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Fee information for rehabilitation providers

For: Service providers Information seekers

Comcare provides fee guidance for services by workplace rehabilitation providers to promote consistent costs across the Comcare scheme.


What our fee guidance is based on

Comcare’s fee guidance for workplace rehabilitation providers is based on several factors.

  • A review of current practices in managing workplace rehabilitation provider costs in the Comcare scheme.
  • A review of fee rates of other Australian workers’ compensation schemes.
  • The results of public consultation on indicative rates.

We acknowledge that workplace rehabilitation service fees may vary for reasons including:

  • case complexity, which includes the nature of the injury or illness, presence of co-morbidities, amount of time an employee has been away from work or is expected to be away, nature of the pre-injury employment, and the circumstances of the claim
  • the workplace rehabilitation provider’s qualifications and level of experience
  • geographical location.

We don't intend our fee guidance to override existing service level agreements between employers and work rehabilitation providers.

We encourage workplace rehabilitation providers and the rehabilitation authority (who is usually the employer), to work together on the type of rehabilitation services required and the appropriate cost for the service.

In order to deliver workplace rehabilitation services in the Comcare scheme, providers must:

Rate for services

The Comcare rate for worker rehabilitation provider services in 2020–21 is $187.97 (+GST) per hour.

This is Comcare’s recommended rate for services, which we provide as a guide to promote consistent costs across the Comcare scheme. Rates are indexed annually on 1 July.

Due to rounding in the indexation process, the rate for multiple hours may vary by a small amount from the rate used for one hour.

Estimated duration of services

Table 1: Types of workplace rehabilitation services and the expected duration of each service

WRP service typeExpected duration of service and fee using an hourly rate of $187.97 (+GST) Description of service

Initial needs assessment (including workplace visit) and report (s.36)

6 to 8 hours

($1127.84 to $1503.79 +GST)

The assessment provides information on an employee’s capability to undertake a rehabilitation program and, if appropriate, the type of program they require.

The assessment typically includes:

  • a meeting with the employee
  • a workplace visit (see workplace assessment below)
  • analysis of pre-injury duties
  • liaison with the treating practitioner(s)
  • identification of potential barriers to rehabilitation and recommended strategies
  • documentation of the assessment findings.

Vocational assessment and report

6 to 8 hours

($1127.84 to $1503.79 +GST)

Vocational assessment includes:

  • an analysis of the employee’s work profile
  • suitable vocational options
  • recommended strategies to achieve vocational goals.

The assessment can range from a brief vocational screening through to detailed assessment and vocational counselling.

Functional assessment and report

4 to 6 hours

($751.90 to $1127.84 +GST)

A functional assessment involves objective measures of an employee’s current work capacity against relevant work demands. The assessment can be onsite or a
standalone assessment when a workplace visit is not possible.

The purpose of the assessment is to identify suitable tasks for the employee.

Workplace assessment and report

4 to 6 hours

($751.90 to $1127.84 +GST)

An onsite assessment to assess the employee’s pre-injury duties, identify suitable tasks and design a rehabilitation program including safe upgrades of tasks and hours.

Progress report

30 to 60 minutes

($93.99 to $187.97 +GST)

A progress report provides an update of the employee’s progress against agreed rehabilitation milestones. The report may include:

  • an update of relevant outcome measures
  • review of screening tools
  • strategies to address barriers to rehabilitation.

A progress report can be:

  • requested at agreed regular intervals or only when considered necessary
  • informal, in the form of an email
  • formal, using a report template.

Closure report

30 to 60 minutes

($93.99 to $187.97 +GST)

A closure report provides a full summary of the employee’s rehabilitation from referral to closure or cessation of work rehabilitation provider services.

Rates for previous years

See Workplace rehabilitation provider fee rates in 2018–20 (PDF, 66.6 KB).

Rate for provider travel time

The Comcare rate for worker rehabilitation provider travel time in 2020–21 is $187.97 (+GST) per hour.

This is Comcare’s recommended rate for provider travel time, which we provide as a guide to promote consistent costs across the Comcare scheme. Rates are indexed annually on 1 July.

Workplace rehabilitation providers can invoice for travel after the first 30 minutes for each trip. Travel of 30 minutes or less is included in the service fee and is not charged separately.

Due to rounding in the indexation process, the rate for multiple hours may vary by a small amount from the rate used for one hour.

How to apply the travel time rate

Workplace rehabilitation providers need to seek prior approval from the rehabilitation authority, who is usually the employer, for travel above 30 minutes.

Travel must be calculated from the workplace rehabilitation provider’s closest office location (or cost centre) to the site being attended.

For example:

  • if a workplace rehabilitation provider travels a total of 45 minutes to the employee’s workplace to perform a workplace assessment, they can charge for 15 minutes of travel.
  • if the workplace rehabilitation provider must return to the employee’s workplace to complete the worksite assessment on a separate date then they can charge another 15 minutes travel.

We encourage workplace rehabilitation providers and rehabilitation case managers to communicate on the need for travel.

Rates for previous years

See Workplace rehabilitation provider fee rates in 2018–20 (PDF, 66.6 KB).

Invoicing procedures and service codes

As a provider, you need to comply with the insurer’s invoicing requirements and have appropriate systems in place to track costs and billing of services provided.

For employees of Australian Government agencies or statutory authorities

Service codes

Comcare workplace rehabilitation provider service codes (PDF, 104.0 KB) must be used by:

  • workplace rehabilitation providers on invoices
  • rehabilitation case managers on all new rehabilitation programs or program alterations.

Itemised invoices

Comcare requires itemised invoices.

Invoices must include the:

Applying GST incorrectly

If Comcare considers that you have applied GST incorrectly, you may be asked to re-issue your invoice. If you are not registered for GST at the time of service, your invoice will be returned. This is due to Australian Taxation Office (ATO) requirements.

Rehabilitation reimbursement forms

For reimbursement of code 90 services:

For reimbursement of codes 92, 93 and 94 services:

We need to receive a signed copy of the relevant rehabilitation form with the invoice, or we will need to return the invoice to you.

Submitting invoices

Submit your invoice to us by:

Do not email invoices directly to a Comcare delegate unless you receive a request to do so.

How Comcare makes payments

Comcare pays workplace rehabilitation providers by electronic funds transfer (EFT).

Payments managed by Comcare are usually made within 28 days of receiving the invoice.

Provide your bank details

When you register as a provider, you need to provide us with your banking—electronic funds transfer (EFT)—details.

Register or update your bank details

Invoice enquiries

For rehabilitation invoice enquiries:

For employees of a self-insured licensee

Workplace rehabilitation providers should contact the self-insured licensee for details of their invoicing procedures and service codes.


More information

For information on providing workplace rehabilitation services, see our Rehabilitation Case Manager handbook (PDF, 658.3 KB).

For more information, email general.enquiries@comcare.gov.au or call us on 1300 366 979.

Page last reviewed: 15 December 2019
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Comcare
GPO Box 9905, Canberra, ACT 2601
1300 366 979 | www.comcare.gov.au

Date printed 02 Jul 2020

https://www.comcare.gov.au/service-providers/workplace-rehabilitation-providers/fees