNMENT GAZETTE, WA 30 October 2009 Workers’ Compensation and Injury Management (Scales of Fees)
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Type of procedure Fee
$
At shoulder 1 037.90 Interscapulothoracic 2 061.95 One digit of foot 278.55 Two digits of one foot 418.00 Three digits of one foot 564.25 Four digits of one foot 703.65 Five digits of one foot 842.90 Toe including metatarsal or part of metatarsal — each
toe 328.90 Foot, at ankle 613.05 Foot, midtarsal or transmetatarsal 529.55 Through thigh, at knee or below knee 905.70 At hip 1 274.70 ASSISTANCE AT OPERATIONS combination of operations) is to be related to the fee listed for the operation (or series or combination of operations) itself.
The fee is 20% of the total fee or the minimum sum of
$175.50, whichever is greater.
30 October 2009 GOVERNMENT GAZETTE, WA 4359 Workers’ Compensation and Injury Management (Scales of Fees)
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USE OF PRIVATE THEATRES
A theatre fee of $105.85 will be paid to practitioners for the use of their private theatre, but this fee may only be charged if the patient would otherwise have been sent to hospital.
Part 3 — Diagnostic Imaging Services
ULTRASOUND
MBS item number Fee (1 November 2008) $ 55028 170.65 55029 59.20 55030 170.65 55031 59.20 55032 170.65 55033 59.20 55036 174.05 55037 59.20 55038 170.65 55039 59.20 55044 174.05 55045 59.20 55048 170.65 55049 59.20 55054 170.65 55070 153.65 55073 53.20 55076 170.65
4360 GOVERNMENT GAZETTE, WA 30 October 2009 Workers’ Compensation and Injury Management (Scales of Fees)
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MBS item number Fee (1 November 2008) $ 55079 59.20 55084 153.65 55085 53.20 55113 360.75 55114 360.75 55115 360.75 55116 401.15 55117 401.15 55118 430.85 55130 265.95 55135 553.05 55238 265.05 55244 265.05 55246 265.05 55248 265.05 55252 265.05 55274 265.05 55276 265.05 55278 265.05 55280 265.05 55282 265.05 55284 265.05 55292 265.05 55294 265.05 55296 173.75
30 October 2009 GOVERNMENT GAZETTE, WA 4361 Workers’ Compensation and Injury Management (Scales of Fees)
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MBS item number Fee (1 November 2008) $ 55600 170.65 55603 170.65 55700 93.75 55703 54.75 55704 109.50 55705 54.75 55706 156.45 55707 109.50 55708 54.75 55709 59.45 55712 179.85 55715 62.55 55718 156.45 55721 179.85 55723 59.45 55725 62.55 55729 42.60 55731 153.35 55733 54.75 55736 198.60 55739 89.10 55759 234.60 55762 93.75 55764 250.20 55766 101.60
4362 GOVERNMENT GAZETTE, WA 30 October 2009 Workers’ Compensation and Injury Management (Scales of Fees)
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MBS item number Fee (1 November 2008) $ 55768 234.60 55770 93.75 55772 250.20 55774 101.60 55800 170.65 55802 59.20 55804 170.65 55806 59.20 55808 170.65 55810 59.20 55812 170.65 55814 59.20 55816 170.65 55818 59.20 55820 170.65 55822 59.20 55824 170.65 55826 59.20 55828 170.65 55830 59.20 55832 170.65 55834 59.20 55836 170.65 55838 59.20 55840 170.65
30 October 2009 GOVERNMENT GAZETTE, WA 4363 Workers’ Compensation and Injury Management (Scales of Fees)
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MBS item number Fee (1 November 2008) $ 55842 59.20 55844 136.60 55846 59.20 55848 170.65 55850 239.05 55852 170.65 55854 59.20 COMPUTED TOMOGRAPHY — EXAMINATION AND REPORT MBS item number Fee (1 November 2008) $ 56001 280.10
56007 359.15
56010 362.05
