Social workers

Find the information you need to deliver and claim for social work services (general and mental health) to Veteran Card holders.

If you’re a member of the veteran community, please refer to the DVA website page about available health services to assist you and your family.

DVA Forms

Visit Provider forms to access all the forms you need to do business with DVA. This includes forms for prior approvals, RAP orders and claims. (Link to social work forms only).

Register as a DVA Provider

DVA has two provider categories for social work – ‘general’ and ‘accredited mental health’.

Social worker (general)

You can apply to become a DVA social work provider and be issued with a DVA Provider Number via a streamlined registration process. For information, email PROVIDER.REGISTRATION [at] dva.gov.au.

Social worker (accredited mental health)

You are automatically registered as a DVA provider when your Medicare Provider Number is issued.

An online Provider Digital Access (PRODA) account allows you to claim for all social work services provided to DVA clients through Services Australia. Find out more at Becoming a DVA healthcare provider.

Services covered by Veteran Cards – Gold and White

Please check full details about card entitlements to ensure your client’s condition is covered at What DVA health cards cover.

A Veteran Card – Gold or White covers social work services that are clinically necessary:

• for all conditions, if the patient holds a Veteran Gold Card
• for specific, accepted conditions, if the patient holds a Veteran White Card. White Card holders can also access treatment from an accredited mental health social worker for mental health conditions, under Non-Liability Health Care arrangements.

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

Referrals and the treatment cycle

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

• medical specialist
• treating hospital doctor
• hospital discharge planner
• Open Arms – Veterans and Families Counselling (see details below).

Under DVA treatment cycle arrangements, a referral to an allied health provider will last up to 12 sessions or 1 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.

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.

Open Arms referrals

Open Arms, which offers services to veterans and their families, partners and children, can refer their clients to social workers for one treatment cycle.

Referrals for subsequent treatment must be made by the DVA client’s GP.

DVA Notes for Social Workers (General and Mental Health)

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.

General notes for allied health providers:

• Notes for allied health providers — section one — general (PDF 1.08 MB)
• Notes for allied health providers — section one — general (DOCX 540 KB)

Notes specific to social workers (general):

• Notes for allied health providers — section 2(m) — social workers (PDF 125 KB)
• Notes for allied health providers — section 2(m) — social workers (DOC 125 KB)

For social workers (accredited mental health), refer to the following Notes:

• Notes for Allied Health Providers — section 2(a) — mental health care providers (PDF 1.03 MB)
• Notes for Allied Health Providers — section 2(a) — mental health care providers (DOCX 204 KB)

Also refer to:

• Schedule of Fees
• Referrals and the treatment cycle
• Claiming

Schedule of Fees - Social Workers (General and Mental Health)

The Schedule of Fees - Social Workers (General) and Schedule of Fees - Social Workers (Mental Health) define 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 claims 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 the information they enter is accurate.

Your provider number cannot be shared, and multiple providers cannot claim under the one provider number. The provider who owns the number will be responsible for any misuse.

For invoicing and billing enquiries, call 1300 550 017.

Your obligations

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

For full details about complying with DVA 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 social work services.

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

Same day claiming

A provider who is both a general and accredited mental health social worker cannot make a claim for both social work and mental health items for the same eligible client, on the same day.

Location of services

The item numbers on the Schedule of Fees – Social Work and the Schedule of Fees – Mental Health differ depending on the location of the social work service.

There are different item numbers for services provided in your rooms, at the client’s home/out of rooms, and other locations, such as residential aged care facilities and private hospitals. You must use the correct item number, as it relates to the service location.

Emergency mental health care

In an emergency situation, a Social Worker - Accredited Mental Health may treat an eligible DVA client without a referral; but must contact DVA for special approval, prior to claiming from Medicare (see Prior Approvals).

Clinical notes

Please ensure adequate clinical notes are kept in relation to each session. In addition, the client file should include, as a minimum, an initial assessment of the client; a copy of the GP, medical specialist, treating hospital doctor or hospital discharge planner referral and treatment cycle reports back to the GP; and other correspondence.

Couples counselling

Please note that DVA does not fund general and accredited mental health social workers to provide counselling for couples (i.e. relationship therapy). (Please note Open Arms provides couples counselling and information about building healthy relationships. Visit the Open Arms website or call 1800 011 046).

Kilometre allowance

DVA may pay a kilometre allowance if you meet all of the following requirements:

• you have a fixed practice location i.e. a street address, not a post office box
• there is a genuine need to travel e.g. to conduct a home assessment or if the entitled person is physically unable to travel
• there is no suitable health care provider located closer to the entitled person.

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

Prior approvals

In exceptional circumstances, you may claim payment for services not included in the Schedule of Fees, if the treatment

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

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

If you consider your client’s needs are sufficiently complex to require extensive coordination and case work, you may submit to DVA a prior approval request for payment of this activity, detailing the number of hours required and the rationale for the work. Approval will be considered on a case by case basis and is not automatically granted.

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 enquiries, contact DVA on 1800 550 457.

Non-Liability Health Care

Social workers (accredited mental health) can provide and claim for mental health care services to DVA White Card holders eligible to receive treatments under Non-Liability Health Care arrangements. This includes counselling and group work, and for all mental health conditions.

For further information, please refer to the Non-Liability Health Care page for health providers on the DVA website.

Mental health resources for your practice and clients

The health professionals page on the Open Arms – Veterans and Families Counselling service website includes a suite of mental health resources and information to support you when treating DVA clients. These include case formulation tools, on-line training courses, and free, CPD accredited webinars on veteran mental health.

Open Arms has also developed innovative self-help tools and resources for veterans and their families, including mobile apps, videos, publications, case studies and peer stories.

Useful links

• Open Arms – Veterans & Families Counselling
• Health programs and services for DVA clients
• Travel for a client’s treatment
• Training for providers
• Research
• Health Providers’ Partnership Forum
• Contact DVA