2015 WorkCover rates for general practitioners

WorkCover payment classification system information – professional medical services

Payment classification code

Type of service

Fee

Service description

AA010

Level A consultation

$37.00

AMA codes must be used for all consultations and medical treatment services.

The rate for consultation fee applies for services provided on or after 1 January 2015. GST should not be charged on the consultation fee.

For further information on the criteria for Level A, B, C & D consultation services, please consult the AMA list of medical services and fees (1 November 2014).

Out-of-hours fees are only payable for emergency attendance and emergency treatment of a worker at a time when the practice is not usually open.

AA020

Level B consultation

$75.00

AA030

Level C consultation

$136.00

AA040

Level D consultation

$210.00

WCO001

Certificate of capacity

$44.50 (plus GST)

Initial certificate of capacity only.

One certification fee may be charged for the initial certificate only.

No fee is payable for subsequent certificates.

To order certificates of capacity phone: WorkCover Publications Hotline 13 10 50.

WCO002

Maximum hourly rate payable to General Practitioner

$266.40 or $22.20 per 5 minutes

This fee is to remunerate for any time spent by the medical practitioner, in addition to the usual medical management, to assist the worker to stay at or return to work. These rates may cover, for example, discussions with employers, case conferences (see definition below), visits to worksites, time spent reviewing injury management or return to work plans and providing additional reports requested from treating doctors and pre-approved by the insurer. These should be billed under the WorkCover payment classification code WCO002 and reflect the time taken (to the nearest five minutes) to deliver the service. 

Case conference

$22.20 per 5 minutes (plus GST)

$266.40 per hour (plus GST)

Case conference means discussions additional to that required for the management of patients with comparable injuries/conditions that are not compensable. Case conferencing can be via a face-to-face meeting, video conference or teleconference with any or all of the following parties – workplace rehabilitation provider, employer, insurer or other treatment provider delivering services to the worker – to assist the worker to stay at or return to work. If the discussion is with the worker, it must involve a third party to be considered a case conference. Discussions between treating doctors and practitioners relating to treatment are considered a normal interaction between referring doctor and practitioner and are not to be charged. File notes of case conferences are to be documented in the medical practitioner’s records indicating the person(s) spoken to, details of discussions, duration of the discussion and outcomes. This information may be required for invoicing purposes.

WCO004

Other medical items

Cost price

The cost of all bandages and dressings etc.

PHS001

Pharmaceutical services

Cost price

Payments for pharmaceutical services.

WCO005

Medical records

$36 (for 33 pages or less). An additional $1.30 per additional page if more than 33 pages (plus GST).

Fee for providing copies of medical records (including treating general practitioner, specialist or consulting surgeon notes and reports).

 

 PDF version of the 2015 WorkCover rates for general practitioners

Catalogue No. WC01690