Workers Rehabilitation and Compensation (Scales of Medical and Other Charges) Variation Regulations 2006 (SA)
South Australia
Workers Rehabilitation and Compensation (Scales of Medical and Other Charges) Variation Regulations 2006
under the Workers Rehabilitation and Compensation Act 1986
Contents
Part 1—Preliminary
Short title
Commencement
Variation provisions
Part 2—Variation of Workers Rehabilitation and Compensation (Scales of Medical and Other Charges) Regulations 1995
Variation of regulation 3—Interpretation
Substitution of Schedule 2
Schedule 2—Scale of charges—physiotherapy services
Substitution of Schedules 4 and 5
Schedule 4—Scales of charges—speech pathologists
Schedule 5—Scales of charges—occupational therapists
Variation of Schedule 6—Scales of charges—chiropractors
Part 1—Preliminary
1—Short title
These regulations may be cited as the Workers Rehabilitation and Compensation (Scales of Medical and Other Charges) Variation Regulations 2006.
2—Commencement
These regulations will come into operation 1 month after the day on which they are made.
3—Variation provisions
In these regulations, a provision under a heading referring to the variation of specified regulations varies the regulations so specified.
Part 2—Variation of Workers Rehabilitation and Compensation (Scales of Medical and Other Charges) Regulations 1995
4—Variation of regulation 3—Interpretation
Regulation 3—after subregulation (2) insert:
(3)If a charge prescribed in a scale of charges is expressed as an amount per hour—
(a)a charge is payable for services provided for less than or more than an hour; and
(b)the amount payable is to be determined by multiplying the amount per hour by the proportion that the number of minutes for which the services are provided rounded to the nearest 5 minutes bears to 60 minutes.
Note—
These regulations apply for the purposes of section 127A of the Motor Vehicles Act 1959 subject to modifications specified by that section and modifications specified by notice in the Gazette under that section.
5—Substitution of Schedule 2
Schedule 2—delete the Schedule and substitute:
Schedule 2—Scale of charges—physiotherapy services
This Schedule must be read in conjunction with the Physiotherapy Fee Schedule Guidelines.
Item No
Service description
Maximum charge
(excl GST)
Consultations
Initial consultation
An initial consultation by a treating physiotherapist involving some or all of the following elements (although the extent of the consultation is at the discretion of the physiotherapist):
• Subjective reporting
Consideration by the physiotherapist of 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
Assessment by the physiotherapist of movement (eg, active, passive, resisted, repeated; muscle tone, spasm, weakness; accessory movements, passive intervertebral movements etc) and the carrying out of appropriate procedures and tests.
• Assessment results
Provisional diagnosis, the setting of the goals of treatment, and the development of a treatment plan, by the physiotherapist.
• Treatment
Discussion between the physiotherapist and the worker regarding working hypothesis, treatment goals and expected outcomes; initial treatment and response and the provision of advice by the physiotherapist regarding home care, including any exercise programs to be followed.
• Clinical records
Recording of information by the physiotherapist in the worker's clinical records, including the results of procedures and tests carried out.
• Communication
Communication by the physiotherapist of information relevant to the rehabilitation and return to work of the worker to the claims agent or self-insured employer, the worker's employer (if not self-insured) and the worker's referring/treating medical expert.
PT107
Short initial consultation of not more than 20 minutes duration.
$34.25
PT108
Initial consultation of more than 20 minutes duration.
$57.10
Subsequent consultation
A subsequent consultation by a treating physiotherapist involving assessment and treatment of a worker's condition and some or all of the other elements listed below (although the extent of the consultation is at the discretion of the physiotherapist):
• History taking/assessment
Consideration by the physiotherapist of the clinical records of the worker relating to the condition and the worker's progress since the previous consultation.
• Examination
Examination by the physiotherapist of the condition.
• Treatment
Appropriate treatment of the condition by the physiotherapist.
• Reassessment and management
Reassessment of the goals of treatment, the treatment plan and the management program by both the worker and the physiotherapist; counselling by the physiotherapist regarding further treatment (if any), care and preventative measures.
