Workers' Compensation and Injury Management (Scales of Fees) Amendment Regulations 2014 (WA)
!2014167GG!
| WESTERN | 4023 |
| AUSTRALIAN | |
| GOVERNMENT | |
| ISSN 1448-949X | PRINT POST APPROVED PP665002/00041 |
PERTH, FRIDAY, 17 OCTOBER 2014 No. 167 SPECIAL PUBLISHED BY AUTHORITY JOHN A. STRIJK, GOVERNMENT PRINTER AT 12.30 PM
© STATE OF WESTERN AUSTRALIA
Workers’ Compensation and Injury Management Act 1981
Workers’ Compensation and Injury
Management (Scales of Fees) Amendment
Regulations 2014
Made by the Administrator 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 2014.
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 2014.
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 “$225.50” and insert:
$231.90
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5. Regulation 6A amended
In regulation 6A delete “$225.50” and insert:
$231.90
6. Regulation 7A amended
In regulation 7A delete “$71.35” and insert:
$73.35
7. Regulation 8 amended
In regulation 8 delete “$168.35” and insert:
$173.10
8. Schedule 1 Part 1 amended
In Schedule 1 Part 1 delete the passage that begins with
“GENERAL PRACTITIONER” and ends immediately before
“CONSULTATIONS AND ATTENDANCES” and insert:
GENERAL PRACTITIONER
CONSULTATIONS Surgery Consultation in hours
Content based
Minor or Specific Service (Level A or B) $72.10
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Extended Service (Level C) $131.75 Comprehensive Service (Level D) $202.40
Time based
up to 5 minutes $43.05 more than 5 minutes to 15 minutes $56.10 more than 15 minutes to 30 minutes $108.25 more than 30 minutes to 45 minutes $163.65 more than 45 minutes to 60 minutes $221.80
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) $54.10 Specific Service (Level B) $108.25 Extended Service (Level C) $197.00 Comprehensive Service (Level D) $305.00
Time based
up to 5 minutes $85.65 more than 5 minutes to 15 minutes $92.95 more than 15 minutes to 30 minutes $144.05 more than 30 minutes $197.00
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VISITS
Consultations at a place other than the Consulting Rooms
in hours
Minor Service (Level A) $90.25 Specific Service (Level B) $123.35 Extended Service (Level C) $183.00 Comprehensive Service (Level D) $255.05
out of hours
Minor Service (Level A) $108.25 Specific Service (Level B) $160.90 Extended Service (Level C) $246.85 Comprehensive Service (Level D) $360.45
TELEPHONE CONSULTATIONS
Time based
up to 5 minutes $24.05 more than 5 minutes to 15 minutes $30.15 more than 15 minutes to 30 minutes $63.10 more than 30 minutes $94.50
CASE CONFERENCES, discussions with employers/insurers,
rehabilitation providers, workplace assessments, etc.
per hour $271.15 TRAVELLING FEES
Rate per kilometre $4.85
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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 $273.75 subsequent attendances $136.95 VISITS
Professional attendance at a place other than consulting rooms and issue of certificate (if required) et al
first attendance $327.80 subsequent attendances $189.15 REHABILITATION PHYSICIANS
CONSULTATIONS
Professional attendance at consulting rooms and issue of certificate (if required) et al
first attendance $273.75 subsequent attendances $136.95 VISITS
Professional attendance at a place other than consulting rooms and issue of certificate (if required) et al
first attendance $327.80 subsequent attendances $189.15
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OCCUPATIONAL PHYSICIANS
CONSULTATIONS
Professional attendance at consulting rooms and issue of certificate (if required) et al
first attendance $278.30 subsequent attendances $136.95 VISITS
Professional attendance at a place other than consulting rooms and issue of certificate (if required) et al
first attendance $327.80 subsequent attendances $189.15 TELEPHONE CONSULTATIONS
Time based
up to 5 minutes $36.00 more than 5 minutes to 15 minutes $44.25 more than 15 minutes to 30 minutes $92.60 more than 30 minutes $139.85
CASE CONFERENCES, discussions with employers/insurers,
rehabilitation providers, workplace assessments, etc.
