Putting you first at the centre of what we do. Keeping you healthy and safe at work. Supporting you when you are harmed at work. Ensuring your scheme works and is sustainable.

Physiotherapy Policy

Policy

Comcare can fund the reasonable cost of physiotherapy treatment required as a result of work-related injuries where the physiotherapist is registered with the Physiotherapy Board of Australia.

Guidelines

What physiotherapy services can Comcare fund?

Comcare can fund the reasonable cost of physiotherapy services where:

there is clinical justification for treatment
the treatment is likely to be effective and achieve or maintain measurable functional improvement
the treatment promotes progress towards functional independence, participation and self management.

Commencing treatment

Comcare is able to fund an initial five sessions of physiotherapy for a new injured worker prior to the submission of a Treatment Notification Plan (TNP).

A referral from a medical practitioner is not required for commencement of physiotherapy by an injured worker.

Comcare requires a TNP to be completed and submitted by the physiotherapist when:

physiotherapy is expected to exceed five (5) treatment sessions
there has been a gap in treatment of greater than 12 months
the Comcare injured worker attends a new physiotherapy clinic.

Only one TNP is usually required during the life of the claim. All fields on the TNP must be completed.

If reasonable additional physiotherapy services are required following the completion of a treatment plan, it is requested that the physiotherapist contact the Claims Services Officer by phone to discuss the progress of the injured worker and the need for further services. Physiotherapists should not submit multiple TNPs, a report or review plans unless specifically requested by Comcare.

Significant gaps in treatment

For the purpose of this policy a gap in treatment is when no physiotherapy services have been sought for more than 12 months and treatment resumes after this period. Comcare is able to fund physiotherapy services after a gap in treatment via the following process:

completion of a TNP
confirmation that the treatment is related to the work-related injury.

Ongoing Treatment

For injured workers receiving long term physiotherapy services, Comcare may request a review of treatment goals and progress. Comcare will write to the physiotherapy service provider and request completion of a Review Treatment Plan (RTP) on a case by case basis. The RTP will be sent to the provider for completion at the time of the review.Comcare will fund the completion of a RTP which is inclusive of a consultation through item number COMPHYSR2 – Consultation with RTP

Invoicing for physiotherapy services inclusive of a TNP

Comcare will fund the completion and submission of the TNP which is inclusive of a consultation through item number COMPHYST1 - Consultation with TNP.

Typical billing may involve the following:

initial Consultation x 1
consultation with TNP x 1
standard consultation x 3

Total Consultations = 5 consultations including a TNP

Invoicing Information required from Physiotherapy providers

Comcare requires that the actual provider of the service be identified on each invoice for payment. It is the responsibility of the registered provider to ensure invoices submitted to Comcare are correct, regardless of who has prepared the account. Invoices sent to Comcare must display the following information:

injured worker name
injured worker claim number
date of services
description of services
service location
amount billed for each service
name of the treating physiotherapist

Relevant forms and notes

Provider Use only