• Communication
Communication by the physiotherapist of information relevant to the rehabilitation and return to work of the worker to the claims agent or self-insured employer, worker's employer (if not self-insured) and the worker's referring/treating medical expert.
• Physiotherapy treatment form
If treatment is expected to extend for longer than 6 weeks, completion by the physiotherapist of a physiotherapy treatment form (in a form approved by the Corporation) and forwarding of the form to the claims agent or self-insured employer.
No additional fee is payable for completion of this form.
• Clinical records
Recording of information by the physiotherapist in the worker's clinical records, including the results of any procedures and tests carried out.
PT205
Brief subsequent consultation of not more than 15 minutes duration.
The consultation will involve minimal physiotherapist contact time.
$28.55
PT210
Standard subsequent consultation of more than 15 minutes duration but not more than 20 minutes duration.
$39.95
PT215
Long subsequent consultation of more than 20 minutes duration but not more than 30 minutes duration.
The consultation will involve all of the elements of a subsequent consultation, and, because of the complexity of the injury, will require extra time for history taking, examination, treatment, documentation and liaison. For example, this type of consultation may be expected in cases of injuries following major trauma or major surgery requiring intensive post-operative treatment.
$57.10
PT220
Prolonged subsequent consultation of more than 30 minutes duration.
The consultation will involve all of the elements of a subsequent consultation and, because of the extreme complexity of the injury or treatment, will require extra time for history taking, examination, treatment, documentation and liaison. This type of consultation is expected in only a limited number of cases, for example, in cases of injuries following extensive burns, multi-trauma, major surgery requiring intensive post-operative treatment such as complicated hand injuries or joint reconstruction and some neurological conditions.
$79.90
Corrective/serial splinting
PT300
Fabrication/fitting/adjustment of splint
$137.00 per hour
Aquatic physiotherapy
PT415
Individual aquatic physiotherapy session
An aquatic physiotherapy session requiring significant planning, supervision and monitoring of individual workers by a physiotherapist.
The prior approval of a claims manager or self-insured employer is required for a session other than—
• the initial session;
• 2 subsequent individual sessions following the initial session;
• a review session at week 4 to 6 of the aquatic physiotherapy program.
$48.10
PT420
Subsequent individual or group aquatic physiotherapy session
An aquatic physiotherapy session not referred to in PT415. If the session is a group session—
• the group will be comprised of not more than 6 workers; and
• the session will involve programs that are unique and individualised to particular workers.
$20.10 per worker
Exercise
PT455
Individual exercise session
Exercise session (other than an aquatic physiotherapy session) planned by a physiotherapist where an individual worker is constantly and directly supervised and assessed by the physiotherapist. The session will involve all or some of the elements of a subsequent consultation (but a subsequent consultation cannot be separately charged).
$48.10
PT460
Group exercise session
Group exercise session (other than an aquatic physiotherapy session) planned and supervised by a physiotherapist for a group of not more than 8 workers. The session will involve all or some of the elements of a subsequent consultation (but a subsequent consultation cannot be separately charged).
$14.25 per worker
Telephone calls
PT552
Telephone call greater than 3 minutes
$19.00
Calls of a case specific nature made by a physiotherapist to, or received by a physiotherapist from, the worker’s referring/treating medical expert, rehabilitation provider, claims agent or self-insured employer, employer (if not self-insured), WorkCover provider consultant or the worker's representative, excluding—
(a) calls made during a consultation; and
(b) calls of a duration of 3 minutes or less.
There is no charge for a telephone call to or from a worker.
Functional capacity evaluation
PT700
Functional capacity evaluation
The maximum time chargeable is 7 hours.
$137.00 per hour
Assessment by a physiotherapist of a worker's work capacity, including—
(a) a series of standardised tests of the worker's physical capabilities focussed on selected work tolerances (ie, the observed and measured physical capabilities that affect a worker's ability to perform the physical demands of specified work tasks); and
(b) an analysis of the results of the tests to infer the worker's capacity to sustain a given work effort (ie, the worker's capacity to undertake specified work at a prescribed frequency over a given period of time, taking into account the pace compatible with such work); and
(c) preparation of a report with an executive summary outlining the major components of the service and relevant findings.