per hour $402.10 TRAVELLING FEES
Rate per kilometre $4.85
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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 $80.25 more than 15 minutes to 30 minutes $160.20 more than 30 minutes to 45 minutes $239.95 more than 45 minutes to 60 minutes $321.05 more than 60 minutes to 75 minutes $363.30 more than 75 minutes $405.50
VISITS
Professional attendance at a place other than consulting visits
rooms and issue of certificate (if required) et al
Time based
up to 15 minutes $131.85 more than 15 minutes to 30 minutes $212.90 more than 30 minutes to 45 minutes $290.55 more than 45 minutes to 75 minutes $371.70 more than 75 minutes $447.90
TELEPHONE CONSULTATIONS
Time based
up to 45 minutes $106.55 more than 45 minutes $232.55
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CASE CONFERENCES, discussions with employers/insurers,
rehabilitation providers, workplace assessments, etc.
per hour $402.10 TRAVELLING FEES
Rate per kilometre $4.85 SPECIALISTS
SURGEONS
CONSULTATIONS
Professional attendance at consulting rooms and issue of certificate (if required) et al
first attendance $155.65 subsequent attendances $81.20 VISITS
Professional attendance at a place other than consulting rooms and issue of certificate (if required) et al
first attendance $209.75 subsequent attendances $133.75 DERMATOLOGISTS
CONSULTATIONS
Professional attendance at consulting rooms and issue of certificate (if required) et al
first attendance $155.65 subsequent attendances $81.20
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VISITS
Professional attendance at a place other than consulting rooms and issue of certificate (if required) et al
first attendance $209.45 subsequent attendances $133.50 TELEPHONE CONSULTATIONS
Time based
up to 5 minutes $36.00 more than 5 minutes to 15 minutes $44.25 more than 15 minutes to 30 minutes $92.60 more than 30 minutes $139.85
CASE CONFERENCES, discussions with employers/insurers,
rehabilitation providers, workplace assessments, etc.
per hour $402.10 TRAVELLING FEES
Rate per kilometre $4.85 ANAESTHETISTS
All anaesthesia fees are calculated by multiplying the units for the consultation, attendance, procedure or service by the$ value per unit allocated by this Schedule.
$ VALUE PER UNIT
$ value per unit $80.95
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9. Schedule 1 Parts 2 and 3 replaced
Delete Schedule 1 Parts 2 and 3 and insert:
Part 2 — Medical procedures
Type of procedure Fee GENERAL Localised burns $60.10 Localised burns, including dressing of, under general anaesthetic $170.95 Extensive burns $103.70 Extensive burns, including dressing of, under general anaesthetic $361.90 Dressing of wounds, under general anaesthetic $170.95 Acupuncture, including consultation $79.75 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 to apply.]
Elbow, by closed reduction $322.45 Elbow, by open reduction $427.65
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Type of procedure Fee Interphalangeal joint, by closed reduction $138.25 Interphalangeal joint, by open reduction $184.25 Mandible, by closed reduction $115.20 Clavicle, by closed reduction $136.70 Clavicle, by open reduction $276.35 Shoulder, not requiring general anaesthetic $153.75 Shoulder, by open reduction, with general anaesthetic $551.25 Shoulder, other, with general anaesthetic $273.00 Metacarpophalangeal joint, by closed reduction $184.25 Metacarpophalangeal joint, by open reduction $246.85 Patella, by closed reduction $207.15 Patella, by open reduction $276.35 Radioulnar joint, by closed reduction $322.45 Radioulnar joint, by open reduction $427.65 Toe, by closed reduction $115.20 Toe, by open reduction $153.00 REMOVAL OF FOREIGN BODIES as independent procedure $50.15 superficial $223.70 deep tissue or muscle $625.20 ear, other than by syringing $161.15 nose, other than by simple probing $161.15 cornea or sclera, embedded $164.55
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Type of procedure Fee FRACTURES
closed reduction means non-operative reduction of the
fracture and included percutaneous fixation and/orexternal 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 including internal orexternal 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 to apply.]
