Independent medical examinations – Medical practitioners fee schedule
View current and past independent medical examinations (IME) - Medical practitioners fee schedules.
WorkSafe item codes for independent medical examiner telehealth now available.
IME – Medical practitioners service fees effective from 1 June 2024
WorkSafe will pay up to a maximum amount for the following categories of service.
Specialist
Item number (Click to sort descending) | Service description (Click to clear sorting) | fee (Click to clear sorting) | GST (Click to clear sorting) | Total (inc GST) (Click to clear sorting) |
|---|---|---|---|---|
SPO100 | Examination & report: Inclusive of reading time (up to 200 pages), conducting the examination, report writing and any incidentals (such as postage, photography and faxing services). Diagnostic tests (such as X-rays) carried out as a necessary part of the examination are not included in the examination and report item code and will be reimbursed in accordance with WorkSafe policies, the relevant Medicare Benefit Schedule item code and WorkSafe's Reimbursement Rates for Medical Practitioners. | $1,800.00 | $180.00 | $1,980.00 |
SPO110 | Complex examination and report: Only payable for WorkSafe Agent referred complex examination and report assessments | $2,200.00 | $220.00 | $2,420.00 |
SPO120 | Work capacity (130 Week) examination and report : Only payable for WorkSafe Agent referred work capacity (130 week) assessments. | $2,200.00 | $220.00 | $2,420.00 |
SPO150 | Subsequent examination & report: Applies where a WorkSafe Agent requests an additional examination and report by the same IME within 12 months of a previous examination and report for the same claim. | $1,080.00 | $108.00 | $1,188.00 |
Loadings additional to examination and report fee are subject to prior written approval from the WorkSafe Agent.
Item number (Click to sort descending) | Service description (Click to clear sorting) | fee (Click to clear sorting) | GST (Click to clear sorting) | Total (inc GST) (Click to clear sorting) |
|---|---|---|---|---|
SPO140 | Report reading 201+ pages: Flat fee payable once only per WorkSafe Agent report for any pre-reading above the included 200 pages. | $262.58 | $26.26 | $288.84 |
SPO141 | Interpreter loading: Applies where a qualified interpreter is required in order to conduct the assessment and additional examination time is required (not applicable for support persons). The interpreter must have been pre-booked by the Agent. | $262.58 | $26.26 | $288.84 |
SPO250 | Urgent Examination and Report: Applies when a WorkSafe Agent has requested IME to complete any type of exam and provide the report to the WorkSafe Agent within 2 business days. The WorkSafe Agent and IME must agree to the expedited time frame prior to accepting the referral. | $270.00 | $27.00 | $297.00 |
SPO350 | Travel to/from assessment (at Agent’s request) per hour: Calculated in 15 minute blocks. Travel only paid when travelling to a location other than IIA's registered practice location/s. Travel for multiple assessments in the one location should be charged on a pro-rata basis across each claim. | $525.15 | $52.52 | $577.67 |
SPO400 | Audio visual viewing: Flat rate for the viewing of all audio-visual material. This fee is payable once only per claim per WorkSafe Agent report request. | $360.00 | $36.00 | $396.00 |
SPO450 | Supplementary report: Applies where a WorkSafe Agent has requested additional response from the IME that was not requested in the initial IME referral. Supplementary reports may be requested when Agents: - provide additional information not initially provided which may impact IME opinion - ask additional questions that were not included in initial referral The IME must have examined the injured worker within the last 6 months. An IME is not required to conduct a re-examination (or re-contact) the injured worker in order to provide the additional information. | $360.00 | $36.00 | $396.00 |
SPO500 | Interim report: Applies when there is a request by a WorkSafe agent to provide information prior to receiving the final IME written report. The advice from the IME may be provided verbally or in writing. | $126.00 | $12.60 | $138.60 |
SPO550 | Non-attendance on day of appointment: Applies where an IME appointment is cancelled by the WorkSafe Agent on the day of appointment or where the injured worker does not attend. | $630.00 | $63.00 | $693.00 |
SPO551 | Cancellation by agent within two business days of appointment: Applies where an IME appointment is cancelled by the WorkSafe Agent within 2 business days of the scheduled appointment. | $360.00 | $36.00 | $396.00 |
Psychiatrist
Item number (Click to sort descending) | Service description (Click to clear sorting) | fee (Click to clear sorting) | GST (Click to clear sorting) | Total (inc GST) (Click to clear sorting) |
