Fees for non-admitted patients

Where an eligible person receives public hospital services as a public patient no charges will be raised, except for the following services provided to non-admitted patients and, in relation to pharmaceuticals only, to admitted patients upon separation:

  • dental services
  • spectacles and hearing aids
  • surgical supplies
  • prostheses – however, this does not include the following classes of prostheses, which must be provided free of charge:
    • artificial limbs
    • prostheses which are surgically implanted, either permanently or temporarily or are directly related to a clinically necessary surgical procedure
  • external breast prostheses funded by the National External Breast Prostheses Reimbursement Program
  • pharmaceuticals at a level consistent with the Pharmaceutical Benefits Scheme statutory co-payments
  • aids, appliances and home modifications
  • other services as agreed between the Commonwealth and Victoria.  

Refer to the National Health Reform Agreement, Section G1

MBS arrangements for funding of MRI apply to public and private non-admitted patients (eligibility conditions apply). Information is available at Improving access to Magnetic Resonance Imaging (MRI) Services fact sheet.

Dental fees

The Dental Health Program funding model is activity-based, using the Australian Dental Association service item codes, rather than courses of care. Performance is measured in terms of Dental Weighted Activity Units (DWAU), calculated using weighted Australian Dental Association item codes.

Funding is aligned to DWAUs to ensure that state activity targets are met.

Participation in Commonwealth initiatives

The Child Dental Benefits Schedule is a means-tested benefit scheme (Family Tax Benefit-A) for children ages 2–17, covering preventative and basic dental treatment.

In December 2016, the Commonwealth advised it would continue the Child Dental Benefits Schedule and retain public sector access, extending the scheme to 31 December 2019.

The Commonwealth initially announced a reduced biennial cap of $700 per child from 1 January 2017. However, on 8 February 2017, the Commonwealth Minister for Health reinstated the Child Dental Benefits Schedule cap of $1,000 per child over two years.

Dental Health Program fees policy

Fees for public dental services apply to:

  • people 18 years old and over who are Health Care or Pensioner Concession Card holders or dependents of concession card holders
  • children from birth to 12 years who are not Health Care or Pensioner Concession Card holders and are not dependents of concession card holders.

Further information on the policy, including a fees schedule and exemptions, is available at dental health.

Refer also Department of Health and Human Services policy and funding guidelines Volume 2: Health operations, Chapter 2

Pharmaceutical fees

Health services are required to provide pharmaceuticals at no charge to their admitted public and private patients. Health services participating in the programs outlined below can access reimbursements for pharmaceuticals and charge patient co-payments, where applicable.

Pharmaceutical reform

Pharmaceutical reforms are designed to make it safer, easier and more convenient for patients to receive adequate medication, and to bring public health services onto a more equal footing with private hospitals.

Health services participating in the Pharmaceutical Reform Agreement have access to the Commonwealth-funded Pharmaceutical Benefits Scheme and the Repatriation Schedule of Pharmaceutical Benefits for non-admitted and admitted patients on discharge, as well as a Commonwealth-subsidised list of pharmaceuticals for same-day admitted patients requiring chemotherapy. These health services are required to incorporate the Australian Pharmaceutical Advisory Council’s guidelines into their practice to achieve the continuum of quality use of medicines between the health service and the community.

Find out more.

Refer also Department of Health and Human Services policy and funding guidelines Volume 2: Health operations, Chapter 2

Non-admitted compensable patient fees (TAC and WorkSafe)

These fees are revised annually in agreement with TAC and WorkSafe. Refer to the drop down list section below for the fee schedule for allied health and medical services.