56013 359.15
56016 416.60
56022 323.20
56028 483.80
56030 323.20
56036 483.80
56041 141.90
56047 181.15
56050 184.20
56053 184.20
56056 223.20
4364 GOVERNMENT GAZETTE, WA 30 October 2009 Workers’ Compensation and Injury Management (Scales of Fees)
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MBS item number Fee (1 November 2008) $ 56062 162.50
56068 241.90
56070 162.50
56076 241.90
56101 330.45
56107 488.50
56141 167.25
56147 246.55
56219 468.55
56220 344.80
56221 344.80
56223 344.80
56224 504.80
56225 504.80
56226 504.80
56227 175.95
56228 175.95
56229 175.95
56230 254.90
56231 254.90
56232 254.90
56233 344.80
56234 504.80
56235 175.90
56236 254.90
30 October 2009 GOVERNMENT GAZETTE, WA 4365 Workers’ Compensation and Injury Management (Scales of Fees)
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MBS item number Fee (1 November 2008) $ 56237 344.80
56238 504.80
56239 175.90
56240 254.90
56259 236.70
56301 423.80
56307 574.50
56341 214.70
56347 290.15
56401 359.15
56407 517.10
56409 359.15
56412 517.10
56441 182.10
56447 260.65
56449 182.10
56452 260.65
56501 553.05
56507 689.50
56541 277.45
56547 350.10
56549 553.05
56551 553.05
56619 316.05
56625 480.70
4366 GOVERNMENT GAZETTE, WA 30 October 2009 Workers’ Compensation and Injury Management (Scales of Fees)
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MBS item number Fee (1 November 2008) $ 56659 161.00
56665 240.50
56801 670.20
56807 804.45
56841 335.20
56847 407.80
57001 670.35
57007 815.55
57041 335.25
57047 407.85
57201 222.90
57247 111.35
57341 675.15
57345 347.05
57350 732.60
57351 732.60
57355 379.45
57356 379.45
DIAGNOSTIC RADIOLOGY MBS item number Fee (1 November 2008) $ 57506 49.35 57509 65.95 57512 67.20 57515 89.55
30 October 2009 GOVERNMENT GAZETTE, WA 4367 Workers’ Compensation and Injury Management (Scales of Fees)
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MBS item number Fee (1 November 2008) $ 57518 53.90 57521 71.95 57524 82.05 57527 109.10 57700 67.20 57703 89.55 57706 53.90 57709 71.95 57712 78.20 57715 101.05 57721 164.65 57901 106.95 57902 106.95 57903 78.45 57906 106.95 57909 107.35 57912 78.20 57915 78.20 57918 78.20 57921 78.20 57924 78.20 57927 82.30 57930 54.55 57933 129.80 57939 106.95
4368 GOVERNMENT GAZETTE, WA 30 October 2009 Workers’ Compensation and Injury Management (Scales of Fees)
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MBS item number Fee (1 November 2008) $ 57942 82.30 57945 71.95 57960 78.65 57963 78.65 57966 78.65 57969 78.65 58100 111.35 58103 91.40 58106 127.70 58108 220.45 58109 78.00 58112 161.35 58115 220.45 58300 66.55 58306 148.30 58500 58.65 58503 78.20 58506 100.85 58509 65.95 58521 71.95 58524 93.70 58527 115.10 58700 76.45 58706 261.90 58715 251.40
30 October 2009 GOVERNMENT GAZETTE, WA 4369 Workers’ Compensation and Injury Management (Scales of Fees)
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MBS item number Fee (1 November 2008) $ 58718 209.25
58721 229.35
58900 59.20
58903 78.90
58909 149.15
58912 182.90
58915 130.90
58916 229.70
58921 224.35
58924 139.45
58927 126.90
58933 341.10
58936 325.10
58939 231.10
59103 35.35
59300 148.45
59303 89.50
59306 166.40
59309 332.70
59312 144.35
59314 87.05
59318 78.05
59503 148.30
59700 160.20
59703 125.90
4370 GOVERNMENT GAZETTE, WA 30 October 2009 Workers’ Compensation and Injury Management (Scales of Fees)
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MBS item number Fee (1 November 2008) $ 59712 188.65