|---|---|---|---|---|
PCT100 | Examination & report: Inclusive of reading time (up to 200 pages), conducting the examination, report writing and any incidentals (such as postage, photography and faxing services). Diagnostic tests (such as X-rays) carried out as a necessary part of the examination are not included in the examination and report item code and will be reimbursed in accordance with WorkSafe policies, the relevant Medicare Benefit Schedule item code and WorkSafe's Reimbursement Rates for Medical Practitioners. | $2,050.00 | $205.00 | $2,255.00 |
PCT100T | Telehealth - Examination & report: Inclusive of reading time (up to 200 pages), conducting the examination, report writing and any incidentals (such as postage, photography and faxing services). Diagnostic tests (such as X-rays) carried out as a necessary part of the examination are not included in the examination and report item code and will be reimbursed in accordance with WorkSafe policies, the relevant Medicare Benefit Schedule item code and WorkSafe's Reimbursement Rates for Medical Practitioners. | $2,050.00 | $205.00 | $2,255.00 |
PCT120 | Work capacity (130 Week) examination and report :
| $2,500.00 | $250.00 | $2,750.00 |
PCT120T | Telehealth - Work capacity (130 Week) examination and report :
| $2,500.00 | $250.00 | $2,750.00 |
PCT125 | Complex examination and report: Complex examination and reports are limited to the following report requests involving four or more of the following: Only payable for WorkSafe Agent referred complex examination and report assessments | $2,500.00 | $250.00 | $2,750.00 |
PCT125T | Telehealth - Complex examination and report: Complex examination and reports are limited to the following report requests involving four or more of the following: Only payable for WorkSafe Agent referred complex examination and report assessments | $2,500.00 | $250.00 | $2,750.00 |
PCT150 | Subsequent examination & report: Applies where a WorkSafe Agent requests an additional examination and report by the same IME within 12 months of a previous examination and report for the same claim. | $1,230.00 | $123.00 | $1,353.00 |
Loadings additional to examination and report fee are subject to prior written approval from the WorkSafe Agent.
Item number (Click to sort descending) | Service description (Click to clear sorting) | fee (Click to clear sorting) | GST (Click to clear sorting) | Total (inc GST) (Click to clear sorting) |
|---|---|---|---|---|
PCT140 | Report reading 201+ pages: Flat fee payable once only per WorkSafe Agent report for any pre-reading above the included 200 pages. | $255.90 | $25.59 | $281.49 |
PCT141 | Interpreter loading: Applies where a qualified interpreter is required in order to conduct the assessment and additional examination time is required (not applicable for support persons). The interpreter must have been pre-booked by the Agent. | $383.85 | $38.39 | $422.24 |
PCT250 | Urgent Examination and Report: Applies when a WorkSafe Agent has requested IME to complete any type of exam and provide the report to the WorkSafe Agent within 2 business days. The WorkSafe Agent and IME must agree to the expedited time frame prior to accepting the referral. | $307.50 | $30.75 | $338.25 |
PCT350 | Travel to/from assessment (at Agent’s request) per hour: Calculated in 15 minute blocks. Travel only paid when travelling to a location other than IIA's registered practice location/s. Travel for multiple assessments in the one location should be charged on a pro-rata basis across each claim. | $511.80 | $51.18 | $562.98 |
PCT400 | Audio visual viewing: Flat rate for the viewing of all audio-visual material. This fee is payable once only per claim per WorkSafe Agent report request. | $410.00 | $41.00 | $451.00 |
PCT450 | Supplementary report: The IME must have examined the injured worker within the last 6 months. An IME is not required to conduct a re-examination (or re-contact) the injured worker in order to provide the additional information. | $410.00 | $41.00 | $451.00 |
PCT500 | Interim report: Applies when there is a request by a WorkSafe agent to provide information prior to receiving the final IME written report. The advice from the IME may be provided verbally or in writing. | $143.50 | $14.35 | $157.85 |
PCT550 | Non-attendance on day of appointment: Applies where an IME appointment is cancelled by the WorkSafe Agent on the day of appointment or where the injured worker does not attend. | $717.50 | $71.75 | $789.25 |
PCT551 | Cancellation by agent within two business days of appointment: Applies where an IME appointment is cancelled by the WorkSafe Agent within 2 business days of the scheduled appointment. | $410.00 | $41.00 | $451.00 |