Worksite assessment
PT730
Worksite assessment
$137.00 per hour
Attendance by a physiotherapist at a worker's workplace in order to obtain an overview of the workplace and determine the availability of suitable duties.
Job analysis
PT740
Job analysis
$137.00 per hour
Job analysis by a physiotherapist, including—
(a) an analysis of the critical physical demands of occupational tasks; and
(b) determining the worker's capacity to undertake the tasks or giving consideration to available medical guidelines and the physiotherapist's knowledge of the worker's diagnosis, pathology and prognosis; and
(c) making recommendations for—
(i) modifying the tasks or the way in which the tasks are undertaken; or
(ii) providing aids or equipment; or
(iii) introducing work practice guidelines to ensure that the worker utilises appropriate body mechanics; and
(d) preparation of a report with an executive summary outlining the major components of the service and relevant findings.
Graduated return to work program
PT750
Graduated return to work program
$137.00 per hour
A program of work duties and work practice guidelines for a worker designed by a physiotherapist to increase the worker’s tolerance for the physical demands of work.
The purpose of the program is to assist the worker to maintain his or her employment while undertaking rehabilitation.
The program will involve actual and productive work duties identified by the physiotherapist as being within the worker's capacity and work practice guidelines relevant to the nature of the worker's injury and the performance of the particular duties.
Activities of daily living assessment
PT760
Activities of daily living assessment
$137.00 per hour
Assessment by a physiotherapist, usually conducted in a worker's home environment, of the worker's level of functioning in relation to personal care, household tasks and recreational and social activities.
The purpose of the assessment is to facilitate the reduction of the adverse impact of the injury on the worker and the early return of the worker to normal activity, and to provide an indicator of functional tolerances for determining work capacity.
Independent clinical assessment
PT780
Independent clinical assessment and report
$137.00 per hour
Service provided by a physiotherapist other than the treating physiotherapist comprising—
(a) a review of the worker's medical history; and
(b) a clinical assessment; and
(c) a review of the worker's activity and functional capacity; and
(d) preparation of a report,
for the purpose of providing a different diagnosis or making recommendations in relation to ongoing treatment goals, the worker's return to work and any other relevant matters.
The report will have been requested in writing by—
(a) a claims agent or self-insured employer; or
(b) a worker or worker's representative.
Functional notification form
PT785
Functional notification form
$19.00
Completion by a physiotherapist of a functional notification form (in a form approved by the Corporation) and provision of the form to a worker's referring/treating medical expert. The form is completed when information directly affecting the worker's capacity to return to work or the process of the worker returning to work is identified by the physiotherapist.
Reports
PT810
Comprehensive report
$205.50
A report by a treating physiotherapist, relating to the status of a claim and comprising a clinical opinion or statement or a response to specific questions, that has been requested in writing by—
(a) a claims agent or self-insured employer; or
(b) a worker or worker's representative.
A report will be taken to be comprehensive when re-examination of the worker is a prerequisite for preparation of the report.
The consultation should be charged in accordance with the appropriate item.
PT820
Standard report
$137.00
A report by a treating physiotherapist, relating to the status of a claim and comprising a clinical opinion or statement or a response to specific questions, that has been requested in writing by—
(a) a claims agent or self-insured employer; or
(b) a worker or worker's representative.
A report will be taken to be standard when re-examination of the worker is not required and the report is based on a transcription of existing clinical records.
Case conference
PT870
Case conference
$137.00 per hour
Case conference, attended by a physiotherapist and authorised by a claims agent or self-insured employer, for the purpose of determining—
• details of limitations/recommendations relating to a sustainable return to work;
• options for management of a worker’s recovery;
• other related information.
A case conference may be requested by—
• a treating medical expert;
• a worker or worker's representative;
• a claims agent or self-insured employer;
• an employer (if not self-insured);
• a rehabilitation provider contracted by WorkCover.
The hourly rate excludes travelling time from rooms or other appropriate departure point to the venue and return. Travel may be charged separately.