59715 238.15
59718 223.45
59724 375.70
59733 178.65
59736 102.85
59739 122.45
59751 230.85
59754 363.85
59760 191.00
59763 222.15
59903 265.30
59912 506.30
59925 601.20
59970 279.30
59971 95.05
59972 253.15
59973 300.65
59974 139.65
60000 935.60
60003 1 372.10
60006 1 951.05
60009 2 283.20
60012 935.60
60015 1 372.10
30 October 2009 GOVERNMENT GAZETTE, WA 4371 Workers’ Compensation and Injury Management (Scales of Fees)
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MBS item number Fee (1 November 2008) $ 60018 1 951.05
60021 2 283.20
60024 935.60
60027 1 372.10
60030 1 951.05
60033 2 283.20
60036 935.60
60039 1 372.10
60042 1 951.05
60045 2 283.20
60048 935.60
60051 1 372.10
60054 1 951.05
60057 2 283.20
60060 935.60
60063 1 372.10
60066 1 951.05
60069 2 283.20
60072 79.85
60075 159.40
60078 239.25
60100 100.85
60500 71.95
60503 49.35
60506 105.75
4372 GOVERNMENT GAZETTE, WA 30 October 2009 Workers’ Compensation and Injury Management (Scales of Fees)
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MBS item number Fee (1 November 2008) $ 60509 164.00
60918 78.20
60927 63.15
61109 429.50
NUCLEAR MEDICINE IMAGING MBS item number Fee (1 November 2008) $ 61302 573.55
61303 722.30
61306 906.80
61307 1 066.85
61310 469.35
61313 387.65
61314 536.65
61316 487.10
61317 629.15
61320 292.50
61328 290.90
61340 323.25
61348 566.50
61352 331.35
61353 493.95
61356 501.90
61360 515.40
61361 589.60
30 October 2009 GOVERNMENT GAZETTE, WA 4373 Workers’ Compensation and Injury Management (Scales of Fees)
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MBS item number Fee (1 November 2008) $ 61364 635.05
61368 285.10
61369 2 575.60
61372 285.10
61373 625.65
61376 183.20
61381 733.80
61383 798.45
61384 878.70
61386 424.90
61387 550.40
61389 473.45
61390 523.85
61393 773.65
61397 315.40
61401 207.40
61402 773.15
61405 442.10
61409 1 116.15
61413 288.70
61417 151.85
61421 613.10
61425 767.50
61426 708.85
61429 693.80
4374 GOVERNMENT GAZETTE, WA 30 October 2009 Workers’ Compensation and Injury Management (Scales of Fees)
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MBS item number Fee (1 November 2008) $ 61430 842.60
61433 635.05
61434 786.35
61437 693.60
61438 859.90
61441 625.65
61442 961.40
61445 366.40
61446 426.25
61449 582.90
61450 507.95
61453 657.65
61454 444.75
61457 601.10
61458 507.15
61461 674.40
61462 166.45
61465 339.20
61469 444.75
61473 224.05
61480 494.30
61484 1 125.60
61485 1 276.70
61495 285.10
61499 323.25
61650 1 122.70
30 October 2009 GOVERNMENT GAZETTE, WA 4375 Workers’ Compensation and Injury Management (Scales of Fees)
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MAGNETIC RESONANCE IMAGING
MBS item number Fee (1 November 2008) $ 63000-63200 1 161.35 63201 1 248.05 63202-63203 832.05 63204 1 248.05 63219-63243 1 248.05 63271-63473 832.05 63491-63494 95.10 63497 285.55 9. Schedules 2, 3, 4, 5, 5A and 6 replaced
Delete Schedules 2, 3, 4, 5, 5A and 6 and insert:
Schedule 2 — Scale of fees — physiotherapists
[r. 3]
Part 1 — General
Service Service Code PA001
Initial Consultation Set Fee A consultation with the physiotherapist including $68.00 the following elements — Subjective assessment — of the following points
as required:Major symptoms and lifestyle dysfunction; current history and treatment; past history and treatment; pain, 24-hour behaviour, aggravating and relieving factors; general health, medication, risk factors.
