When a worker has an injury which entitles them to compensation, WorkSafe or self insurers are liable to pay the reasonable cost of the hospital services required because of the workplace injury.
WorkSafe can pay the reasonable costs of medical services up to a maximum amount as detailed in the relevant fee schedule.
- Non arrangement private hospital fee schedule (available from the fees A to Z page)
- Non arrangement private day hospital fee schedule (available from the fees A to Z page)
- Non arrangement private rehabilitation hospital fee schedule (available from the fees A to Z page)
- Non arrangement private psychiatric hospital fee schedule (available from the fees A to Z page)
WorkSafe's policies provide guidance to health professionals on what considerations are involved in determining what WorkSafe can and cannot pay.
- Private hospitals policy
- Travel expenses for medical and hospital services and medical reviews policy
The Commonwealth Department of Health and Ageing has established a comprehensive framework of regulations to provide affordable access to high quality private hospital and health care services for all Victorians.
This regulatory framework for private hospitals is widely accepted by the private health industry and is therefore a significant consideration for WorkSafe in setting private hospital policy, guidelines and fees at reasonable cost.
WorkSafe Victoria has a comprehensive framework of arrangements with the Victorian Department of Human Services for funding public hospital services required by injured workers. Acute admissions are funded by casemix, subacute admissions (rehabilitation) are funded on a per day basis, and outpatient services are funded on an occasion of service basis. Guidelines for funding WorkSafe patients and billing arrangements are published each year by the Department of Human Services.
WorkSafe will pay Victorian public hospitals in accordance with the Department of Human Services fee schedules, guidelines and arrangements for WorkSafe patients.