Distal phalanx of finger or thumb
fracture, by closed reduction $207.15 fracture, intra-articular, by closed reduction $240.20 fracture, by open reduction $276.35 fracture, intra-articular, by open reduction $345.40 Middle phalanx of finger
fracture, by closed reduction $312.55 fracture, intra-articular, by closed reduction $353.60 fracture, by open reduction $411.20 fracture, intra-articular, by open reduction $518.15 Proximal phalanx of finger or thumb
fracture, by closed reduction $411.20 fracture, intra-articular, by closed reduction $485.20 fracture, by open reduction $551.25 fracture, intra-articular, by open reduction $690.90
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Type of procedure Fee Metacarpal fracture, by closed reduction $411.20 fracture, intra-articular, by closed reduction $485.20 fracture, by open reduction $551.25 fracture, intra-articular, by open reduction $690.90 Carpal Scaphoid, by open reduction $921.20 Carpal Scaphoid, other $411.20 Carpus (excluding Scaphoid), by open reduction $575.70 Carpus (excluding Scaphoid), other $230.35 Radius by closed management $460.45 by open management $921.20 Radius or Ulnar, distal end, (Colies’, Smith’s or Barton’s)
by closed reduction $690.90 by open reduction $921.20 Ribs (1 or more), each attendance $105.40 Tibia, plateau of, medial or lateral by closed reduction $830.75 by open reduction $1 102.10 Tibia, plateau of, medial and lateral
by closed reduction $1 381.75 by open reduction $1 850.60 SUTURES
face or neck, less than 7 cm, superficial $164.55 face or neck, less than 7 cm, deep $250.05
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Type of procedure Fee
face or neck, more than 7 cm, superficial $250.05 face or neck, more than 7 cm, deep $427.65 except face or neck, less than 7 cm, superficial $125.00 except face or neck, less than 7 cm, deep $187.50 except face or neck, more than 7 cm, superficial $187.50 except face or neck, more than 7 cm, deep $411.20 AMPUTATIONS
Hand, midcarpal or transmetacarpal $625.20 Hand, forearm or through arm $723.80 At shoulder $1 225.35 Interscapulothoracic $2 434.45 One digit of foot $328.90 Two digits of one foot $493.55 Three digits of one foot $666.20 Four digits of one foot $830.75 Five digits of one foot $995.20 Toe including metatarsal or part of metatarsal — each toe $388.40 Foot, at ankle $723.80 Foot, midtarsal or transmetatarsal $625.20 Through thigh, at knee or below knee $1 069.35 At hip $1 505.00
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Type of procedure Fee 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
$207.15, whichever is greater.USE OF PRIVATE THEATRES A theatre fee of $125.00 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
(1 November 2009) Fee 55028 $201.50
55029 $69.85
55030 $201.50
55031 $69.85
55032 $201.50
55033 $69.85
55036 $205.45
55037 $69.85
55038 $201.50
55039 $69.85
55044 $205.45
55045 $69.85
55048 $201.50
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MBS item number
(1 November 2009) Fee 55049 $69.85 55054 $201.50 55070 $181.40 55073 $62.85 55076 $201.50 55079 $69.85 55084 $181.40 55085 $62.85 55113 $425.90 55114 $425.90 55115 $425.90 55116 $473.65 55117 $473.65 55118 $508.65 55130 $314.00 55135 $652.95 55238 $312.95 55244 $312.95 55246 $312.95 55248 $312.95 55252 $312.95 55274 $312.95 55276 $312.95 55278 $312.95
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MBS item number
