Title: Workers Rehabilitation and Compensation (Scales of Medical andOther Charges) Variation Regulations 2004
Subject: Workers Rehabilitation andCompensation Act 1986
Author: Office of Parliamentary Counsel
Category: public
Document comments: 32

No 32 of 2004 published in Gazette 20.5.2004 p 1331

Workers Rehabilitation and Compensation (Scales of Medical and Other Charges) Variation Regulations 2004

Workers Rehabilitation and Compensation (Scales of Medical and Other Charges) Variation Regulations 2004
Part 1—Preliminary

Workers Rehabilitation and Compensation (Scales of Medical and Other Charges) Variation Regulations 2004
Preliminary—Part 1

Workers Rehabilitation and Compensation (Scales of Medical and Other Charges) Variation Regulations 2004
Part 2—Variation of Workers Rehabilitation and Compensation (Scales of Medical and Other Charges) Regulations 1995

Workers Rehabilitation and Compensation (Scales of Medical and Other Charges) Variation Regulations 2004
Variation of Workers Rehabilitation and Compensation (Scales of Medical and Other Charges) Regulations 1995—Part 2

Workers Rehabilitation and Compensation (Scales of Medical and Other Charges) Variation Regulations 2004
Schedule 1—Substituted schedule

Workers Rehabilitation and Compensation (Scales of Medical and Other Charges) Variation Regulations 2004
Substituted schedule—Schedule 1

South Australia
Workers Rehabilitation and Compensation (Scales of Medical and Other Charges) Variation Regulations 2004
under the Workers Rehabilitation and Compensation Act 1986

Contents
Part 1—Preliminary
1	Short title
2	Commencement
3	Variation provisions
Part 2—Variation of Workers Rehabilitation and Compensation (Scales of Medical and Other Charges) Regulations 1995
4	Substitution of Schedule 2—Scale of Charges—Physiotherapy services
Schedule 1—Substituted schedule
Schedule 2—Scale of charges—physiotherapy services

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 2004.
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—Substitution of Schedule 2—Scale of Charges—Physiotherapy services
Schedule 2—delete the Schedule and substitute the Schedule in Schedule 1 of these regulations

Schedule 1—Substituted schedule
Schedule 2—Scale of charges—physiotherapy services

Item No. | Service Description | Charge
| CORE PHYSIOTHERAPY SCHEDULE SERVICES |
| Refer to the Physiotherapy Service and Fee Schedule Guidelines for requirements regarding the delivery of core schedule services. |
| CONSULTATIONS |

INITIAL CONSULTATION
It is recommended that the treating physiotherapist, on the commencement of physiotherapy treatment, notifies the Self-Managed Employer, Exempt Employer or Claims Agent in respect of any new claim.
An initial consultation involves some or all of the following elements, the components of which are at the discretion of the treating physiotherapist:

(i)	Subjective Reporting
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.

(ii)	Objective Assessment
Movement – active, passive, resisted, repeated; muscle tone, spasm, weakness; accessory movements, passive intervertebral movements etc. Appropriate procedures/tests as indicated.

(iii)	Assessment Results
Provisional diagnosis; goals of treatment; treatment plan.

(iv)	Treatment
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.

(v)	Documentation
Recording all of the above in the clinical record of the patient, as well as: X-ray and results of other relevant tests; skin tests, warnings (if applicable).

(vi)	Communication
Communication of information relevant to the rehabilitation and return to work of the patient/injured worker to the employer, Self-Managed Employer, Exempt Employer, Claims Agent, or coordinating general practitioner.

PT105

Initial consultation, assessment, treatment
Initial assessment and treatment of condition

$47.70

SUBSEQUENT CONSULTATIONS
Reassessment and treatment of condition. This consultation must involve some or all of the following elements, the components of which are at the discretion of the treating physiotherapist.

(i)	History Taking/Assessment
The history and assessment related to the condition previously treated and its behaviour following the previous treatment.

(ii)	Examination
Examination by the physiotherapist of the condition previously treated.

(iii)	Treatment
An appropriate treatment is performed.

(iv)	Reassessment
Reassessment by both the patient and the physiotherapist.

(v)	Discussion of the Management Program with Patient/Carer
The goals of treatment and management program are discussed with the patient and counselling given regarding care and/or action to be taken before the next consultation or if no further treatment is required, regarding care and preventative measures.

(vi)	Communication
The appropriate management of a case involves communicating standard information to key parties. Information relevant to the management of the claim should be communicated to the treating general practitioner, Claims Agent case manager, Claims Agent medical, rehabilitation or physiotherapy advisor or non-medical experts involved in the claim.

(vii)	Physiotherapy Treatment Form
This form is to be completed once only as part of a subsequent consultation and forwarded to the Claims Agent with their invoice. This form will be initiated by the physiotherapist and forwarded to the Claims Agent where treatment is expected to extend for longer than 6 weeks.
No additional fee is billable for the completion of this form.

