Fee notes for GPs and specialists

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Chronic Pain Honorarium

Where an anaesthetist specialises in pain management, the Australian Society of Anaesthetists (ASA) may recommend that the anaesthetist have access to the Chronic Pain Honorarium.

The Chronic Pain Honorarium rules outline the following:

• an eligible anaesthetist may receive one payment per patient within a 12-month period
• the Honorarium is payable only where pain has existed for a minimum of eight weeks
• the date of service must be the last date of the quarter (for example, for dates between 1 January 2018 and 31 March 2018, the date of service keyed must be 31 March 2018)

In exceptional circumstances, more than one honorarium may be approved by DVA for a genuine new episode of pain within a 12-month period. Prior approval is required for the extra payment and must be indicated by the anaesthetist on his/her account. Appropriate documentation supporting such an occurrence must accompany the request.

Chronic Pain Honorarium fees

The latest fees are available in the Medical Software Vendor File and Fee schedules for Medical Services.

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Clinical notes fees

Fees effective 1 July 2014

Fees current at 31 December 2023

Fees for the provision of clinical notes (when requested by DVA)

DVA Item No.	Description	GPs
CN01	For notes which give a statement of attendance of diagnosis only or a brief record of one or two visits. Includes provision of a standard patient health summary	$29.90
CN02	For a statement of attendances and transcriptions of notes which may include specialist reports and diagnosis, results of X-rays, pathology tests etc	$61.85
CN03	For notes which, in addition to the information supplied as in CN02, include a summing up of the case over a period of time and/or with opinions helpful to the Department	$93.35
CN04	In exceptional cases, a higher fee (up to a maximum of $162) when a practitioner is required to spend considerable time in research into records of the case and in recording opinion	$162.00

When claiming payment for the provision of clinical notes requested by DVA, you must quote the relevant DVA item number shown above. The invoice should be sent to the requesting area. Please follow the schedule and process below in relation to compensation claim requests.

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Compensation fees

Fees effective 1 July 2014

Fees current at 31 December 2023

Listed below is the schedule of fees for medico-legal services provided by GPs to be used when determining payment for work conduction for compensation purposes. to use when determining payment of fees for compensation purposes. Please note that GST should be claimed on all services provided for medico-legal purposes including responding to requests for information from DVA. Amount of GST charged should be clearly specified on your tax invoice.

One item number from each of the three schedules below can be billed for each request, if relevant. These fees apply to the request and not to each condition separately.

Not all claims will require additional information. A report and invoice should be submitted only following a request for information from DVA. Payment for work completed without a request from DVA is not guaranteed.

Once the relevant paperwork has been completed, use the Transaction Reference Number provided by DVA to upload your invoice and reports to the Provider Upload Page. For further information regarding billing for compensation claims, please see our Quick Tip guide.

Compensation Schedule 1 – Consultation fees

Surgery consultations

DVA Item No.	Description	GPs
DCC01	Less than 20 minutes	$37.10
DCC02	20 to 40 minutes	$71.80
DCC03	More than 40 minutes	$105.10

Home or hospital visits

DVA Item No.	Description	GPs
DCC04	Less than 40 minutes	$97.70
DCC05	More than 40 minutes	$131.60

Compensation Schedule 2 – Completion of Medical Forms (with or without consultation)

DVA Medical Report forms, Medical Impairment Assessment forms, Diagnostic Reports, and Ability to Work forms

Cost per page (inclusive of GST) Consultation not required

$14.70

Compensation Schedule 3 - Clinical Notes

DVA Item No.	Description	GPs
DCN01	A brief record of an individual's treatment. Includes provision of a standard patient health summary.	$29.95
DCN02	A brief record of an individual's treatment, together with copies of specialist reports and/or test results.	$69.00
DCN03	A more comprehensive record of an individual's treatment, together with copies of specialist reports and/or test results.	$93.40
DCN04	A detailed record of an individual's treatment, together with copies of specialist reports and/or test results.	$162.00

Completion of claim forms

DVA Item No.	Description	GPs
DCN01	plus relevant consultation fee e.g. Consultation less than 20 minutes plus DCN01	$37.10 + $29.95 (Clinical notes fee)

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Coordinated Veterans' Care program fees

See Coordinated Veterans' Care Program (CVC Program) for information and current fees (LMOs and GPs only).

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Derived fees ready reckoner for General Practitioners

The Derived fees ready reckoner for General Practitioners is available in the Medical Software Vendor File and Fee schedules for Medical Services.

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Diagnostic imaging fees

The latest diagnostic imaging fees are available in the Medical Software Vendor File and Fee schedules for Medical Services.