(1 November 2009) Fee 55280 $312.95
55282 $312.95
55284 $312.95
55292 $312.95
55294 $312.95
55296 $205.15
55600 $201.50
55603 $201.50
55700 $110.70
55703 $64.65
55704 $129.30
55705 $64.65
55706 $184.65
55707 $129.30
55708 $64.65
55709 $70.20
55712 $212.40
55715 $73.85
55718 $184.65
55721 $212.40
55723 $70.20
55725 $73.85
55729 $50.30
55731 $181.10
55733 $64.65
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MBS item number
(1 November 2009) Fee 55736 $234.45
55739 $105.20
55759 $277.00
55762 $110.70
55764 $295.45
55766 $119.95
55768 $277.00
55770 $110.70
55772 $295.45
55774 $119.95
55800 $201.50
55802 $69.85
55804 $201.50
55806 $69.85
55808 $201.50
55810 $69.85
55812 $201.50
55814 $69.85
55816 $201.50
55818 $69.85
55820 $201.50
55822 $69.85
55824 $201.50
55826 $69.85
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MBS item number
(1 November 2009) Fee 55828 $201.50
55830 $69.85
55832 $201.50
55834 $69.85
55836 $201.50
55838 $69.85
55840 $201.50
55842 $69.85
55844 $161.30
55846 $69.85
55848 $201.50
55850 $282.25
55852 $201.50
55854 $69.85
COMPUTED TOMOGRAPHY —
EXAMINATION AND REPORTMBS item number Fee (1 November 2009) 56001 $330.70 56007 $424.00 56010 $427.45 56013 $424.00 56016 $491.85 56022 $381.55 56028 $571.20 56030 $381.55
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MBS item number Fee (1 November 2009) 56036 $571.20
56041 $167.55
56047 $213.95
56050 $217.45
56053 $217.45
56056 $263.50
56062 $191.85
56068 $285.60
56070 $191.85
56076 $285.60
56101 $390.20
56107 $576.70
56141 $197.45
56147 $291.05
56219 $553.25
56220 $407.05
56221 $407.05
56223 $407.05
56224 $595.95
56225 $595.95
56226 $595.95
56227 $207.75
56228 $207.75
56229 $207.75
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MBS item number Fee (1 November 2009) 56230 $300.95
56231 $300.95
56232 $300.95
56233 $407.05
56234 $595.95
56235 $207.70
56236 $300.95
56237 $407.05
56238 $595.95
56239 $207.70
56240 $300.95
56259 $279.45
56301 $500.35
56307 $678.25
56341 $253.50
56347 $342.55
56401 $424.00
56407 $610.50
56409 $424.00
56412 $610.50
56441 $215.00
56447 $307.75
56449 $215.00
56452 $307.75
56501 $652.95
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MBS item number Fee (1 November 2009) 56507 $814.05
56541 $327.55
56547 $413.40
56549 $652.95
56551 $652.95
56619 $373.10
56625 $567.50
56659 $190.10
56665 $283.95
56801 $791.30
56807 $949.85
56841 $395.70
56847 $481.45
57001 $791.45
57007 $962.90
57041 $395.80
57047 $481.50
57201 $263.20
57247 $131.40
57341 $797.15
57345 $409.80
57350 $864.95
57351 $864.95
57355 $448.00
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MBS item number Fee (1 November 2009) 57356 $448.00
DIAGNOSTIC RADIOLOGY MBS item number Fee (1 November 2009) 57506 $58.25 57509 $77.85 57512 $79.35 57515 $105.75 57518 $63.60 57521 $84.95 57524 $96.85 57527 $128.85 57700 $79.35 57703 $105.75 57706 $63.60 57709 $84.95 57712 $92.35 57715 $119.35 57721 $194.35 57901 $126.30 57902 $126.30 57903 $92.60 57906 $126.30 57909 $126.30 57912 $92.35
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MBS item number Fee (1 November 2009) 57915 $92.35 57918 $92.35 57921 $92.35 57924 $92.35 57927 $97.10 57930 $64.40 57933 $153.25 57939 $126.30 57942 $97.10 57945 $84.95 57960 $92.90 57963 $92.90 57966 $92.90 57969 $92.90 58100 $131.40 58103 $107.95 58106 $150.75 58108 $260.25 58109 $92.10 58112 $190.45 58115 $260.25 58300 $78.60 58306 $175.00 58500 $69.25
