Early Intervention Physiotherapy Framework (EIPF) services guidelines

The EIPF model has been developed to facilitate return to work and return to health outcomes. The initial consultation is recognised as an important opportunity to influence return to work and recovery outcomes. There is an expectation that, when appropriate, the EIPF physiotherapist will contact any other key parties in the return to work and/or return to health process, such as the Employer, GP or Occupational Rehabilitation provider.

The initial consultation is the first consultation provided by the EIPF physiotherapist for assessment and treatment of the work-related injury or illness. It should be delivered on a one-to-one basis with the worker. The session duration must represent reasonable and appropriate clinical practice and include:

• initial assessment (including history taking and physical examination)
• intervention and/or treatment
• tailored goal setting and treatment planning
• expectation setting around recovery and return to work
• screening for barriers to recovery
• record of clinical notes.

The initial consultation fee includes the time taken to complete an Allied Health Recovery Management Plan (AHRMP) for submission to WorkSafe. This must be submitted within the first 5 consultations.

An initial consultation can only be billed once by the same provider, clinic or clinical group.

A standard consultation is any consultation occurring after the initial consultation provided by the EIPF physiotherapist. Standard consultations are reimbursed at a higher rate on the EIPF fee schedule for a period of 7 months from the worker’s date of injury.

It should be delivered on a one-to-one basis with the worker. The session duration must be a minimum of 20 minutes and represent reasonable and appropriate clinical practice. It includes:

• reassessment
• intervention and/or treatment
• reviewing progress towards goals and adapting treatment plan when goals are not being met
• expectation setting around recovery and return to work
• monitoring barriers to recovery and acting on these when goals are not met
• record of clinical notes.

WorkSafe recognises that early intervention can be time consuming, and that identifying and managing complexities around return to work, risk factors for complications, and communication expectations often requires more time than standard consultations allow.

The early intervention extended consultation can be billed twice within the first 7 months from the date of injury without prior approval. It should be delivered on a one-to-one basis with the worker.

The session duration must be a minimum of 40 minutes and represent reasonable and appropriate clinical practice. It includes:

• reassessment (including subjective and/or objective assessment)
• intervention and/or treatment
• tailored goal setting and treatment planning
• expectation setting around recovery and return to work
• screening for barriers to recovery
• record of clinical notes.

WorkSafe can pay the reasonable cost of group consultations provided by an EIPF physiotherapist that meet the following criteria.

• A minimum of 1 and maximum of 6 participants in the class or group session.
• Constant overall supervision and intermittent individual attention to each WorkSafe participant in the group from the EIPF physiotherapist.
• Maximum payment rate is per person.
• Clinical notes must be completed for all WorkSafe participants.

The session or class must be a minimum of 30 minutes. The total duration must represent reasonable and appropriate clinical practice based on the total number of participants.

Extended consultations require prior written approval from WorkSafe and can only be requested by the treating EIPF physiotherapist where a prior consultation has been delivered.

WorkSafe can pay the reasonable costs of extended consultations where a worker requires extra time, beyond that of a standard consultation, due to the complex nature of their injury. WorkSafe will assess whether the extended consultation is reasonable and necessary for injuries such as:

• moderate to severe acquired brain injury
• crush injuries
• extensive burns
• spinal cord injuries
• multiple orthopaedic fractures
• limb amputations
• other complex neurological conditions
• other severe injuries not listed above will be considered on merit.

The extended consultation application form should be completed by an EIPF physiotherapist to apply for pre-approval to use the extended EIPF physiotherapy consultation item number. Physiotherapists should not bill the extended consultation item number until they have written approval from WorkSafe. The extended consultation item number can be approved for a maximum of 6 months per application. If extended consultations are required after this time, the EIPF physiotherapist must complete another extended consultation application form.

EIPF Physiotherapists can be reimbursed by WorkSafe for the completion of the extended consultation application form.

More information

EIPF Physiotherapists can be paid in line with the EIPF fee schedule for treatment required after an eligible procedure. The post-operative rate recognises that certain eligible procedures return the injury to an acute state, and that more intensive treatment and greater communication between stakeholders is required to achieve optimal rehabilitation and return to work outcomes.