Schedule of Fees

  • Non-admitted allied health
    Service Provided Session  Code  Fee for Service ($) From 1 July 2017- 30 June 2018  Fee for Service ($) From 1 July 2018 - 30 June 2019 
    Allied Health Assistant  Individual (15 min)  PUB76A   $17.55  $17.99
      Individual (30 min)  PUB76B   $35.10  $35.98
      Individual (45 min)  PUB76C   $52.65  $53.97
      Individual (60 min)  PUB76D   $70.21  $71.96
      Worksite / Home Inspection (15 min)  PUB77A   $19.31  $19.79 
      Worksite / Home Inspection (30 min)  PUB77B   $38.61  $39.58 
      Worksite / Home Inspection (45 min) PUB77C   $57.92  $59.37
      Worksite / Home Inspection (60 min)  PUB77D   $77.23  $79.16
      Travel time ^^ (30 min) PUB78B  $43.87  $44.97
      Travel time ^^ (45 min) PUB78C  $65.81  $67.46
      Travel time ^^ (60 min)  PUB78D  $87.75  $89.94
    Chiropody/Podiatry Individual (15 min) PUB41A/AA  $22.33  $22.89
      Individual (30 min) PUB41B/BB  $44.67  $45.79
      Individual (45 min) PUB41C/CC  $67.00  $68.68
      Individual (60 min) PUB41D/DD  $89.34  $91.57
    Dietician  Individual (15 min)  PUB17A/AA  $22.33  $22.89
      Individual (30 min) PUB17B/BB  $44.67  $45.79
      Individual (45 min) PUB17C/CC  $67.00  $68.68
      Individual (60 min) PUB17D/DD  $89.34  $91.57
      Worksite / Home Inspection (15 min) PUB83A  $24.58  $25.19 
      Worksite / Home Inspection (30 min) PUB83B  $49.16  $50.39
      Worksite / Home Inspection (45 min)  PUB83C  $73.73  $75.58
      Worksite / Home Inspection (60 min)  PUB83D  $98.31  $100.77
      Travel time ^^ (30 min) PUB84B  $43.87  $44.97
      Travel time ^^ (45 min) PUB84C  $65.81  $67.46
      Travel time ^^ (60 min) PUB84D  $87.75  $89.94
    Hydrotherapy Individual (15 min) PUB23A/AA  $22.33  $22.89
      Individual (30 min) PUB23B/BB   $44.67  $45.79
      Individual (45 min) PUB23C/CC  $67.00  $68.68
      Individual (60 min) PUB23D/DD  $89.34  $91.57
      Group (15 min) PUB22A/AA  $13.56  $13.90
      Group (30 min) PUB22B/BB  $27.13  $27.80
      Group (45 min) PUB22C/CC  $40.69  $41.71
      Group (60 min) PUB22D/DD   $54.25  $55.61
    Nursing services **  Individual (15 min)  PUB09A  $22.33  $22.89
      Individual (30 min)  PUB09B  $44.67  $45.79
      Individual (45 min)  PUB09C  $67.00  $68.68
      Individual (60 min)  PUB09D  $89.34  $91.57
      Worksite / Home Inspection (15 min)  PUB85A  $24.58  $25.19
      Worksite / Home Inspection (30 min)  PUB85B  $49.16  $50.39
      Worksite / Home Inspection (45 min)  PUB85C  $73.73  $75.58
      Worksite / Home Inspection (60 min)  PUB85D  $98.31  $100.77
      Travel time ^^ (30 min) PUB86B  $43.87  $44.97
      Travel time ^^ (45 min) PUB86C  $65.81  $67.46
      Travel time ^^ (60 min) PUB86D  $87.75  $89.94
    Occupational Therapy  Worksite / Home Inspection (15 min)  PUB67AA  $24.58  $25.19
      Worksite / Home Inspection (30 min)  PUB67BB  $49.16  $50.39
      Worksite / Home Inspection (45 min)  PUB67CC  $73.73  $75.58
      Worksite / Home Inspection (60 min)  PUB67DD  $98.31  $100.77
      Individual (15 min)  PUB20A/AA  $22.33  $22.89
      Individual (30 min)  PUB20B/BB  $44.67  $45.79
      Individual (45 min)  PUB20C/CC   $67.00  $68.68