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MBS item number Fee (1 November 2009) 58503 $92.35 58506 $119.15 58509 $77.85 58521 $84.95 58524 $110.65 58527 $135.90 58700 $90.30 58706 $309.25 58715 $296.80 58718 $247.10 58721 $270.80 58900 $69.85 58903 $93.15 58909 $176.10 58912 $215.95 58915 $154.60 58916 $271.20 58921 $264.90 58924 $164.65 58927 $149.75 58933 $402.75 58936 $383.85 58939 $272.85 59103 $41.80 59300 $175.35
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MBS item number Fee (1 November 2009) 59303 $105.65
59306 $196.50
59309 $392.75
59312 $170.45
59314 $102.80
59318 $92.15
59503 $175.00
59700 $189.10
59703 $148.70
59712 $222.75
59715 $281.15
59718 $263.75
59724 $443.55
59733 $210.95
59736 $121.45
59739 $144.65
59751 $272.60
59754 $429.55
59760 $225.55
59763 $262.30
59903 $224.40
59912 $597.75
59925 $709.85
59970 $329.70
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MBS item number Fee (1 November 2009) 59971 $112.25
59972 $298.80
59973 $354.90
59974 $164.85
60000 $1 104.70
60003 $1 620.00
60006 $2 303.50
60009 $2 695.75
60012 $1 104.70
60015 $1 620.00
60018 $2 303.50
60021 $2 695.75
60024 $1 104.70
60027 $1 620.00
60030 $2 303.50
60033 $2 695.75
60036 $1 104.70
60039 $1 620.00
60042 $2 303.50
60045 $2 695.75
60048 $1 104.70
60051 $1 620.00
60054 $2 303.50
60057 $2 695.75
60060 $1 104.70
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MBS item number Fee (1 November 2009) 60063 $1 620.00
60066 $2 303.50
60069 $2 695.75
60072 $94.30
60075 $188.25
60078 $282.45
60100 $119.15
60500 $84.95
60503 $58.25
60506 $124.90
60509 $193.65
60918 $92.35
60927 $74.55
61109 $507.05
NUCLEAR MEDICINE IMAGING MBS item number Fee (1 November 2009) 61302 $677.20
61303 $852.80
61306 $1 070.60
61307 $1 259.60
61310 $554.10
61313 $457.70
61314 $633.60
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MBS item number Fee (1 November 2009) 61316 $575.10
61317 $742.85
61320 $345.30
61328 $343.45
61340 $381.65
61348 $668.85
61352 $391.15
61353 $583.15
61356 $592.55
61360 $608.50
61361 $696.15
61364 $749.80
61368 $336.60
61369 $3 040.90
61372 $336.60
61373 $738.75
61376 $216.30
61381 $866.40
61383 $942.70
61384 $1 037.45
61386 $501.65
61387 $649.90
61389 $559.00
61390 $618.45
61393 $913.45
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MBS item number Fee (1 November 2009) 61397 $372.40
61401 $244.90
61402 $912.80
61405 $521.95
61409 $1 317.80
61413 $340.85
61417 $179.30
61421 $723.85
61425 $906.20
61426 $836.95
61429 $819.15
61430 $994.85
61433 $749.80
61434 $928.45
61437 $818.90
61438 $1 015.25
61441 $738.75
61442 $1 135.05
61445 $432.60
61446 $503.30
61449 $688.20
61450 $599.75
61453 $776.45
61454 $525.05
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MBS item number Fee (1 November 2009) 61457 $709.75
61458 $598.75
61461 $796.20
61462 $196.55
61465 $400.45
61469 $525.05
61473 $264.55
61480 $583.65
61484 $1 328.95
61485 $1 507.40
61495 $336.60
61499 $381.65
61650 $1 325.55
MAGNETIC RESONANCE IMAGING MBS item number Fee (1 November 2009) 63000-63200 $982.40 63201 $1 473.50 63202-63203 $982.40 63204 $1 473.50 63219-63243 $1 473.50 63271-63473 $982.40 63491-63494 $112.30 63497 $337.15
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10. 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 $80.25 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.