(viii)	Clinical Records
Comprehensive clinical notes must be kept recording all of the above.

PT205

Subsequent consultation – Level A
Assessment, treatment. This consultation must involve some, but not usually all, of the elements of a Subsequent Consultation and requires minimal practitioner contact time.

$22.00

PT210

Subsequent consultation– Level B
Assessment, treatment. This consultation must involve some or all of the elements of a Subsequent Consultation.

$37.85

PT215

Subsequent consultation – Level C
Assessment, treatment. This consultation must include all of the elements of a Subsequent Consultation, but because of the complexity of the injury, will require extra time for history taking, examination, treatment, documentation and liaison (eg injuries following major trauma, major surgery requiring intensive post-operative treatment).

$47.85

PT220

Subsequent consultation – Level D
Assessment, treatment. This consultation must include all of the elements of a Subsequent Consultation but requires greater time and should only be required in a limited number of cases where the case and treatment are extremely complex (eg 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).

$63.70

CORRECTIVE/SERIAL SPLINTING
Refer to the Physiotherapy Service and Fee Schedule Guidelines for further details regarding the types of splints available to the physiotherapist and the conditions associated with the provision of these splints.

PT300 | Fabrication/Fitting/Adjustment of Splint | $103.40 per hour

PT390

Materials used to construct or modify a splint
(Note: ‘DF’ means derived fee. Each account will be considered on its merits.)

DF

AQUATIC PHYSIOTHERAPY AND EXERCISE SERVICES
Refer to Physiotherapy Service and Fee Schedule Guidelines for further details regarding delivery of Aquatic Physiotherapy services.

| AQUATIC PHYSIOTHERAPY (HYDROTHERAPY) |

PT415

Initial/individual aquatic physiotherapy (hydrotherapy) consultation
The first aquatic physiotherapy session requires significant planning, supervision and monitoring of individual clients and this item should be used.
This item may then be used for the 2 subsequent aquatic physiotherapy consultations after the initial service. It may also be used for one review at week 4-6 of the program.
Only in exceptional circumstances should the item PT415 be utilised after the first three appointments (eg. severe trauma, fear of water) where much closer supervision is required. Prior case manager approval is required in these circumstances.

$37.85

PT420

Subsequent/group aquatic physiotherapy (hydrotherapy) consultation
Aquatic physiotherapy sessions after the first three visits are to be billed at this rate. Clients may be treated in a group but all the programs must be unique and individualised to the particular client.

$15.80 per person

| EXERCISE |

PT455

Individual exercise consultation
Individual reassessment and exercise treatment of condition planned and supervised by a physiotherapist. This consultation must involve some or all of the elements of a Subsequent Consultation and the client to physiotherapist ratio must be 1:1 for the duration of the consultation.

$37.85

PT460

Group exercise consultation
Group exercise session planned and supervised by a physiotherapist. This consultation must involve some or all the elements of a Subsequent Consultation, with exercise treatment undertaken in a group. Each group must be comprised of a maximum of 8 patients per session.

$11.20 per person

PT429

Entry fee, aquatic physiotherapy (hydrotherapy) or exercise
Entry to a public or privately operated facility.
This item may be utilised when the physiotherapist supervises an individual or group exercise or aquatic physiotherapy session with a patient to reimburse them for entry paid for the patient. This item is not to be used if the physiotherapist is an employee of the exercise or hydrotherapy facility. For group sessions, this fee is applicable for each participant supervised by the physiotherapist.
(Note: ‘DF’ means derived fee. Each account will be considered on its merits.)

DF

| TRAVEL |
| The treating physiotherapist must receive prior approval from the Self-Managed Employer, Exempt Employer or Claims Agent before providing this service. |
| All travel items refer to return trips to and from rooms to a workplace, hospital, patient’s home or case conference. |
| Refer to the Physiotherapy Service and Fee Schedule Guidelines for further details regarding travel. |

PT905

Travel
Travel up to 100km from Adelaide GPO

$90.00 per hour

PT900

Travel after 100km from Adelaide GPO
Travel with a destination more than 100km distance from GPO where the physiotherapist is based in the metropolitan area attracts a 20% loading to be charged under this item.

$100.00 per hour

| TELEPHONE CALLS |
| Refer to the Physiotherapy Service and Fee Schedule Guidelines for further details regarding telephone calls. |

PT552

Telephone call
Calls of case specific nature made to or received from the worker’s referring/treating medical expert, rehabilitation provider, claims agent, self managed employer or self insured (exempt) case manager, employer, WorkCover Corporation Provider Consultant or worker advocate.
Excludes calls made during consultation and calls to or from the worker.

$15.00

| TREATMENT REVIEW |

PT785

Functional Notification Form
Completion of the Functional Notification Form will be initiated primarily by the treating physiotherapist when information is identified which directly impacts upon the patient’s capacity to return to work and any other issues influencing the return to work process. This form must be forwarded directly to the treating general practitioner. The Functional Notification Form may only be completed when it complies with the criteria specified within the Physiotherapy Service and Fee Schedule Guidelines.

