Notes for Allied Health Providers, Section 2B

December 2011

SECTION TWO

Table of Contents

Providing chiropractic services

Types of chiropractic services that can be provided

Diagnostic imaging

Prior financial authorisation2

Treatment thresholds/limits2

Restrictions on services2

Rehabilitation Appliances Program (RAP)3

Fees3

Only a chiropractor who is registered with the Department of Human Services (DHS) at the time of service is eligible to provide services to entitled persons.

The Repatriation Commission and the Military Rehabilitation and Compensation Commission (the Commissions) will only accept financial responsibility for chiropractic services involving treatment of the musculo-skeletal system. The services the Commissions will accept are listed in the DVA Chiropractors Schedule of Fees. No other treatment will be accepted.

Chiropractic providers who wish to perform and assess x-rays on entitled persons at their practice location(s) must register their qualifications with DVA. To register with DVA, the provider must provide documentary proof of their licence to perform radiography under relevant legislation, and certify they have x-ray equipment on site for each location at which they wish to perform x-rays.

The relevant documentation is to be forwarded to the Medicare Australia Liaison and Contract Management section at DVA who will review it and register your qualifications to undertake diagnostic imaging with DHS. Contact details are located in Section One of these Notes [see clause 126].

There are specific item numbers requiring prior financial authorisation indicated by shading and an asterisk (*) in the DVA Chiropractors Schedule of Fees. Fee schedules are available at:

For information on how to seek prior financial authorisation, refer to Section One of these Notes [see clauses 37-42].

For information on treatment thresholds and limits refer to Section One of these Notes [see clauses 19-22].

While all chiropractic services claimed must be in accordance with the patient’s clinical need, the following specific restrictions exist:

only one initial consultation can be claimed per referral. Should a patient continue to require treatment after the 12 month referral period, a new referral may be issued however an additional initial consultation can not be claimed for the original condition;
a subsequent consultation and an initial consultation cannot be provided on the same day for the same patient;
only one subsequent consultation item per patient can be provided each day; and
concurrent delivery of chiropractic and physiotherapy services for the same condition to any entitled person is not permitted.

Chiropractors are able to claim up to three initial consultations for an entitled person in the 12 month referral period. Each initial consultation must be for a new episode of care, or a new and unrelated condition. For each separate condition claimed as an initial consultation, an entitled person must first be assessed by their Medical Practitioner as requiring the treatment and have been issued a referral.

A new episode of care is defined as being when a period of more than three months has lapsed since the entitled person received treatment for the same condition.

Chiropractors are recognised prescribers of certain appliances under the Department’s Rehabilitation Appliances Program (RAP). When utilising the RAP scheme, prescribers must issue the RAP item prescription to the appropriate contracted supplier. Contact DVA to obtain full details including which appliances you can prescribe, prescription forms and information on contracted RAP suppliers. Refer to Section One of these Notes [see clause 130] for contact details.

DVA’s fees for radiology services provided by licensed chiropractors are set at 100percent of the Medicare Benefits Schedule.

NOTES FOR CHIROPRACTORSJune 2013

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