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.
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Service Service Code 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 program to be followed.Documentation of consultation — as required
that could include:The assessment findings, physiotherapy
intervention(s), evaluation of intervention(s), plan
for future treatment and results of other relevant
tests and warnings (if applicable).Includes:
Individual services provided in rooms, home
or hospital; hydrotherapy treatment;
extended treatments; and services provided
outside of normal business hours. Courtesy communication by the
physiotherapist with the medical practitioner
such as acknowledgment of referral. The physiotherapist’s notes of the
consultation.
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Service Service Code Does not include:
Oral or written communication by the
physiotherapist with a medical specialist,
medical practitioner, employer, insurer or
vocational rehabilitation provider (other than
a courtesy communication with the medical
practitioner). Oral communication has a
specific item number in this Table (PK001). The physiotherapist’s involvement in case
conferences. This service has a specific item
number in this Table (PQ001).PB001
Standard Consultation Set Fee Consultation for one body area or condition $64.45 including the following elements —
subjective re-assessment; objective re-assessment; appropriate management, intervention or
advice; documentation of consultation. Includes:
Individual services provided in rooms, home
or hospital; hydrotherapy treatment;
extended treatments; and services provided
outside of normal business hours. Courtesy communication by the
physiotherapist such as brief oral or written
communication with the medical
practitioner.
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Service Service Code Does not include:
Oral or written communication by the
physiotherapist with a medical specialist,
medical practitioner, employer, insurer or
vocational rehabilitation provider (other than
a courtesy communication with the medical
practitioner). Oral communication has a
specific item number in this Table (PK001). The physiotherapist’s involvement in case
conferences. This service has a 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 $81.55 treatment/management of 2 distinct
areas/conditions.PG001
Group Consultation — per person Cost per participant
Includes non-individualised services provided to $19.80 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 $183.10 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
Progress/Standard Report Set Fee A report relating to a specific worker that is $80.25 provided to a medical specialist, medical
practitioner, employer, insurer or vocational
rehabilitation provider that contains (where
applicable) —
a summary of assessment findings; treatment/management services provided and
results obtained; recommendations for further
treatment/management; functional and objective improvements; perceived treatment duration required; return to work recommendation; perceived barriers to return to work; questionnaire results and implications.
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Service Service Code
A maximum combined total of 3 reports or
Treatment Management Plans (PR003)
permitted without prior approval from
insurer. Additional reports require prior
approval from insurer.Does not include:
Courtesy communication by the
physiotherapist such as brief oral or written
communication with the medical
practitioner.PR002
Comprehensive Report Hourly rate**
As above for progress/standard report and contains $183.10 information relating to more detailed assessments
and interventions performed.The specific requirements for a comprehensive
report must be discussed with the insurer prior to
approval with a suggested maximum duration of
2 hours.
PR003 Treatment Management Plan Set Fee Provision of a completed Treatment Management $80.25 Plan that must contain —
clinical assessment of injured worker and
results of any investigation; injured worker’s current work status and
level of incapacity; proposed management plan including —
1.
the proposed work and functional goals and estimated timeframe in weeks;
2.
description and number of proposed treatment methods;
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Service Service Code 3. the number of weeks treatment is to be conducted;
4. the injured worker’s expected fitness for plan;
5. other comments or recommendations (including barriers to recovery where relevant).
A maximum combined total of 3 Treatment
Management Plans or reports (PR001) permitted
without prior approval from insurer. Additional
Treatment Management Plans require priorapproval from insurer.
