Allied health professionals
We provide information for people who provide allied health services to employees who have an accepted claim under the Safety, Rehabilitation and Compensation Act 1988 (SRC Act).
Overview of allied health services
Allied health services are delivered by professionals who are not doctors, dentists or nurses. There are a broad range of allied health services and the services may be provided under the direction of a legally qualified medical practitioner, such as a general practitioner or a medical specialist.
Allied health services include:
- exercise therapy
- massage therapy
In recognition of the health benefits of good work, Comcare’s goal for allied health services is to support the employee to recover at and return to work.
If you are an employee, see medical treatment to find out how to apply for allied health services.
Standards for allied health professionals
Allied health professionals providing services under the SRC Act must have the appropriate qualifications, skills and experience to provide those services.
Australian Health Practitioners Regulation Authority (AHPRA) standards
The Australian Health Practitioners Regulation Authority (AHPRA) sets registration standards for the allied health sector professions of chinese medicine, chiropractic, occupational therapy, optometry, osteopathy, pharmacy, physiotherapy, podiatry and psychology.
Allied health professionals offering these services must meet AHPRA’s registration standards to deliver services in the Comcare scheme.
Registration with professional association
Comcare strongly recommends that employees engage an allied health provider with relevant membership to an appropriate professional body.
By choosing a provider with a membership to a professional body, the employee and Comcare can be confident that the provider has the training and competencies to deliver high quality, individualised services.
The Clinical Framework
Comcare endorses the Clinical Framework for the Delivery of Health Services (PDF, 1.2 MB). This framework outlines a set of guiding principles for the delivery of allied health services to injured or ill employees.
The principles include:
- measure and demonstrate the effectiveness of treatment
- adopt a biopsychosocial approach
- empower the injured person to manage their injury
- implement goals focused on optimising function, participation and return to work
- base treatment on the best available research evidence.
We expect you, as a provider of an allied health service, to adopt these principles within the standards of your profession.
The process for engaging an allied health provider
Step 1: Employee applies
An employee identifies treatment requirements with their medical practitioner or allied health provider. The employee receives a plan for their treatment – this can be included in their medical certificate. The employee seeks approval for medical treatment from their claims manager.
Step 2: Assessment
A claims manager will assess this application. The claims manager may require more information from you or the employee to make a determination and may require a treatment plan to be completed.
The claims manager will general consider whether:
- there is a clinical justification for treatment
- the treatment is likely to be effective and support functional improvement
- the treatment helps the employee move towards functional independence, participation and self-management.
Step 3: Determination
If approved, the claim manager issues a determination for the services to the employee in writing.
The determination shows the level of services that have been approved and the length of time.
Step 4: Employee receives treatment
The allied health provider works with the employee to deliver the approved services.
Step 5: Services are reviewed
Claims managers regularly review the services that are approved to ensure the:
- employee is receiving an appropriate level of service; and
- type of assistance being provided meets the employee’s needs.
We expect the type and frequency of allied health services an employee requires will reduce as they recover and adapt.
Physiotherapy and Psychology services & Treatment plans
Employees of an Australian Government agency or statutory authority
When a plan must be completed
A treatment plan must be provided when working with employees of an Australian government agency or statutory authority.
Comcare can fund an initial five sessions of services for an accepted compensable injury. After this, Comcare requires a Physiotherapy Treatment Plan (PDF, 111.5 KB) (PDF, 147.8 KB) or Psychology Treatment Plan (PDF, 150.4 KB) to be submitted.
A Treatment Plan must be completed and submitted when:
- services are expected to exceed five treatment sessions
- there has been a gap in treatment more than 12 months
- the employee is attending a new physiotherapy or psychology clinic.
Only one Treatment Plan is usually required during the life of the claim. All fields on the Treatment Plan must be completed.
If reasonable additional services are needed at the end of a treatment plan, you must call Comcare to discuss the employee’s progress and the need for further services. Following this call you will also be required to provide a new Treatment Plan.
Please note: Psychologists must get prior approval where these is reasonable justification for consultations to exceed 60 minutes. Without prior approval, we can only fund a maximum of 60 minutes per consultation per day. Request for extended consultations can be made using a Psychology Extended Consultation Request form (PDF, 58.5 KB) (PDF, 125.0 KB). This form is required in addition to the Psychology Treatment Plan (PDF, 128.2 KB) (PDF, 150.4 KB).
Significant gaps in treatment
A gap in treatment is when services have not been provided for more than 12 months.
Following a gap in treatment, Comcare can fund services after:
- a Physiotherapy Treatment Plan (PDF, 111.5 KB) (PDF, 147.8 KB) or Psychology Treatment Plan (PDF, 150.4 KB) to be completed and submitted
- confirmation has been received that the treatment is related to a work-related injury.
If your client is receiving long-term services, we may ask for a review of your treatment goals and progress. A Physiotherapist or Psychologist from Comcare’s Clinical Panel may also contact you to discuss your treatment plan.
These forms are for employees of an Australian government agency or statutory authority.
- Physiotherapy Treatment Plan (PDF, 147.8 KB)
- How to use the Physiotherapy Treatment Plan (PDF, 99.7 KB).
- Psychology Treatment Plan (PDF, 150.4 KB)
- How to use the Psychology Treatment Plan (PDF, 97.7 KB)
- Psychology Extended Consultation Request form (PDF, 125.0 KB).
Invoicing for services delivered under a treatment plan
There are special requirements for invoicing when the services are delivered under a treatment plan. See the Payment for Services section below for more information.
Employees of self-insured licensees
If the employee works for a self-insured licensee, allied health providers should check with the claims manager to confirm any specific requirements around treatment plans.
Payment for services
Rates of payment
Comcare provides guidance on the upper limits for fees for allied health treatment. See Rates for medical and allied health treatment.
Invoicing for a Treatment Plan
When a Treatment Plan is required, Comcare will pay for the completion and submission of the Treatment Plan, including a consultation. See Rates for medical and allied health treatment.
The item numbers are:
- physiotherapy - PHYST1 (Consult with PTP)
- psychology - PSYT1 (Psychology Consult with PTP)
How providers are paid
There are two ways you can be paid:
- through the claims manager (preferred method), or
- by the employee.
Through the claims manager
If the employee's claim is managed by Comcare, you can send invoices for approved services directly to Comcare. Invoices should include the information required in a service provider invoice.
Email the invoice to firstname.lastname@example.org.
Comcare usually makes payment within 28 days of receiving the invoice. For more information, see Operating as a Comcare service provider.
If the employee’s claim is managed by a self-insured licensee, you work directly with the licensee.
By the employee
Where necessary, allied health service providers can seek payment directly from the employee receiving the service. The employee can then seek reimbursement from their claims manager.
Resources for treating health practitioners
Comcare produces resources for allied health professionals and GPs that provide information relating to treating employees with work-related injury or illness. View our resources for treating health practitioners.