Travel
PT905
Travel time
$116.45 per hour
Travel, authorised by a claims agent or self-insured employer, by a treating physiotherapist for the purposes of—
(a) a case conference; or
(b) a home, hospital or worksite visit; or
(c) consultation where the worker is otherwise unable to attend the physiotherapist's clinic or rooms.
There is no charge for travel from 1 clinic or rooms to another clinic or rooms.
Non scheduled services
PT999
Non scheduled services
$137.00 per hour
A service of a kind not listed above, provided by a physiotherapist and authorised by a claims agent or self-insured employer prior to the delivery of the service as being necessary, appropriate and reasonably required.
6—Substitution of Schedules 4 and 5
Schedules 4 and 5—delete the Schedules and substitute:
Schedule 4—Scales of charges—speech pathologists
This Schedule must be read in conjunction with the Speech Pathology Fee Schedule Guidelines.
Item No
Service description
Maximum charge
(excl GST)
Consultations
Initial consultation
An initial consultation by a speech pathologist involving some or all of the following elements:
• the taking of a detailed case history;
• counselling (according to the worker's emotional needs);
• determination of options for ongoing management following assessment;
• consideration and implementation of appropriate treatment;
• administration of a standardised clinical assessment or an empirical clinical assessment;
• assessment of the ability of the worker to communicate at the worker's workplace;
• evaluation and analysis of assessment results.
The initial consultation will be designed to form the basis of the diagnosis and assist in prognostic indications and treatment planning.
E0149
Standard initial consultation of up to 1.5 hours duration.
$128.00 per hour
E0151
Extended initial consultation of more than 1.5 hours duration (up to a maximum time chargeable of 2.5 hours).
$128.00 per hour
Subsequent consultation
A subsequent consultation by a speech pathologist involving treatment and intervention designed to restore the worker's function to optimal levels. The consultation may involve—
• tasks specifically related to skill development;
• counselling to facilitate adjustment and transfer of restored skill to everyday communicative situations.
E0249
Subsequent consultation of up to 1 hour duration.
$128.00 per hour
Reports
E0810
Comprehensive report
$256.00
A report by a treating speech pathologist, relating to the status of a claim and comprising a clinical opinion or statement or a response to specific questions, that has been requested in writing by—
(a) a claims agent or self-insured employer; or
(b) a worker or worker's representative.
A report will be taken to be comprehensive when re-examination of the worker is a prerequisite for the preparation of the report.
The consultation should be charged in accordance with the appropriate item.
E0820
Standard report
$192.00
A report by a treating speech pathologist, relating to the status of a claim and comprising a clinical opinion or statement or a response to specific questions, that has been requested in writing by—
(a) a claims agent or self-insured employer; or
(b) a worker or worker's representative.
A report will be taken to be standard when re-examination of the worker is not required and the report is based on a transcription of existing clinical records.
Telephone calls
E0850
Telephone call greater than 3 minutes
$2.15 per minute
Calls of a case specific nature made by a speech pathologist to, or received by a speech pathologist from, the worker’s referring/treating medical expert, rehabilitation provider, claims agent or self-insured employer, employer (if not self-insured), WorkCover provider consultant or the worker's representative excluding—
(a) calls made during a consultation; and
(b) calls of a duration of 3 minutes or less.
There is no charge for a telephone call to or from a worker.
Case conference
E0870
Case conference
$128.00 per hour
Case conference, attended by a speech pathologist and authorised by a claims agent or self-insured employer, for the purpose of determining—
• details of limitations/recommendations relating to a sustainable return to work;
• options for management of a worker's recovery;
• other related information.
A case conference may be requested by—
• a treating medical expert;
• a worker or worker's representative;
• a claims agent or self-insured employer;
• an employer (if not self-insured);
• a rehabilitation provider contracted by WorkCover.
The hourly rate excludes travelling time from rooms or other appropriate departure point to the venue and return. Travel may be charged separately.
Travel
E0910
Travel time
$108.80 per hour
Travel, authorised by a claims agent or self-insured employer, by a treating speech pathologist for the purposes of—
• a case conference; or
• a home, hospital or worksite visit; or
• a consultation where the worker is otherwise unable to attend the speech pathologist's clinic or rooms.