4376 GOVERNMENT GAZETTE, WA 30 October 2009 Workers’ Compensation and Injury Management (Scales of Fees)
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Service Service Code Objective assessment — of the following points
as required:Movement — active, passive, resisted, repeated;
muscle tone, spasm, weakness; accessory
movements, passive intervertebral movements etc.
Appropriate procedures/tests as indicated.Appropriate initial management, treatment or advice — based on assessment findings that could include the following as required: Provisional diagnosis; goals of treatment;
treatment plan. Discussion with the patient
regarding working hypothesis and treatment goals
and expected outcomes; initial treatment and
response; advice regarding home care including
any exercise programs to be followed.Documentation of consultation — as required
that could include:The assessment findings, physiotherapy
intervention(s), evaluation of interventions, plan
for future treatment and results of other relevant
tests and warnings (if applicable).Includes:
• or hospital; hydrotherapy treatment;
Individual services provided in rooms, home outside of normal business hours.
• Courtesy communication by the
physiotherapist with the medical practitioner
such as acknowledgement of referral.•
The physiotherapist’s brief communication with the medical practitioner regarding the injured worker’s management.
30 October 2009 GOVERNMENT GAZETTE, WA 4377 Workers’ Compensation and Injury Management (Scales of Fees)
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Service Service Code Does not include:
•
Any oral or written communication by the physiotherapist with a third party initiated by or requested by the insurer and/or the employer relating to the treatment or rehabilitation of a specific worker (such as suitable work duties).
•
Communication by the physiotherapist with a third party initiated by or requested by the insurer and/or the employer. This service has
a specific item number in this Table
(PK001).
• conferences. The physiotherapist’s
Physiotherapist’s involvement in case specific item number in this Table (PQ001).
PB001 Standard Consultation Set Fee Consultation for one body area or condition $54.60 including the following elements —
• subjective re-assessment; • objective re-assessment; • appropriate management, intervention or
advice;• documentation of consultation. Includes:
• or hospital; hydrotherapy treatment;
Individual services provided in rooms, home outside of normal business hours.
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Service Service Code
• Courtesy communication by the written updates to the medical practitioner.
Does not include:
• Any oral or written communication by the physiotherapist with a third party initiated by or requested by the insurer and/or the employer relating to the treatment or rehabilitation of a specific worker (such as suitable work duties). • Communication by the physiotherapist with a third party initiated by or requested by the insurer and/or the employer has a specific item number in this Table (PK001).
• conferences. The physiotherapist’s
The physiotherapist’s involvement in case specific item number in this Table (PQ001).
PC001 Two distinct areas of treatment per visit Set Fee Same description as PB001 except relates to the $69.05 treatment/management of 2 distinct
areas/conditions.PG001 Group Consultation — per person Cost per participant Includes non-individualised services provided to $16.80 more than one individual whether —
• in rooms, home or hospital; • hydrotherapy treatment; • extended treatments; •
services provided outside of normal business hours.
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Service Service Code PE001
Worksite Visit — prior approval from insurer Hourly required. rate** Prior to a worksite evaluation, consideration of $155.10 details such as relevance to injury; intended
outcomes; likely duration and reporting
requirements should be made and discussed with
the insurer with a suggested maximum duration of
2 hours.Does not include reports or travel. PR001 Reports Any report relating to a specific worker required by or requested by —
• medical specialist; • medical practitioner; • employer; • insurer. Excludes courtesy communication such as acknowledgement of referral and brief updates to the medical practitioner.