      Individual (60 min)  PUB20D/DD  $89.34  $91.57
      Group (15 min)  PUB19A/AA  $13.56  $13.90
      Group (30 min)  PUB19B/BB  $27.13  $27.80
      Group (45 min)  PUB19C/CC  $40.69  $41.71
      Group (60 min)  PUB19D/DD  $54.25  $55.61
      Travel time ^^ (30 min)  PUB92B  $43.87  $44.97
      Travel time ^^ (45 min) PUB92C  $65.81  $67.46
      Travel time ^^ (60 min) PUB92D  $87.75  $89.94
    Orthoptics Individual (15 min) PUB42A/AA  $22.33  $22.89
      Individual (30 min) PUB42B/BB  $44.67  $45.79
      Individual (45 min) PUB42C/CC   $67.00  $68.68
      Individual (60 min) PUB42D/DD  $89.34  $91.57
    Orthotist/Prosthetist  Individual (15 min)  PUB70A/AA  $22.33  $22.89
      Individual (30 min)  PUB70B/BB  $44.67  $45.79
      Individual (45 min)  PUB70C/CC  $67.00  $68.68
      Individual (60 min)  PUB70D/DD  $89.34  $91.57
    Orthotist/Prosthetist - Manufacture  Time to manufacture (per hour) greater than 1 hour should be charged pro-rata at hourly rate  PUB608   $101.30  $103.84
      Minor repair (Prosthesis). Total cost of consumables, materials, consultation and manufacturing time (Minor repairs are any repairs up to $250) PUB610  Depends on the total cost of the repairs or change of prescription costs (<$250) Depends on the total cost of the repairs or change of prescription costs (<$250)
      Major repair (Prosthesis). Total cost of consumables and materials only. Consultation and/or manufacturing time to be billed separately under corresponding item numbers (Major repairs are any repairs above $250 inclusive of consumables)   PUB614 Depends on the total cost of the repairs or change of prescription costs (<$250) Depends on the total cost of the repairs or change of prescription costs (<$250)
      New prostheses or change of prescription. Total cost of consumables and materials only. Consultation and/or manufacturing time to be billed separately under corresponding item numbers   PUB612 Depends on the total cost of the repairs or change of prescription costs Depends on the total cost of the repairs or change of prescription costs
      Prosthetic Management Review Form - lower extremity or upper extremity. Total cost for completion of Form   PUB618  $51.51  $52.79
      Orthosis (purchase) - to be used when submitting invoice for payment for orthotic equipment, aids & appliances - not to be used for clinical or manufacturing services.   EQ035 Depends on the total cost of the orthosis. Depends on the total cost of the orthosis. 
    Physical Education (Not applicable for WorkCover patients)   Individual (15 min)  PUB58A  $22.33  $22.89
       Individual (30 min)  PUB58B  $44.67  $45.79
       Individual (45 min)  PUB58C  $67.00  $68.68
       Individual (60 min)  PUB58D  $89.34  $91.57
       Group (15 min)  PUB59A  $13.56  $13.90
       Group (30 min)  PUB59B  $27.13  $27.80
       Group (45 min)  PUB59C  $40.69  $41.71
       Group (60 min)  PUB59D  $54.25  $55.61
     Physiotherapy  Individual (15 min)  PUB13A  $22.33  $22.89
       Individual (30 min)  PUB13B  $44.67  $45.79
       Individual (45 min)  PUB13C  $67.00  $68.68
       Individual (60 min)  PUB13D  $89.34  $91.57
       Group (15 min)  PUB14A  $13.56  $13.90
       Group (30 min)  PUB14B  $27.13  $27.80