PT001 Travel Hourly rate** Travel when the most appropriate management of $146.55 the patient requires the provider to travel away
from their normal practice. The insurer must
provide pre-approval for travel in excess of one
hour.If services are provided to more than one worker 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 $18.40 involving the physiotherapist with one or more of per 6 minute the following — block doctor, employer, insurer/claims manager,
rehabilitation providers and worker.17 October 2014 GOVERNMENT GAZETTE, WA 4061 Workers’ Compensation and Injury Management (Scales of Fees)
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Service Service Code The aim of the case conference is to plan,
implement, manage or review treatment options
and/or rehabilitation plan.PK001 Communication
Any required oral communication by the $18.40 physiotherapist with a medical specialist, medical per 6 minute practitioner, employer, insurer or vocational block rehabilitation provider (other than a courtesy communication with the medical practitioner) relating to the treatment or rehabilitation of a specific worker.
The physiotherapist must keep a written record of
the details of the communication, including its
date, time and duration.Maximum duration per communication is
30 minutes.Maximum cumulative duration of communications
per claim is one hour. When the maximum
cumulative duration has been reached, prior
approval from insurer for a minimum of 5 blocks
of 6 minutes is required.PS001
Specific Physiotherapy Assessment — prior Hourly approval from insurer required rate** Includes specific types of assessments not $183.10 classified elsewhere in these scales required by the
insurer which physiotherapists may undertake
(e.g. diagnostic ultrasound imaging, Functional
Capacity Assessments (FCA’s), seating and
wheelchair assessments).
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Service Service Code PW001
Specific Physiotherapy Intervention — prior Hourly approval from insurer required (*replaces rate** PD001). $183.10 Includes treatments not classified elsewhere in per hour to a these scales required by the insurer which maximum of physiotherapists may undertake (e.g. treatment of 2 hours** severe multiple area trauma, burns, neurologically
injured patients and patients with severe spinal
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.Part 2 — Exercise-based programs
Type of service Fee
EXE20 Initial Consultation/Assessment
Insurer approval must be obtained prior to $183.10 undertaking the service. per hour to Review of current medical and vocational status. a maximum
of
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 — $183.10
per hour toprogram implementation — prescription and a maximum provision of exercises (land or pool based); of one program monitoring; hour** post program screening questionnaire relating to
worker’s level of function;
psychosocial reassessment;communication/liaison with relevant parties. EXE02 Initial report
Includes — $183.10
per hour toinitial assessment report outlining results a maximum (self-reported and objective), recommendations of one and exercise rehabilitation plan; hour** current status as per medical certification and
proposed outcome status;detailed cost plan outlining proposed outcome, services required and proposed costs for insurer approval.
EXE03 Subsequent reports
Progress report to be provided at the request of the $183.10 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 of $183.10 the service delivery detailing —
per hour to a maximum
physiological testing results pre and post program; of worker attendance/program compliance. 30 minutes
**EXE05 Gym membership/Entry fees
Includes direct cost of membership (pool or gym). Market Prior approval from insurer required. rates EXE06 Travel
Travel when the most appropriate management of $146.55 the patient requires the provider to travel away per 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 $18.40 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
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
Insurer approval must be obtained prior to $183.10 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 3 — Scale of fees: chiropractors
[r. 3]
Type of service Fee
1. Initial consultation and examination $63.50 2. Subsequent consultation $52.95 3. Spinal x-ray, one region $126.15 4. Spinal x-ray, 2 or more regions $189.45 5. Travel (per kilometre) $1.00 Schedule 4 — Scale of fees: occupational therapists
[r. 5]
Type of service Fee
1. Brief consultation (< 15 minutes) $27.35 2. Short consultation (15 minutes to < 30 minutes) $54.90 3. Standard consultation (30 minutes to < 45 minutes) $90.55 4. Extended consultation (45 minutes to < one hour) $135.80 5. Extended consultation ( > one hour) $181.20 6. Standard group consultation (30 minutes) per person $59.45 7.
Travel costs are to be calculated at the hourly rate by the length of time spent travelling
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Schedule 5 — Scale of fees: speech pathologists
[r. 7]
Type of service Fee 1. Initial consultation/assessment (up to and including
one hour) $167.40 2.
Initial consultation/assessment (exceeding one hour) $216.80 3.