Progress/Standard report Set Fee Report should contain summarised information or $68.00 assessment findings, treatment services provided,
results obtained with specific recommendations
for further management and return to work if
applicable.
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Service Service Code
Comprehensive report Hourly rate**
As above for progress/standard report and contains $155.10 and interventions performed.
information relating to more detailed assessments report must be discussed with the insurer prior to approval with a suggested maximum duration of 2 hours.
PT001 Travel Hourly Rate** Travel when the most appropriate management of $124.10 from their normal practice. The insurer must
provide pre-approval for travel in excess of one
hour.the patient requires the provider to travel away before leaving a venue, the fee for the journey is to be apportioned equally between workers.
PQ001 Case Conferences Face-to-face or telephone communication $15.60 involving the physiotherapist with one or more of per 6 minute the following — block rehabilitation providers and worker.
doctor, employer, insurer/claims manager, implement, manage or review treatment options and/or rehabilitation plan.
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Service Service Code PK001 Communication
Any requested or required oral communication by $15.60 per the physiotherapist with relevant parties (treating 6 minute medical practitioners, employers and insurers) block relating to the treatment or rehabilitation of a
specific worker.
Excludes courtesy communication such as
acknowledgement of referral and brief updates to
the medical practitioner.
Maximum time allowable per communication of
30 minutes.PS001
Specific Physiotherapy Assessment — prior Hourly approval from insurer required. Rate** Includes specific types of assessments not $155.10 classified elsewhere in these scales required by the
insurer which physiotherapists may undertake
(e.g. diagnostic ultrasound imaging, Functional
Capacity Assessments (FCE’s), seating and
wheelchair assessments).PW001
Specific Physiotherapy Intervention — prior Hourly approval from insurer required (*replaces PD001). Rate** Includes treatments not classified elsewhere in $155.10 these scales required by the insurer which Max duration physiotherapists may undertake (e.g. treatment of of service severe multiple area trauma, burns, neurologically provision injured patients and patients with severe spinal 2 hours injuries, ergonomic corrections of workplace,
specialised real-time ultrasound imaging, short
consultations).** Denotes that where the service provided is a fraction of one hour, the amount
chargeable is to be calculated as that fraction of the maximum amount.
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Part 2 — Exercise-based programs
Type of service Fee
EXE20 Initial Consultation/Assessment
Insurer approval must be obtained prior to $155.10 undertaking the service.
per hour to a maximum
• Review of current medical and vocational of
status. 2 hours**
• Communication/Liaison with relevant
parties.• Physiological Assessment/testing. • Screening Questionnaires relating to
worker’s level of function.• Program design based on above. • Exercise facility/equipment coordination
(pool or gym based).•
Provider to patient ratio must be 1:1 for the duration of the consultation.
EXE21 Subsequent Exercise Consultation/Assessment
Includes — $155.10 per
hour to a
• program implementation — prescription and maximum
provision of exercises (land or pool based);
of one hour**
• program monitoring; •
post program screening questionnaire relating to worker’s level of function;
• psychosocial reassessment; • communication/liaison with relevant parties.
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Type of service Fee
EXE02 Initial report
Includes — $155.10 per
hour to a
• initial assessment report outlining results
(self-reported and objective), maximum recommendations and exercise rehabilitation of one plan; hour**
• current status as per medical certification and proposed outcome status; • detailed cost plan outlining proposed costs for insurer approval.