       Group (45 min)  PUB14C  $40.69  $41.71
       Group (60 min)  PUB14D  $54.25  $55.61
       Worksite / Home Inspection (15 min)  PUB66A  $24.58  $25.19
       Worksite / Home Inspection (30 min)  PUB66B  $49.16  $50.39
       Worksite / Home Inspection (45 min)  PUB66C  $73.73  $75.58
       Worksite / Home Inspection (60 min)  PUB66D  $98.31  $100.77
      Travel time ^^ (30 min)  PUB93B  $43.87  $44.97
      Travel time ^^ (45 min)  PUB93C  $65.81  $67.46
      Travel time ^^ (60 min)   PUB93D  $87.75  $89.94
     Psychology  Individual (15 min)  PUB08A  $39.68  $40.67
       Individual (30 min)   PUB08B  $79.36  $81.35
       Individual (45 min)  PUB08C  $119.05  $122.02
       Individual (60 min)  PUB08D  $158.73  $162.70
       Group (15 min)  PUB07A  $23.89  $24.49
       Group (30 min)  PUB07B  $47.78  $48.97
       Group (45 min)  PUB07C  $71.67  $73.46
       Group (60 min)  PUB07D  $95.56  $97.94
     Report ^  Initial assessment and preparation of rehabilitation plan  PUB94  $87.75  $89.94
     Social Work  Individual (15 min)  PUB40A  $22.33  $22.89
       Individual (30 min)  PUB40B  $44.67  $45.79
       Individual (45 min)  PUB40C  $67.00  $68.68
       Individual (60 min)  PUB40D  $89.34  $91.57
       Worksite / Home Inspection (15 min)  PUB79A  $24.58  $25.19
       Worksite / Home Inspection (30 min)  PUB79B  $49.16  $50.39
       Worksite / Home Inspection (45 min)  PUB79C  $73.73  $75.58
       Worksite / Home Inspection (60 min)  PUB79D  $98.31  $100.77
       Travel time ^^ (30 min)  PUB80B  $43.87  $44.97
       Travel time ^^ (45 min)  PUB80C  $65.81  $67.46
       Travel time ^^ (60 min)  PUB80D  $87.75  $89.94
     Speech Therapy  Individual (15 min)  PUB29A  $22.33  $22.89
       Individual (30 min)  PUB29B  $44.67  $45.79
       Individual (45 min)  PUB29C  $67.00  $68.68
       Individual (60 min)  PUB29D  $89.34  $91.57
       Group (15 min)  PUB30A  $13.56  $13.90
       Group (30 min)  PUB30B  $27.13  $27.80
       Group (45 min)  PUB30C  $40.69  $41.71
       Group (60 min)  PUB30D  $54.25  $55.61
       Worksite / Home Inspection (15 min)  PUB81A  $24.58  $25.19
       Worksite / Home Inspection (30 min)  PUB81B  $49.16  $50.39
       Worksite / Home Inspection (45 min)  PUB81C  $73.73  $75.58
       Worksite / Home Inspection (60 min)  PUB81D  $98.31  $100.77
       Travel time ^^ (30 min)  PUB82B  $43.87  $44.97
       Travel time ^^ (45 min)  PUB82C  $65.81  $67.46
       Travel time ^^ (60 min)  PUB82D  $87.75  $89.94
     Chemist    PUB005  $21.93   $22.48
     Interpreting  First 2 hours  PUB10  $121.66  $124.70
       per hour after initial 2 hours  PUB11  $41.95  $43.00
     Vocational Counselling (WorkCover patients only)  Individual (15 min)  PUB53A  Fees to be advised by the Victorian WorkCover Authority  Fees to be advised by the Victorian WorkCover Authority
       Individual (30 min)  PUB53B    
       Individual (45 min)  PUB53C    
       Individual (60 min)  PUB53D    
       Group (15 min)  PUB54A    
       Group (30 min)  PUB54B    
       Group (45 min)  PUB54C    
       Group (60 min)  PUB54D    
     Hand Splints *  Individual (varied)  PUB71A  $35.00 to $190.00  $35.00 to $190.00