Use of the post-operative item number must meet the following criteria.

• Can only be billed for a maximum of 3 months following an eligible procedure listed on the post-operative physio eligible procedure list.
• The eligible procedure occurs within 2 and a half years of the date of the work-related injury.
• The 3-month period commences from the first post-operative EIPF service following an eligible procedure.
• The session duration must be a minimum of 20 minutes and represent reasonable and appropriate clinical practice.

More information

Information provided on the Certificate of Capacity helps WorkSafe make claims-related decisions to better support a worker's independence, recovery and safe return to work. When EIPF physiotherapists accurately complete a Certificate of Capacity, critical information provided about the worker's injuries and their capacity for work can be used to help facilitate better outcomes for them.

WorkSafe has an item number for issuing a subsequent certificate of capacity for EIPF physiotherapists. This recognises that EIPF physiotherapists play a key role in assessing functional capacity and certifying what a person can do in respect to their return to work. The comprehensive conversation required for a Certificate of Capacity can’t always be completed in a standard consultation, especially when other treatment techniques are also needed. The Certificate of Capacity item number can be billed in addition to a consultation item number if required.

WorkSafe can pay for a Certificate of Capacity where each of the following criteria is met.

• A subsequent Certificate of Capacity is issued for a maximum period of 28 days, as only a medical practitioner can issue the first Certificate of Capacity.
• The Certificate of Capacity has been signed by both the EIPF physiotherapist and the worker at the time of consultation, and a copy is retained in the worker’s clinical records.
• The Certificate of Capacity has been accurately completed and submitted to WorkSafe.
• Certificates of Capacity must not be provided to workers by telehealth unless there are exceptional circumstances and prior approval is sought from WorkSafe.
• If a Certificate of Capacity is approved to be provided via telehealth the consultation must be audiovisual not audio only.
• Only one certification consultation (for a subsequent certificate) can be billed each 28 days, unless there is a change in capacity that necessitates a new certificate. A “change in capacity” means a change in the functional tolerances and/or capabilities of the worker which will influence the hours or duties they are able to perform at work.

Certificate of capacity

Certificate of capacity for health providers

Telehealth attendance means audiovisual or audio only consultation between the EIPF physiotherapist and worker. Audiovisual connection is always preferred where possible.

WorkSafe can pay for telehealth physiotherapy services in line with the Telehealth policy.

Telehealth policy

Aquatic physiotherapy (previously referred to as hydrotherapy) is a physiotherapy treatment modality carried out in a heated pool (aquatic physiotherapy facility). It combines the properties of water with the knowledge and skills of the provider, to make treatment more effective and to improve rehabilitation outcomes.

WorkSafe expects that providers deliver these services in line with relevant Australian guidelines for aquatic physiotherapists working in and/or managing hydrotherapy pools, and the Clinical Framework.

Aquatic physiotherapy consultations delivered on a one-to-one basis must be for a minimum of 20 minutes (standard consultation) or 40 minutes (long consultation). 

Aquatic physiotherapy group consultations must meet the following criteria.

• A minimum of 1 and maximum of 6 participants in the class or group session.
• Constant overall supervision and intermittent individual attention to each WorkSafe participant in the group from the physiotherapist.
• Maximum payment rate is per person.
• Clinical notes must be completed for all WorkSafe participants.
• The group session or class must be a minimum of 30 minutes, and the total duration should represent reasonable and appropriate clinical practice based on the total number of participants.

Rates for aquatic physiotherapy are inclusive of travel as the aquatic physiotherapy facility is considered an extension of a provider’s usual place of practice when delivering these services. For an onsite aquatic physiotherapy facility, WorkSafe will not pay for pool entry fees. For an external aquatic physiotherapy facility, casual pool entry fees for the worker can be reimbursed in line with WorkSafe’s gym and swimming memberships fee schedule.

Gym and swimming memberships fee schedule

The purpose of a return to work (RTW) case conference is to bring the following parties together in a collaborative setting to support recovery and return to work goals.

• The injured worker.
• The treating health practitioner(s).
• WorkSafe.
• The occupational rehabilitation consultant.