EXE03 Subsequent reports
Progress report to be provided at the request of the $155.10 per referrer. hour to a
maximum
of
30 minutes
**EXE04 Final report
Comprehensive report to be provided at the end of $155.10 per the service delivery detailing — hour to a
maximum
• physiological testing results pre and post of
program; 30 minutes
• worker attendance/programme compliance. **
EXE05 Gym membership/Entry fees
Includes direct cost of membership (pool or gym). Market Prior approval from insurer required. rates
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Type of service Fee
EXE06 Travel
Travel when the most appropriate management of $124.10 per the patient requires the provider to travel away hour ** The insurer must provide pre-approval for travel in
excess of one hour.from their normal practice. before leaving a venue, the fee for the journey is to be apportioned equally between workers.
EXE08 Communication
Any requested or required oral communication $15.60 with relevant parties (treating medical per practitioners, employers and insurers) relating to 6 minute the treatment of a specific worker. block Excludes courtesy communication such as
acknowledgement of referral and brief updates to
the medical practitioner.
Maximum time allowable per communication of
30 minutes.EXE09 Attendance at Medical Case Conferences
Prior insurer approval must be obtained prior to $155.10 per undertaking the service. hour ** ** Denotes that where the service provided is a fraction of one hour, the amount
chargeable is to be calculated as that fraction of the maximum amount.Schedule 3 — Scale of fees — chiropractors
[r. 4]
Type of service Fee $
1. Initial consultation and examination 53.80 2. Subsequent consultation 44.85
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Type of service Fee $
3. Spinal x-ray, one region 106.85 4. Spinal x-ray, 2 or more regions 160.45 5. Travel (per kilometre) 0.80 Schedule 4 — Scale of fees — occupational
therapists
[r. 5]
Type of Service Fee $
1. Brief consultation (< 15 minutes) 23.20 2. Short consultation (15 minutes to < 30 minutes) 46.55 3. Standard consultation (30 minutes to < 45 minutes) 76.70 4. Extended consultation (45 minutes to < one hour) 115.05 5. Extended consultation ( > one hour) 153.45 6. Standard group consultation (30 minutes) per person 50.35 7.
Travel costs are to be calculated at the hourly rate by the length of time spent travelling.
Schedule 5 — Scale of fees — speech pathologists
[r. 7]
Type of service Fee $
1. Initial consultation/assessment (up to and including
one hour) 141.80 2. Initial consultation/assessment (exceeding
one hour) 183.65
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Type of service Fee $
3. Subsequent consultation (<½ hour) 61.90 4. Subsequent consultation (½ hour – one hour) 80.30 5. Subsequent consultation (>one hour) 108.40 Schedule 5A — Scale of fees — exercise
physiologists
[r. 7B]
Exercise-based programs
Type of service Fee
EXE20 Initial Consultation/Assessment
Insurer approval must be obtained prior to $155.10 undertaking the service.
per hour to a maximum of
• Review of current medical and vocational
status. 2 hours**
• Communication/Liaison with relevant
parties.• Physiological Assessment/testing. • Screening questionnaires relating to
worker’s level of function.• Program design based on above. • Exercise facility/equipment coordination
(pool or gym based).Provider to patient ratio must be 1:1 for the
duration of the consultation.
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Type of service Fee
EXE21 Subsequent Exercise
Consultation/Assessment
Includes — $155.10
per hour to a
• program implementation — prescription
and provision of exercises (land or pool maximum of based); one hour**
• program monitoring; •
post program screening questionnaire relating to worker’s level of function;
• psychosocial reassessment; • communication/liaison with relevant
parties.
EXE02 Initial report
Includes — $155.10
per hour to a
• initial assessment report outlining results
(self-reported and objective), maximum of recommendations and exercise one hour** rehabilitation plan;
• current status as per medical certification and proposed outcome status; • detailed cost plan outlining proposed costs for insurer approval.
EXE03 Subsequent reports
Progress report to be provided at the request of $155.10 the referrer.
per hour to a maximum of 30 minutes**
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Type of service Fee
EXE04 Final report
Comprehensive report to be provided at the end $155.10 of the service delivery detailing —
per hour to a maximum of
• physiological testing results pre and post
program; 30 minutes**
• worker attendance/program compliance.