    Note:

    * Hand Splints, where clinically indicated and fitted under the supervision of a hand therapist. Medical information may be required to justify the need for a splint.

    ** Note that PUB 09A - PUB 09D and PUB 85A - PUB 85D may relate to the treatment of wound management, medication reviews, continence management, and liaising with a client's general practitioner or specialist.

    A charge for the re-application of plaster for treatment of a fracture can also be raised where this service is performed by a nurse in an outpatient clinic. If another suitably qualified person such as an orthotist or prosthetist performs the task, then the PUB item number listed under that discipline can be billed.

    *** Note: The TAC ED Attendance fee (which includes the facility fee) has increased from 1 July 2014 to $276. The Worksafe ED Attendance fee has increased from 1 July 2014 to $147.

    ^ Report refers to completion of 'Outpatient Rehabilitation Plan' only when required.

    ^^ Requests for travel require prior written approval by TAC and clinical justification from the allied health practitioner. Travel time to the client is for a round trip.

    Includes 10% GST.

    Vocational counselling is a WorkCover approved service, but only if provided by occupational rehabilitation providers approved for that purpose. Approved occupational rehabilitation providers should contact WorkCover to determine the appropriate fee.

    TAC will pay the reasonable cost of custom-made splints provided by hospital Outpatient Departments. When submitting accounts for these items, please include a description of the custom-made splint. 

    TAC and WorkCover insurers require an item number on all accounts for outpatient services (item numbers are listed in the table above).

    Before any rehabilitation treatment is commenced on a TAC outpatient, both a Rehabilitation Assessment and a Rehabilitation Plan must be completed, and submitted to the TAC for their approval.

     Service Provided  Fee
    Registered Medical Practitioners

    Registered Medical Practitioners providing services to compensable patients in the Accident and Emergency/Casualty (non-admitted) or Outpatient Departments may charge a consultation fee in accordance with the Commonwealth Medicare Benefits Schedule.

    For medical practitioners who are employees of a hospital (including HMOs and registrars), the hospital must invoice the relevant third party payer (e.g. TAC Insurance or a WorkCover insurer) for the service.
      Specialist & Consultant Physicians with the right of private practice, may continue to invoice TAC according to the TAC Schedule of Medical Practitioner Rates. 

    Services delivered in the emergency department of any public hospital should be invoiced by the public hospital using the non-admitted item codes. Medical services should be invoiced using PUB/PMF 104 - initial and PUB/PMF 105 - subsequent. 


  • Non-admitted medical services
     Service Provided - Session  Item Number  Code Fee for Service ($) From 1 July 2017 to 30 June 2018 Fee for Service ($) From 1 July 2018 to 30 June 2019
    TAC/VWA TAC/VWA
     GP - Brief Consultation
     # VR GP's    		 (1 patient)  PUB/PMF04  $45.21  $46.34 
    (2 patients)    $31.54  $32.32 
    (3 patients)    $26.96 $27.64 
    (4 patients)    $24.68  $25.30 
    (5 patients)    $23.31  $23.90 
    (6 patients)    $22.41  $22.97 
    (7 patients)    $19.94  $20.44 