Where appropriate, the employer may also attend the case conference.

Typically, a RTW case conference will be requested by WorkSafe or the occupational rehabilitation consultant. However, a treating health practitioner can request a case conference by contacting WorkSafe or the occupational rehabilitation consultant directly. Confirmation of contact with WorkSafe and/or the occupational rehabilitation consultant must be retained in the worker’s clinical records.

Either WorkSafe or the occupational rehabilitation consultant must be in attendance at the RTW case conference. RTW case conferences are not approved for contact between treating health practitioners where WorkSafe or the occupational rehabilitation consultant is not present. RTW case conferences do not include a one-to-one discussion with a member of the Clinical Panel.

Administration and any follow up required after the RTW case conference is included in the RTW case conference fee.

More information

EIPF Physiotherapists play a key role in safe and sustainable return to work and health. WorkSafe encourages EIPF physiotherapists to consider whether conducting a workplace assessment would help a worker.

A workplace assessment is a proactive intervention used to facilitate better return to work and health outcomes for workers. Examples of when a workplace assessment may be appropriate include:

• as an early intervention tool to initiate a return to work
• to confirm the availability and/or suitability of modified or alternative duties
• to confirm timeframes for a worker to return to work if certified totally or partially unfit for work
• to discuss suitable work duties and hours to support a return-to-work plan
• if the worker has reported difficulties in sustaining employment
• to discuss and address any identified return to work barriers.

WorkSafe recognises that workplace environments and conditions vary greatly and that workplace assessment reports will differ depending on the individual circumstances of the workplace.

A workplace assessment report completed by an EIPF physiotherapist contains the following information:

• Worker details (name, claim number, employer, DOB, date of injury, nature of injury and/or diagnosis).
• Workplace assessment details (date of visit, location, attendees).
• Pre-injury duties and hours (brief description).
• Current status of worker (including certified capacity, work status, and return to work goals).
• Identified barriers and proposed solutions and/or alternatives.
• Suitable duties identified.
• Conclusions (duties and positions identified, current capacity and how this relates to identified duties, recommendations for future return to work supports).
• Other, such as follow-up discussions with the worker, the worker’s general practitioner, employer and other stakeholders.

The workplace assessment and report item can be billed for a maximum of 3 hours and includes:

• time spent arranging the assessment
• travel time to the worker's workplace
• time spent undertaking the assessment
• report writing.
• Prior approval from the worker's employer is required before a workplace assessment is conducted on premises. When billing the workplace assessment and report item number, providers should specify the time taken to complete each of the above inclusions.

WorkSafe can pay the reasonable costs of travel for EIPF physiotherapists providing approved services in a community setting. For example, a worker’s home, care facility or workplace.

Prior written approval from WorkSafe must be requested for travel expenses. A request to WorkSafe for travel must include the:

• worker's name and claim number
• specific conditions and injuries to be treated
• clinical justification as to why travel is required
• approximate distance and cost per episode of travel (round-trip)
• number of travel episodes requested.

Where a physiotherapist has more than one practice address, travel must be recorded from the practice rooms nearest to the worker's location. The physiotherapist must record the distance from one appointment to the next when workers are treated consecutively, not from each appointment to the practice.

The cost of travel is paid on a per kilometre basis and can be paid only where:

• travel to the worker is clinically justified
• travel is not already included in the consultation rate
• no other physiotherapist offering an equivalent service is situated within a 30-kilometre round trip of the worker. WorkSafe expects a worker to seek treatment from a physiotherapist within their local area.

Travel rates are different for regional and metropolitan areas. Travel is paid at the rate where most of the travel occurred. For example, 10km in a regional area and 20km in a metropolitan area would result in payment for 30km of travel at the metropolitan rate. Metropolitan and regional areas are as defined by the Victorian Department of Health.

When invoicing for travel, the physiotherapist should record the:

• number of metropolitan and/or regional kilometres travelled
• applicable metropolitan or regional rate
• item number and include the prior written approval from WorkSafe.

WorkSafe can also reimburse the reasonable travel expenses of a worker attending a physiotherapist in line with the travel expenses policy.

Travel expenses policy