EXE05 Gym membership/Entry fees
Includes direct cost of membership (pool or Market rates gym). Prior approval from insurer required. EXE06 Travel
Travel when the most appropriate management $124.10 of the patient requires the provider to travel per hour ** The insurer must provide pre-approval for travel
in excess of one hour.away from their normal practice. before leaving a venue, the fee for the journey is to be apportioned equally between workers.
EXE08 Communication
Any requested or required oral communication $15.60 with relevant parties (treating medical per 6 minute practitioners, employers and insurers) relating to block the treatment of a specific worker.
Excludes courtesy communication such as
acknowledgment of referral and brief updates to
the medical practitioner.
Maximum time allowable per communication of
30 minutes.
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Type of service Fee
EXE09 Attendance at Medical Case Conferences
Prior insurer approval must be obtained prior to $155.10 undertaking the service. per hour **
** Denotes that where the service provided is a fraction of one hour, the amount
chargeable is to be calculated as that fraction of the maximum amount.Schedule 6 — Scale of maximum fees — approved
medical specialists
[r. 9]
Part 1 — Assessments
Description of assessment Maximum fee**
1. Examination and provision of report and $1 046.15 (or, if an certificate — straightforward interpreter is present at assessment — other than a service the examination, mentioned in item 4, 5, 6 or 8. $1 307.60 excluding any
fee payable to the
interpreter)2. Examination and provision of report and $1 307.60 (or, if an certificate — moderately complex interpreter is present at assessment (e.g. reviewing multiple the examination, questions and reports; impairment $1 569.15 excluding any involving more complex assessments; fee payable to the more than one body system involved) — interpreter) other than a service mentioned in item 4,
5, 6 or 8.3. Examination and provision of report and $1 569.15 (or, if an certificate — complex assessment interpreter is present at (e.g. multiple injuries; severe the examination, impairment such as spinal cord injury or $1 830.65 excluding any head injury) — other than a service fee payable to the mentioned in item 4, 5, 6 or 8. interpreter)
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Description of assessment Maximum fee**
4. Examination of any of ear, nose and $1 046.15 (or, if an throat only, including audiometric interpreter is present at testing, and provision of report and the examination, certificate — other than a service $1 307.60 excluding any mentioned in item 8. fee payable to the
interpreter)5. Examination and provision of report and $1 569.15 (or, if an certificate — psychiatric — standard interpreter is present at assessment — other than a service the examination, mentioned in item 8. $1 830.65 excluding any
fee payable to the
interpreter)6. Examination and provision of report and $2 615.20 (or, if an certificate — psychiatric — complex interpreter is present at assessment (e.g. reviewing significant the examination, documented prior psychiatric history) — $2 876.70 excluding any other than a service mentioned in item 8. fee payable to the
interpreter)7. Consolidation of written assessments $523.00 from multiple assessors. 8. Re-examination and provision of report $784.55 (or, if an and certificate. interpreter is present at
the examination,
$1 046.15 excluding any
fee payable to the
interpreter)9. Provision of supplementary report and $261.55 certificate. Part 2 — Attempted assessments
Description of circumstances Maximum fee**
1. If a worker who is required under $523.00 Part VII Division 2 of the Act to submit to an examination by an approved
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Description of circumstances Maximum fee** medical specialist does not attend, in a
case in which —(a)
no prior arrangements to cancel the examination are made; or
(b) the examination is cancelled,
otherwise than at the request of the
approved medical specialist, with
less than one working day’s notice.
** Denotes that where the service provided is a fraction of one hour, the amount
chargeable is to be calculated as that fraction of the maximum amount.Recommended by WorkCover WA on the 17th day of September 2009.
The common seal of ) WorkCover WA )
) L.S ) )
MICHELLE REYNOLDS. WENDY ATTENBOROUGH.
By Command of the Governor,
PETER CONRAN, Clerk of the Executive Council.
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