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Dose Administration Aid (DAA) service fees

Fees for GPs effective 1 July 2014

Fees current at 31 December 2023

Description, item number and GP fee

Description	Item No.	GP Fee (115% MBS)1
Home Medicines Review2	MBS 900	$196.05
VAPAC authorisation Prescribe six months DAA Script for referral to community pharmacist for Veteran's Six Monthly Review (VSMR)	MBS Consult3
Assess and review VSMR	CP42	$50.00

1. Only GPs registered with Medicare receive the higher fee (115% MBS).
2. Home Medicines Review (HMR) — also known as a Domiciliary Medication Management Review — can be claimed once in a 12-month period except where there is significant change in the patient's condition — new diagnosis, discharge from hospital. HMR is no longer a pre-requisite to commencing the DAA Service. However, DVA recommends strongly that an HMR is conducted within the first six-month cycle where no other HMR has been performed within the preceding 12 months.
3. The relevant consultation item from the Medicare Benefits Schedule will need to be claimed.

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Kilometre allowance

Kilometre allowance for each kilometre after the first 10 kilometres in accordance with provisions in Section 10 of the GP notes is 76 cents per kilometre (effective 1 November 2012).

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Medication review fees

Medication review items are reviewed annually on 1 July.

DVA Item No.	Description	Fee
CP20	Medication review undertaken in rooms	$117.00
CP21	Medication review undertaken at the patient's home or institution	$153.85

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Optical Coherence Tomography (OCT)

Ophthalmology providers can claim for OCT services for DVA clients using the Medicare Benefits Schedule (MBS) items 11219 or 11220.  It is the responsibility of the ophthalmology provider to determine which of the MBS items – 11219 or 11220 – is appropriate to claim for each DVA client.

DVA will pay 140% of the MBS fee amount when an ophthalmology provider claims MBS item 11219 or 11220 for a DVA client.

As these services are claimable through MBS items, providers will need to adhere to the MBS requirements, including restrictions on the number of times an OCT service can be claimed.  Providers can check the requirements for claiming each item online at MBS online.

If an ophthalmologist identifies a clinical need for an additional OCT service for an individual DVA client not covered by the MBS items, they may submit a request for prior financial approval of the treatment to DVA.

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Pathology fee schedule

The Pathology Fee Schedule is available in the Medical Software Vendor File and Fee schedules for Medical Services
Psychiatrist fees

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Attachment B to the Guidelines for psychiatric compensation claims

Effective 1 November 2013

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Medical services covered by this schedule

The fees listed overleaf apply to medical services conducted at the request of Rehabilitation and Compensation Sections. They do not apply to either of the following:

• treatment services under a Gold or White Card
• services requested by Income Support Sections

Payment will be made for medical services which are requested by an officer of this department. The department will NOT pay for medical reports which are requested by other parties, including veterans or former members of the ADF, their advocates, solicitors or dependants.

Invoicing procedure

A Tax Invoice must be lodged, attached to the completed form.

Note

• All fees for reports and consultations provided as part of this investigation incur Goods and Services Tax (GST) if the provider is GST registered.
• To enable payment to be made promptly, the tax invoice should be attached to the medical report form. An invoice cannot be paid until the related report is received.
• GST has been included in all of the rates listed overleaf. The report and the invoice should be addressed to the contact officer who requested the report.
• Do not use Treatment Service Vouchers for these accounts.
• Categories of the Medical Services which may be requested and the relevant fees are listed.
• The fees outlined represent an amount for the consultation (where required) and report-writing time.

Type of service provided and fee

Type of service provided	Fee (GST inclusive)
Providing Clinical Notes (brief photocopies only)	$51.70
Standard report without consultation	$193.90
Extended report without consultation	$290.90
For a report that involves one standard consultation (up to one hour) that addresses all parts of the Diagnostic Guidelines for Psychiatric Assessment, comments on laboratory and other investigations, and may or may not include an interview with a family member or other third party:	$805.00
For a report that involves two standard consultations or one consultation of up to two hours' duration, that addresses all parts of the Diagnostic Guidelines for Psychiatric Assessment, comments on laboratory and other investigations, and includes interview with a family member or other third party:	$1,155.20
For a report that involves three consultations or one consultation of up to three hours' duration, that addresses all parts of the Diagnostic Guidelines for Psychiatric Assessment, comments on laboratory and other investigations, and includes an interview with a family member or other third party:	$1,507.60
Administration and documentation of a clinical instrument (such as CAPS) attracts an additional fee.	$135.20
For an assessment of all specified emotional and behavioural conditions including completion of a Departmental Emotional Behavioural Impairment Worksheet. The fee includes all consultations with the veteran and family members or other third parties in which the sole or major objective was to obtain data to assess the impairment.	$452.50

In some circumstances, the Department may be willing to negotiate a different fee, however, prior written approval must be obtained.

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Relative Value Guide fee schedule

The Relative Value Guide (RVG) Fee Schedule is available at Software Vendor File and Fee schedules for Medical Services.

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Rural Enhancement Initiative

The Rural Enhancement Initiative (REI) loading of 10% continues to apply to relevant consult items for services at hospitals designated under the REI. The REI is not payable on items listed on the RMFS or RVG.

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Veterans Access Payment

For information regarding Veterans Access Payment, see Medical Services fee schedules.

 

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