There is no charge for travel from 1 clinic or rooms to another clinic or rooms.
Non-scheduled services
E0999
Non scheduled services
$128.00 per hour
A service of a kind not listed above, provided by a speech pathologist and authorised by a claims agent or self-insured employer prior to the delivery of the service as being necessary, appropriate and reasonably required.
Schedule 5—Scales of charges—occupational therapists
This Schedule must be read in conjunction with the Occupational Therapy Fee Schedule Guidelines.
Item No
Service description
Maximum charge
(excl GST)
Consultation (individual worker)
A consultation by an occupational therapist involving some or all of the following elements:
• clinical assessment;
• clinical treatment;
• graded activity/exercise;
• pain management;
• stress management;
• relaxation training;
• biomechanical education;
• independent living skills training.
OT105
Initial consultation (history, examination and treatment)
$137.00 per hour
OT205
Subsequent consultation and treatment
$137.00 per hour
Corrective/serial splinting
OT300
Fabrication/fitting/adjustment of splint
$137.00 per hour
Work simulation (group program)
OT502
Work simulation, group program
$38.15 per hour per worker
A graduated program of activities planned and supervised by an occupational therapist used to simulate work conditions and the physical demands of duties.
The program will involve at least 2, and not more than 5, workers and will take place at the occupational therapist's rooms. The program will be highly structured, goal orientated and individualised for each worker.
The purpose of the program is to maximise the worker's ability to return to work.
The program will usually be agreed to by the worker to encourage attendance and appropriate behaviour at work.
Telephone calls
OT552
Telephone call greater than 3 minutes
$19.00
Calls of a case specific nature made by an occupational therapist to, or received by an occupational therapist from, the worker’s referring/treating medical expert, rehabilitation provider, claims agent or self-insured employer, employer (if not self-insured), WorkCover provider consultant or the worker's representative, excluding—
(a) calls made during a consultation; and
(b) calls of a duration of 3 minutes or less.
There is no charge for a telephone call to or from a worker.
Pain management group program
OT602
Pain management, group program
$38.15 per hour per worker
Pain management by way of a group program planned and supervised by an occupational therapist involving at least 2, but not more than 5, workers.
Functional capacity evaluation
OT700
Functional capacity evaluation
The maximum time chargeable is 7 hours.
$137.00 per hour
Assessment by an occupational therapist of a worker's work capacity, including—
(a) a series of standardised tests of the worker's physical capabilities focussed on selected work tolerances (ie, the observed and measured physical capabilities that affect a worker's ability to perform the physical demands of specified work tasks); and
(b) an analysis of the results of the tests to infer the worker's capacity to sustain a given work effort (ie, the worker's capacity to undertake specified work at a prescribed frequency over a given period of time, taking into account the pace compatible with such work); and
(c) preparation of a report with an executive summary outlining the major components of the service and relevant findings.
Worksite assessment
OT730
Worksite assessment
$137.00 per hour
Attendance by an occupational therapist at a worker's workplace in order to obtain an overview of the workplace and determine the availability of suitable duties.
Job analysis
OT740
Job analysis
$137.00 per hour
Job analysis by an occupational therapist, including—
(a) an analysis of the critical physical demands of occupational tasks; and
(b) determining the worker's capacity to undertake the tasks or giving consideration to available medical guidelines and the occupational therapist's knowledge of the worker's diagnosis, pathology and prognosis; and
(c) making recommendations for—
(i) modifying the tasks or the way in which the tasks are undertaken; or
(ii) providing aids or equipment; or
(iii) introducing work practice guidelines to ensure that the worker utilises appropriate body mechanics; and
(d) preparation of a report with an executive summary outlining the major components of the service and relevant findings.
Graduated return to work program
OT750
Graduated return to work program
$137.00 per hour
A program of work duties and work practice guidelines for a worker designed by an occupational therapist to increase the worker’s tolerance for the physical demands of work.
The purpose of the program is to assist the worker to maintain his or her employment while undertaking rehabilitation.
