TAC physiotherapy – what you need to know
If you’ve been involved in a motor vehicle accident, the TAC is able to pay for medical treatment.
You can read about TAC and the payment of medical expenses here.
This page will specifically explore TAC physiotherapy and what you need to know if you are wanting to claim the cost of treatment from the TAC.
Physio treatment within 90 days after the accident
If you need TAC treatment within 90 days after your accident you do not need to get approval from the TAC to have physiotherapy treatment.
You just need to make sure that you have an accepted TAC claim, that the treatment is recommended by a medical or health practitioner, and that the treatment is for an injury or injuries that you suffered in the accident.
You do not need to contact the TAC and ask them to provide you with the details of a physiotherapist in your area that is approved by the TAC.
You are able to see any physiotherapist that you choose.
You just need to contact the physiotherapist that you want to book in with, tell them that you have a TAC claim and when you attend your appointment provide them with your TAC claim number.
Physio treatment 90 days or more after the accident
If you are wanting to claim physiotherapy treatment 90 days or more after the accidentand the TAC haven’t previously approved more treatment, then you’ll need to contact the TAC and ask them to approve physiotherapy treatment.
It’s likely that they will require material in support from your physiotherapist or another medical practitioner saying why you need the treatment.
This might mean that you just need to get a short letter from the physiotherapist after your first session and then provide it to the TAC.
If it is more than six months since you’ve had any medical treatment paid for by the TAC, then the TAC will generally request that you ask for approval for treatment.
As with other medical expenses the TAC will cover, when it comes to physiotherapy treatment they will have set fees that they will pay.
If your provider bills you more than the amount the TAC is prepared to pay for physiotherapy treatment, then you’ll be required to pay any extra amount to the physiotherapist.
What the TAC will pay for in relation to physiotherapy
For an initial consultation the maximum rate payable by the TAC is $75.43.
For a standard consultation the maximum rate is $57.48.
If the physiotherapist is required to attend and provide treatment outside their rooms, for an initial consultation the TAC will pay a maximum of $107.66.
For a standard consultation (again outside their rooms) the TAC will pay $86.15.
If the physiotherapist is required to inspect equipment and provide a report (again outside of their rooms) the maximum amount payable is $126.35.
In relation to telehealth consultations, the maximum amount that the TAC will pay is $75.43 for an initial consultation and $57.48 for a standard consultation.
There’s more information on the TAC’s website in relation to specific amounts that they will pay.
The above figures are affective 1 July 2021 and may change every financial year.
Paying for physio treatment
You have two options when it comes to paying a physiotherapist for treatment.
You can give the physiotherapist your TAC claim number and ask them to send their account to the TAC directly.
The TAC will then need to pay the physiotherapist on your behalf.
As mentioned above, if the physiotherapist wants to bill more than what the TAC will pay for, then you’ll need to pay the difference.
The other option is to pay the physiotherapist yourself after your treatment and then submit proof of payment to the TAC who will then need to reimburse you.
Note that some providers will prefer you to pay and then seek reimbursement from the TAC yourself.
If this is a concern of yours then before you book in with a particular physiotherapist it’s not a bad idea to ask them what they prefer to do in terms of payment.
If the TAC don’t approve physio treatment
If the TAC doesn’t approve treatment, then you can ask them to perform an internal review or alternatively, if you have a lawyer, lodge a dispute application.
If the matter still doesn’t resolve, then you can pursue the matter to VCAT.
You can read more about these options here.