     GP - Standard Consultation

    		 (1 patient) PUB/PMF024 $66.39  $68.05 
     # VR GP's (2 patients)    $52.71  $54.03 
      (3 patients)    $48.15  $49.35 
      (4 patients)    $45.86  $47.01 
      (5 patients)    $44.50  $45.61 
      (6 patients)    $43.58  $44.67 
      (7 patients)    $41.13  $42.16 
     GP - Long Consultation (1 patient)  PUB/PMF037  $102.94  $105.52 
     # VR GP's (2 patients)    $89.26  $91.50 
      (3 patients)    $84.70 $86.82 
      (4 patients)    $82.41  $84.47 
      (5 patients)    $81.05 $83.08 
      (6 patients)   $80.14  $82.14 
      (7 patients)    $77.68  $79.62 
     GP - Prolonged Consultation  (1 patient)  PUB/PMF047  $138.63  $142.10 
     # VR GP's (2 patients)   $124.95  $128.08 
      (3 patients)    $120.39  $123.40 
      (4 patients)    $118.11  $121.06 
      (5 patients)    $116.74  $119.66 
      (6 patients)    $115.82  $118.72 
      (7 patients)    $113.37  $116.20
     GP - Brief Consultation (1 patient)  PUB/PMF058  $25.80  $26.45 
     # Non VR GP's (2 patients)   $17.48  $17.91 
      (3 patients)    $14.72 $15.09 
      (4 patients)    $13.33  $13.67 
      (5 patients)    $12.47  $12.78 
      (6 patients)    $11.93  $12.23 
      (7 patients)    $9.89  $10.13
     GP - Standard Consultation (1 patient)  PUB/PMF059  $36.02  $36.92 
     # Non VR GP's (2 patients)    $26.61  $27.28 
      (3 patients)    $23.49  $24.08 
      (4 patients)    $21.93  $22.48 
      (5 patients)    $20.96 

    $21.49
      (6 patients)    $20.37  $20.88 
      (7 patients)    $17.95  $18.40
     GP - Long Consultation (1 patient)  PUB/PMF060  $54.83  $56.20 
     # Non VR GP's (2 patients)    $46.50 $47.67
      (3 patients)    $43.75  $44.85 
      (4 patients)    $42.36  $43.42 
      (5 patients)    $41.50  $42.53 
      (6 patients)    $40.96  $41.98 
      (7 patients)    $38.91  $39.89 
     GP - Prolonged Consultation  (1 patient)  PUB/PMF065  $78.48  $80.44 
     # Non VR GP's (2 patients)    $70.15  $71.91 
      (3 patients)    $67.40  $69.09 
      (4 patients)    $66.01  $67.66 
      (5 patients)    $65.15  $66.78 
      (6 patients)   $64.61  $66.23 
      (7 patients)    $62.57  $64.13 
     Specialist - Initial Attendance PUB/PMF 104  $91.97  $94.27 
     Specialist - Subsequent Attendance PUB/PMF 105  $46.23  $47.38 
     Consultant Physician - Initial Attendance PUB/PMF 110  $162.23  $166.29 
     Consultant Physician - Subsequent Attendance PUB/PMF 116  $81.17  $83.20 
     Consultant Physician - Minor Subsequent Attendance PUB/PMF 119  $46.23  $47.38 
     Professional Attendance - Prolonged (1-2 hours) PUB/PMF 160  $233.46 $239.30 
     Professional Attendance - Prolonged (2-3 hours) PUB/PMF 161  $389.08  $398.81 
     Professional Attendance - Prolonged (3-4 hours) PUB/PMF 162  $544.55  $558.16 
     Professional Attendance - Prolonged (4-5 hours) PUB/PMF 163  $700.44  $717.95 
     Professional Attendance - Prolonged (>5 hours) PUB/PMF 164  $778.28  $797.73 
     Consultant Psychiatrist - Attendance 15 mins PUB/PMF 300  $46.61  $47.77 
     Consultant Psychiatrist - Attendance 30 mins PUB/PMF 302  $92.94  $95.27 
     Consultant Psychiatrist - Attendance 45 mins PUB/PMF 304  $143.09  $146.67 
     Consultant Psychiatrist - Attendance 75 mins PUB/PMF 306  $197.44  $202.37 
     Consultant Psychiatrist - Attendance > 75 mins PUB/PMF 308  $229.15  $234.88 

    Note:

    For manually submitted accounts please use PUB prefix. For electronically submitted accounts please use PMF prefix.

    When billing for medical practitioner services provided in Casualty or an Accident & Emergency Department, the name of the treating doctor is to be included on the hospital invoice.

    # For GP consultation additional codes have been added to recognise the different payments for vocationally registered (VR) and non VR GPs in the MBS. For a non VR to graduate to VR GP, Fellowship of the Royal College of General Practitioners or Australian College of Rural and Remote Medicine is required.