Private hospital – Non-arrangement services fee schedule

View current and past private hospital – non-arrangement service fee schedules.

GST information for fee schedules

Maximum fees listed in this fee schedule are exclusive of GST. If GST is applicable, WorkSafe Victoria will pay the GST component in addition to the maximum fee. Providers should provide a tax invoice where amounts are subject to GST. For queries regarding whether the services you provide to an injured worker are taxable (that is, subject to GST) please contact the Australian Taxation Office and/or your tax advisor.

Private hospital – Non-arrangement service fees effective from 1 July 2023

WorkSafe will pay up to a maximum amount for the following categories of the service.

Emergency services

Item number (Click to sort descending)	Service description (Click to clear sorting)	Maximum payment rate (Click to clear sorting)
FACFEE	Emergency attendance fee – GST incl. Facilities with a recognised Private Emergency Department	$102.34

Advanced surgical patients

Description (Click to sort descending)	Episode classification (Click to clear sorting)	Maximum payment rate (Click to clear sorting)
> 14 days	AS	$672.20
1 - 14 days	AS	$865.59

General surgical patients

Description (Click to sort descending)	Episode classification (Click to clear sorting)	Maximum payment rate (Click to clear sorting)
> 14 days	GS	$672.20
1 - 14 days	GS	$773.92

Medical patients

Description (Click to sort descending)	Episode classification (Click to clear sorting)	Maximum payment rate (Click to clear sorting)
> 14 days	M	$672.20
1 - 14 days	M	$773.92

Hospital in the home

Description (Click to sort descending)	Episode classification (Click to clear sorting)	Maximum payment rate (Click to clear sorting)
Hospital in the home	HIT	$442.07

Approved intensive care

Description (Click to sort descending)	Episode classification (Click to clear sorting)	Maximum payment rate (Click to clear sorting)
1 - 4 days	ICU	$2,637.34

Approved coronary care

Description (Click to sort descending)	Episode classification (Click to clear sorting)	Maximum payment rate (Click to clear sorting)
1 - 14 days	CCU	$1,568.15

Day surgery patients

Description (Click to clear sorting)	Episode classification (Click to sort descending)	Maximum payment rate (Click to clear sorting)
	Band 1	$264.59
	Band 2	$317.52
	Band 3	$396.77
	Band 4	$440.88

Theatre bands

Description (Click to clear sorting)	Episode classification (Click to sort descending)	Maximum payment rate (Click to clear sorting)
	Band 1	$374.80
	Band 1A	$114.12
	Band 2	$539.70
	Band 3	$682.37
	Band 4	$869.20
	Band 5	$1,211.80
	Band 6	$1,507.05
	Band 7	$2,036.61
	Band 8	$2,708.68
	Band 9	$3,961.07
	Band 9A	$2,963.05
	Band 10	$5,427.25
	Band 11	$5,936.36
	Band 12	$7,473.96
	Band 13	$8,436.95

Explanatory Notes

All Services and invoicing must be provided in line with the following guidelines located on the WorkSafe website worksafe.vic.gov.au

WorkSafe Private Hospital Policy and Invoicing guidelines
WorkSafe Prosthesis guidelines
WorkSafe Elective Surgery Policy
WorkSafe Pharmacy Policy
WorkSafe MBS Rules