The program will involve actual and productive work duties identified by the occupational therapist as being within the worker's capacity and work practice guidelines relevant to the nature of the worker's injury and the performance of the particular duties.
Activities of daily living assessment
OT760
Activities of daily living assessment
$137.00 per hour
Assessment by an occupational therapist, usually conducted in a worker's home environment, of the worker's level of functioning in relation to personal care, household tasks and recreational and social activities.
The purpose of the assessment is to facilitate the reduction of the adverse impact of the injury on the worker and the early return of the worker to normal activity, and to provide an indicator of functional tolerances for determining work capacity.
Independent clinical assessment
OT780
Independent clinical assessment and report
$137.00 per hour
Service provided by an occupational therapist other than the treating occupational therapist comprising—
(a) a review of the worker's medical history; and
(b) a clinical assessment; and
(c) a review of the worker's activity and functional capacity; and
(d) preparation of a report,
for the purpose of providing a different diagnosis or making recommendations in relation to ongoing treatment goals, the worker's return to work and any other relevant matters.
The report will have been requested in writing by—
(a) a claims agent or self-insured employer; or
(b) a worker or worker's representative.
Functional estimation form
OT785
Functional estimation form
$19.00
Completion by an occupational therapist of a functional estimation form (in a form approved by the Corporation) and provision of the form to a worker's referring/treating medical expert. The form is completed when information directly affecting the worker's capacity to return to work or the process of the worker returning to work is identified by the occupational therapist.
Reports
OT810
Comprehensive report
$205.50
A report by a treating occupational therapist, relating to the status of a claim and comprising a clinical opinion or statement or a response to specific questions, that has been requested in writing by—
(a) a claims agent or self-insured employer; or
(b) a worker or worker's representative.
A report will be taken to be comprehensive when re-examination of the worker is a prerequisite for the preparation of the report.
The consultation should be charged in accordance with the appropriate item.
OT820
Standard report
$137.00
A report by a treating occupational therapist, relating to the status of a claim and comprising a clinical opinion or statement or a response to specific questions, that has been requested in writing by—
(a) a claims agent or self-insured employer; or
(b) a worker or worker's representative.
A report will be taken to be standard when re-examination of the worker is not required and the report is based on a transcription of existing clinical records.
Case conference
OT870
Case conference
$137.00 per hour
Case conference, attended by an occupational therapist and authorised by a claims agent or self-insured employer, for the purpose of determining—
• details of limitations/recommendations relating to a sustainable return to work;
• options for management of a worker's recovery;
• other related information.
A case conference may be requested by—
• a treating medical expert;
• a worker or worker's representative;
• a claims agent or self-insured employer;
• an employer (if not self-insured);
• a rehabilitation provider contracted by WorkCover.
The hourly rate excludes travelling time from rooms or other appropriate departure point to the venue and return. Travel may be charged separately.
Travel
OT905
Travel time
$116.45 per hour
Travel, authorised by a claims agent or self-insured employer, by a treating occupational therapist for the purposes of—
(a) a case conference; or
(b) a home, hospital or worksite visit; or
(c) consultation where the worker is otherwise unable to attend the physiotherapist's clinic or rooms.
There is no charge for travel from 1 clinic or rooms to another clinic or rooms.
Non-scheduled services
OT999
Non scheduled services
$137.00 per hour
A service of a kind not listed above provided by an occupational therapist and authorised by a claims agent or self-insured employer prior to the delivery of the service as being necessary, appropriate and reasonably required.
7—Variation of Schedule 6—Scales of charges—chiropractors
Schedule 6, item headed "Telephone calls"—after "Calls of a" insert:
case
Note—
As required by section 10AA(2) of the Subordinate Legislation Act 1978, the Minister has certified that, in the Minister's opinion, it is necessary or appropriate that these regulations come into operation as set out in these regulations.
Made by the Governor
following consultation as required under section 32(13) of the Workers Rehabilitation and Compensation Act 1986 and with the advice and consent of the Executive Council
on 28 September 2006
No 227 of 2006
06WKC002CS
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