$15.00

PT780

Independent clinical assessment
Includes a review of medical history, activity and a clinical examination to provide a differential diagnosis and/or make recommendations regarding ongoing treatment goals and return to work.
This service includes the provision of a report detailing relevant findings and recommendations.
The Self-Managed Employer, Exempt Employer or Claims Agent must be notified prior to the provision of this service to seek approval for payment.
This service will NOT be performed by the treating physiotherapist.
Refer to the Physiotherapy Service and Fee Schedule Guidelines for service standards and indicators for use regarding Independent Clinical Assessment.

$107.80 per hour

SUPPLEMENTARY SCHEDULE SERVICES
Refer to the Physiotherapy Service and Fee Schedule Guidelines for requirements regarding the delivery of supplementary schedule services

| REHABILITATION AND RETURN TO WORK SERVICES |
| Refer to the Physiotherapy Service and Fee Schedule Guidelines for service requirements and indicators for use of each rehabilitation and return to work service listed within this schedule. |

PT700

Functional Capacity Assessment (FCA) or Functional Capacity Evaluation (FCE) (Standardised)
This service is undertaken to determine a worker’s inferred work capacity based on assessment of a worker’s physical capabilities through a series of standardised tests that focus on selected work tolerances. Maximum time – 7 hours including report preparation.

$107.80 per hour

PT730

Worksite assessment
Involves attending the worksite in order to ascertain the availability of duties, including an overview of the following:
	—	physical environment;
	—	mental work demands;
	—	human behaviour;
	—	working conditions;
	—	educational requirements;
	—	other conditions.

$107.80 per hour

PT740

Job analysis
Aims to identify specific tasks or employment options that are within a worker’s capacity and ability to perform, through modifications to elements of the job, the provision of aids and equipment or training that will safely extend the worker’s capacity range.
The analysis consists of four main categories:
	—	workstation design;
	—	work demands (intellectual/physical/sensory/perceptual);
	—	equipment;
	—	work environment.

$107.80 per hour

PT750

Work hardening on site
Aims to increase a worker’s capacity, tolerance and endurance for the physical and intellectual demands of specified duties and employment, resulting in improved work performance and leading to a safe return to suitable employment.

$107.80 per hour

PT760

Activities of daily living assessment
Conducted in a worker’s home with the aim of meeting the following objectives:
	—	providing essential services for severely injured workers; and/or
	—	maintaining or improving a worker’s level of physical functioning at home;
	—	preventing further injury or aggravation;
	—	assisting in preventing the development of chronicity in a worker’s condition.

$107.80 per hour

| OTHER SERVICES |

PT810

Comprehensive report
A Self-Managed Employer, Exempt Employer or Claims Agent may request a comprehensive report in response to a series of specific questions.
A report will be taken to be comprehensive when requested by a Self-Managed Employer, Exempt Employer or Claims Agent and re-examination of the worker is a prerequisite for the preparation of the report.
All reports referred to under this item are chargeable on an hourly basis with a maximum time chargeable of 1.5 hours.

$103.40 per hour

PT820

Standard report
A Self-Managed Employer, Exempt Employer or Claims Agent may request a standard report in response to a series of specific questions.
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 records.
All reports referred to under this item are chargeable on an hourly basis with a maximum time chargeable of 1 hour.
Refer to the Physiotherapy Service and Fee Schedule Guidelines for standards required for report writing.

$103.40 per hour

PT870

Case conference
Case conferences are used 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.

$103.40 per hour

A case conference may be requested by:
	—	a treating medical expert;
	—	an employer;
	—	a worker or worker advocate;
	—	a Self-Managed Employer, Exempt Employer, Claims Agent or appointed Rehabilitation Coordinator.

| The holding of a case conference must be authorised by the Self-Managed Employer, Exempt Employer or Claims Agent before the case conference is convened. |
| Refer to the Physiotherapy Service and Fee Schedule Guidelines for further detail regarding case conferences. |

CURAP

Therapeutic appliance
Includes an appliance or aid for reducing the extent of a compensable disability or enabling a patient to overcome in whole or in part the effects of a compensable disability (eg TENS machine).
(Note: ‘DF’ means derived fee. Each account will be considered on its merits.)
Refer to the Physiotherapy Service and Fee Schedule Guidelines for further detail regarding therapeutic appliances.

DF

PT999

Non scheduled services
The use of this item number requires the approval of the Self-Managed Employer, Exempt Employer or Claims Agent prior to the delivery of the service.
This item number is used when the provision of services not listed on the Core or Supplementary Fee Schedule is necessary, appropriate and reasonably required.
Refer to the Physiotherapy Service and Fee Schedule Guidelines for further detail regarding non-scheduled services.

$103.40 per hour

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
with the advice and consent of the Executive Council
on 20 May 2004
No 32 of 2004
03WKC003CS