Medical practitioners, allied health and pharmacists

Allied health professionals

For: Service providers Information seekers

Information for allied health professionals who provide services to employees with an accepted claim under the Safety, Rehabilitation and Compensation Act 1988 (SRC Act).

What are 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 that 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:

counselling
exercise therapy
massage therapy
occupational therapy
osteopathy
pharmacy
physiotherapy
psychology.

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 Agency standards

The Australian Health Practitioners Regulation Agency (AHPRA) sets registration standards for allied health sector professions including:

Chinese medicine
chiropractic
occupational therapy
optometry
osteopathy
pharmacy
physiotherapy
podiatry
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). The 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 allied health professionals 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 and 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 you to submit a:

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.

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.

All fields on the treatment plan should be completed before it is submitted to Comcare. Any period of ongoing treatment should be covered by a treatment plan.

Psychologists must get prior approval where there 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, 127.1 KB). This form is required in addition to the treatment plan.

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 or psychology treatment plan has been submitted and it has been confirmed that treatment is required for a work-related injury.

Ongoing treatment

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.

Forms

These forms are for employees of an Australian government agency or statutory authority.

Physiotherapy forms

Psychology forms

Invoicing for services delivered under a treatment plan

There are special requirements for invoicing when services have been 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.

See a list of corporations and organisations with a self-insurance licence.

Payment for services

Rates of payment

Rates for medical and allied health treatment outlines the upper fee limits for allied health treatments.

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.

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.

1. Through the claims manager

If the employee’s claim is managed by Comcare, you can submit their relevant allied health services invoices for payment in three ways:

Digitally via Tyro Health - This is our preferred invoicing method and the quickest way to get paid
by email at general.enquiries@comcare.gov.au
by post to Comcare, GPO Box 9905, Canberra ACT 2601

If you submit your invoices to Comcare digitally through Tyro Health, payment is usually next business day for approved invoices. For invoices submitted by email or post payment will take longer.

See more information on what to include on your invoice and if to apply Goods and Services Tax.

If the employee’s claim is managed by a self-insured licensee, you should work directly with the licensee.

Remember, only submit invoices after services have been provided.

2. 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 and information for allied health professionals treating employees with work-related injury or illness. View our resources for treating health practitioners.

Page last reviewed: 05 January 2023