Physiotherapists

Last updated:

26 July 2024

Find the information you need to deliver and claim for physiotherapy services to Veteran Card holders.

If you’re a member of the veteran community, go to Physiotherapy services.

DVA Forms
Become a DVA health care provider
Services covered by Veteran Cards – Gold and White
Referrals and treatment cycle
DVA Provider Notes
Schedule of Fees
Claiming
Your obligations
Common compliance issues
Prior approvals
Rehabilitation Appliances Program (RAP)
Residential Aged Care Facilities (RACF)
Useful links

DVA Forms

Visit Provider forms to access all the forms you need to do business with us. This includes forms for prior approvals, RAP orders and claims.

Become a DVA health care provider

Services covered by Veteran Cards – Gold and White

Please check What a DVA health card covers for full details about card entitlements to ensure your client’s condition is covered.

A Veteran Card – Gold or White covers physiotherapy treatment that is clinically necessary:

for all conditions, if the patient holds a Veteran Gold Card
for specific, accepted conditions only, if the patient holds a Veteran White Card.

If you are unsure whether a DVA client is eligible to receive physiotherapy services, contact us on 1800 550 457.

Referrals and treatment cycle

If you are treating a Veteran Card holder, they will need a valid referral from their GP. For an initial treatment cycle, the referral could alternatively come from a:

medical specialist
treating hospital doctor
hospital discharge planner.

Under DVA treatment cycle arrangements, a referral to an allied health provider will last up to 12 sessions or one year, whichever ends first.

Once a treatment cycle has ended, the client needs a new referral from their GP before you can provide further treatment. The client can have as many treatment cycles as their GP determines are clinically necessary.

The treatment cycle does not apply to physiotherapy treatment for clients who hold a Veteran Gold Card - Totally and Permanently Incapacitated.

Veteran Card holders with severe or complex needs may have tailored referral arrangements through the At Risk Client Framework, approved by their usual GP.

For full details about the treatment cycle and referral arrangements, please check Treatment cycle information for allied health providers.

DVA Provider Notes

By accepting a patient’s Veteran Card – Gold or White, you agree to follow the Notes that apply to your profession.

The Notes are legally binding, and it is your responsibility to become familiar with them. They are divided into two sections, and you need to comply with both.

Section 1: General notes for allied health providers

Section 2: Notes specific to physiotherapists

Please also refer to:

Referrals and treatment cycle
Schedule of Fees
Claiming.

Schedule of Fees

The Schedule of Fees – (Physiotherapists) defines the treatments and services you can provide to DVA clients and the payment amounts you can claim.

By accepting a Veteran Card – Gold or White, you agree to accept the DVA fee as full payment. You cannot charge the Veteran Card holder any ‘gap’ fee.

For your profession’s up-to-date schedule, visit DVA Fee Schedules.

Claiming

Visit Provider claiming for full details on how to claim payment from us.

Please note you are responsible for your provider number and you will be accountable for any claiming errors.

If someone else submits claims on your behalf, you should ensure they do not make any mistakes.

Your provider number cannot be shared, and multiple providers cannot claim under the one provider number. The provider who owns the number will bear the consequences of misuse.

For invoicing and billing enquiries, call 1300 550 017.

Your obligations

Each year we review unusual provider claiming, which may result in an education process or financial recoveries.

For full details about complying with our requirements, please refer to Provider compliance.

Common compliance issues

Before you treat a DVA client, please check the Schedule of Fees and Notes for full details about limits and restrictions on physiotherapy services.

Some common compliance issues include the following. Please note these are not exhaustive and you must check the Schedule of Fees for complete details about your profession’s Schedule of Fees item numbers.

Consultations

You can only claim one consultation (including all treatment) for the same patient on the same day.

Initial Consultation

Each treatment cycle must start with an initial consultation. You can only claim one initial consultation item with each treatment cycle.

The initial consultation includes creating or updating the patient care plan.

You need to establish whether the client is eligible before you start treatment. Treatment for White Card holders must be related to an accepted disability.

Standard Consultation

After the initial consultation, use standard consultations to treat a DVA client. You can provide a standard consultation:

in rooms
in the home
at a public or private hospital
at a residential aged care facility.

Group and aquatic physiotherapy treatments are also considered standard consultations for treatment cycle purposes.

Standard consultations should be claimed for the ongoing treatment of a musculoskeletal condition.

Extended Consultation

An extended consultation covers treatment of either:

2 acute and unrelated areas
an acute condition when a chronic condition needs ongoing treatment.

You should not claim an extended consultation for treatment of:

related areas
multiple, chronic musculoskeletal conditions.

Lymphoedema treatment

You can only claim item PH41 if you have the appropriate recognised training to treat lymphoedema. Evidence of certification is required. Please send a copy of your certification to provider.registration [at] dva.gov.au (PROVIDER[dot]REGISTRATION[at]dva[dot]gov[dot]au) before submitting any claims.

You cannot claim for lymphoedema treatment if the client is already receiving lymphoedema treatment from an occupational therapist.

Multiple allied healthcare treatments

A DVA client can receive only one of the following treatments for the same condition during the same referral period:

physiotherapy
osteopathy
chiropractic.

Consumables, aids and splints

All items noted below are in the Schedule of Fees for Physiotherapists. (These are not RAP items).

Consumables

Item number PH92 covers consumables used for treatment during the consultation, such as tape and acupuncture needles.

Item number PH93 covers items provided to the client for use after the consultation, such as Therabands, small weights, Pilates mats and gym balls.

You cannot claim items the client should purchase at a pharmacy or supermarket for self-management of conditions, such as fisiocrem or hot/cold packs.

Small medical aids and appliances

Use item number PH94 for small, low cost items only. These may include:

walking aids
compression garments
TENS units
orthoses such as a soft collar or knee brace.

You cannot claim items that exceed the maximum fee allowable under item number PH94.

Postage/freight

Item number PH98 covers postage or freight only for an item you buy for a DVA client and claim for under PH94.

The postage PH98 claim must always be submitted along with the related PH94 claim for that posted item.

Splints and Casts

Item numbers PH95 and PH96 are for the supply of splints and casts only.

You can also order splints through RAP.

Kilometre allowance

We may pay a kilometre allowance if:

you are not a mobile provider
you have a fixed practice location
there is a genuine need to visit a client at home
your client’s home is more than 10 km from their nearest physiotherapy clinic.

We will only pay the allowance for the part of your trip that is more than 10 km from the practice nearest to the client.

Prior approvals

In exceptional circumstances, you may claim payment for treatments not included in the Schedule of Fees, if they:

can be clinically justified for the client’s referred condition
are evidence-based.

You must ask us for prior approval before providing the treatment.

To submit a request, please complete the D1328 Treatment Prior Financial Approval Request Form and email it to health.approval [at] dva.gov.au (health[dot]approval[at]dva[dot]gov[dot]au).

For inquiries, contact us on 1800 550 457.

Rehabilitation Appliances Program (RAP)

Physiotherapists can prescribe aids and appliances to eligible Veteran Card holders through the RAP National Schedule of Equipment.

The item must be clinically necessary and support the patient’s referred condition.

You cannot supply these items yourself. You need to place an order through RAP, using the relevant RAP Form. The items will be supplied by a DVA-contracted RAP supplier.

Residential Aged Care Facilities (RACF)

From 1 October 2022, access to allied health care services and the Rehabilitation Aids Program (RAP) was expanded to eligible DVA clients in residential aged care, regardless of their care level.

For full details, please refer to DVA Provider News article, All veterans in age care now eligible to access allied health services.