Subsequent consultation (< 30 minutes) $73.05 4.
Subsequent consultation (30 minutes — one hour) $94.80 5.
Subsequent consultation (> one hour) $127.95 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 $183.10 undertaking the service.
per hour to a maximum of
2 hours**
Review of current medical and vocational status.
Communication/Liaison with relevant parties.
Physiological Assessment/testing.
Screening questionnaires relating to worker’s
level of function.
Program design based on above.
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Type of service Fee 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 $183.10 Includes —
per hour to a maximum
program implementation — prescription and of one provision of exercises (land or pool based); 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 — $183.10
per hour toinitial assessment report outlining results a maximum (self-reported and objective), recommendations of one and exercise rehabilitation plan; hour** current status as per medical certification and
proposed outcome status;detailed cost plan outlining proposed outcome, services required and proposed costs for insurer approval.
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Type of service Fee
EXE03 Subsequent reports
Progress report to be provided at the request of $183.10 the referrer.
per hour to a maximum of
30 minutes
**
EXE04 Final report
Comprehensive report to be provided at the end $183.10 of the service delivery detailing —
per hour to a maximum
physiological testing results pre and post of program; 30 minutes worker attendance/program compliance. ** EXE05 Gym membership/Entry fees
Includes direct cost of membership (pool or Market gym). rates Prior approval from insurer required. EXE06 Travel
Travel when the most appropriate management $146.55 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.
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Type of service Fee
EXE08 Communication
Any requested or required oral communication $18.40 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
acknowledgment of referral and brief updates to
the medical practitioner.
Maximum time allowable per communication of
30 minutes.EXE09 Attendance at Medical Case Conferences
Insurer approval must be obtained prior to $183.10 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 $1 235.10 (or, if an certificate — straightforward assessment — interpreter is present at other than a service mentioned in item 4, 5, the examination, 6 or 8. $1 543.90 excluding
any fee payable to the
interpreter)
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Description of assessment Maximum fee**
2. Examination and provision of report and $1 543.90 (or, if an certificate — moderately complex interpreter is present at assessment (e.g. reviewing multiple the examination, questions and reports; impairment $1 852.65 excluding involving more complex assessments; more any fee payable to the than one body system involved) — other interpreter) than a service mentioned in item 4, 5, 6
or 8.3. Examination and provision of report and $1 852.65 (or, if an certificate — complex assessment interpreter is present at (e.g. multiple injuries; severe impairment the examination, such as spinal cord injury or head injury) — $2 161.35 excluding other than a service mentioned in item 4, 5, any fee payable to the 6 or 8. interpreter) 4. Examination of any ear, nose and throat $1 235.10 (or, if an only, including audiometric testing and interpreter is present at provision of report and certificate — other the examination, than a service mentioned in item 8. $1 543.90 excluding
any fee payable to the
interpreter)5. Examination and provision of report and $1 852.65 (or, if an certificate — psychiatric — standard interpreter is present at assessment — other than a service the examination, mentioned in item 8. $2 161.35 excluding
any fee payable to the
interpreter)6. Examination and provision of report and $3 087.60 (or, if an certificate — psychiatric — complex interpreter is present at assessment (e.g. reviewing significant the examination, documented prior psychiatric history) — $3 396.40 excluding other than a service mentioned in item 8. any fee payable to the
interpreter)7. Consolidation of written assessments from $617.55 multiple assessors.
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Description of assessment Maximum fee**
8. Re-examination and provision of report and $926.30 (or, if an certificate. interpreter is present at
the examination,
$1 235.10 excluding
any fee payable to the
interpreter)9. Provision of supplementary report and $308.80 certificate. Part 2 — Attempted assessments
Description of circumstances Maximum fee**
1. If a worker who is required under Part VII $617.55 Division 2 of the Act to submit to an examination by an approved 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 18th day of September 2014.
The Common Seal of WorkCover WA L.S. CHRIS WHITE. GREG JOYCE.
N. HAGLEY, Clerk of the Executive Council.
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