DVA arrangements for physiotherapists
Find the information you need to deliver and claim for physiotherapy services to Veteran Card holders.
If you’re a member of the veteran community, go to Physiotherapy services.
On this page
- COVID-19 arrangements
- Become a DVA health care provider
- Services covered by Veteran Cards – Gold and White
- Referrals and treatment cycle
- DVA Provider Notes
- Schedule of Fees
- Your obligations
- Common compliance issues
- Prior approvals
- Rehabilitation Appliances Program (RAP)
- Residential Aged Care Facilities (RACF)
- DVA Forms
- Useful links
Visit COVID-19 information for healthcare providers for details about DVA arrangements during the pandemic, including access to telehealth services.Back to top
Become a DVA health care provider
Register as a DVA health care provider so you can provide and claim services for DVA clients.Back to top
Services covered by Veteran Cards – Gold and White
Please check What a DVA health card covers for full details about card entitlements to ensure your client’s condition is covered.
A Veteran Card – Gold or White covers physiotherapy treatment that is clinically necessary:
- for all conditions, if the patient holds a Veteran Gold Card
- for specific, accepted conditions only, if the patient holds a Veteran White Card.
If you are unsure whether a DVA client is eligible to receive physiotherapy services, contact us on 1800 550 457.Back to top
Referrals and treatment cycle
If you are treating a Veteran Card holder, they will need a valid referral from their GP. For an initial treatment cycle, the referral could alternatively come from a:
- medical specialist
- treating hospital doctor
- hospital discharge planner.
Under DVA treatment cycle arrangements, a referral to an allied health provider will last up to 12 sessions or one year, whichever ends first.
Once a treatment cycle has ended, the client needs a new referral from their GP before you can provide further treatment. The client can have as many treatment cycles as their GP determines are clinically necessary.
The treatment cycle does not apply to physiotherapy treatment for clients who hold a Veteran Gold Card - Totally and Permanently Incapacitated.
Veteran Card holders with severe or complex needs may have tailored referral arrangements through the At Risk Client Framework, approved by their usual GP.
For full details about the treatment cycle and referral arrangements, please check Treatment cycle information for allied health providers.Back to top
DVA Provider Notes
By accepting a patient’s Veteran Card – Gold or White, you agree to follow the Notes that apply to your profession.
The Notes are legally binding, and it is your responsibility to become familiar with them. They are divided into two sections, and you need to comply with both.
Section 1: General notes for allied health providers
- Notes for allied health providers — section one — general (PDF 964 KB)
- Notes for allied health providers — section one — general (DOCX 545 KB)
Section 2: Notes specific to physiotherapists
- Notes for allied health providers — section 2(j) — physiotherapists (PDF 103 KB)
- Notes for allied health providers — section 2(j) — physiotherapists (DOC 125 KB)
Please also refer to:Back to top
Schedule of Fees
The Schedule of Fees – Physiotherapists defines the treatments and services you can provide to DVA clients and the payment amounts you can claim.
By accepting a Veteran Card – Gold or White, you agree to accept the DVA fee as full payment. You cannot charge the Veteran Card holder any ‘gap’ fee.
Schedule of Fees:
Software vendor files
- Dental and allied health — software vendor file (XML 383 KB) — updated 1 February 2021
- Dental and allied health — software vendor file (XLSX 67 KB) — updated 1 February 2021
- Historical dental and allied health software vendor files
Visit Provider claiming for full details on how to claim payment from us.
Please note you are responsible for your provider number and you will be accountable for any claiming errors.
If someone else submits claims on your behalf, you should ensure they do not make any mistakes.
Your provider number cannot be shared, and multiple providers cannot claim under the one provider number. The provider who owns the number will bear the consequences of misuse.
For invoicing and billing enquiries, call 1300 550 017.Back to top
Each year we review unusual provider claiming, which may result in an education process or financial recoveries.
For full details about complying with our requirements, please refer to Provider compliance.Back to top
Common compliance issues
Some common compliance issues include the following. Please note these are not exhaustive and you must check the Schedule of Fees for complete details about your profession’s Schedule of Fees item numbers.
You can only claim one consultation (including all treatment) for the same patient on the same day.
Each treatment cycle must start with an initial consultation. You can only claim one initial consultation item with each treatment cycle.
The initial consultation includes creating or updating the patient care plan.
You need to establish whether the client is eligible before you start treatment. Treatment for White Card holders must be related to an accepted disability.
After the initial consultation, use standard consultations to treat a DVA client. You can provide a standard consultation:
- in rooms
- in the home
- at a public or private hospital
- at a residential aged care facility.
Group and aquatic physiotherapy treatments are also considered standard consultations for treatment cycle purposes.
Standard consultations should be claimed for the ongoing treatment of a musculoskeletal condition.
An extended consultation covers treatment of either:
- 2 acute and unrelated areas
- an acute condition when a chronic condition needs ongoing treatment.
You should not claim an extended consultation for treatment of:
- related areas
- multiple, chronic musculoskeletal conditions.
You can only claim item PH41 if you have the appropriate recognised training to treat lymphoedema. Evidence of certification is required. Please send a copy of your certification to medicare.australia.queries.act [at] dva.gov.au before submitting any claims.
You cannot claim for lymphoedema treatment if the client is already receiving lymphoedema treatment from an occupational therapist.
Multiple allied healthcare treatments
A DVA client can receive only one of the following treatments for the same condition during the same referral period:
Consumables, aids and splints
Item number PH92 covers consumables used for treatment during the consultation, such as tape and acupuncture needles.
Item number PH93 covers items provided to the client for use after the consultation, such as Therabands, small weights, Pilates mats and gym balls.
You cannot claim items the client should purchase at a pharmacy or supermarket for self-management of conditions, such as fisiocrem or hot/cold packs.
Small medical aids and appliances
Use item number PH94 for small, low cost items only. These may include:
- walking aids
- compression garments
- TENS units
- orthoses such as a soft collar or knee brace.
You cannot claim items that exceed the maximum fee allowable under item number PH94.
Item number PH98 covers postage or freight only for an item you buy for a DVA client and claim for under PH94.
The postage PH98 claim must always be submitted along with the related PH94 claim for that posted item.
Splints and Casts
Item numbers PH95 and PH96 are for the supply of splints and casts only.
You can also order splints through RAP.
We may pay a kilometre allowance if:
- you are not a mobile provider
- you have a fixed practice location
- there is a genuine need to visit a client at home
- your client’s home is more than 10 km from their nearest physiotherapy clinic.
We will only pay the allowance for the part of your trip that is more than 10 km from the practice nearest to the client.Back to top
In exceptional circumstances, you may claim payment for treatments not included in the Schedule of Fees, if they:
- can be clinically justified for the client’s referred condition
- are evidence-based.
You must ask us for prior approval before providing the treatment.
To submit a request, please complete the D1328 Treatment Prior Financial Approval Request Form and email it to health.approval [at] dva.gov.au.
For inquiries, contact us on 1800 550 457.Back to top
Rehabilitation Appliances Program (RAP)
Physiotherapists can prescribe aids and appliances to eligible Veteran Card holders through the RAP National Schedule of Equipment.
The item must be clinically necessary and support the patient’s referred condition.
You cannot supply these items yourself. You need to place an order through RAP, using the relevant RAP Form. The items will be supplied by a DVA-contracted RAP supplier.Back to top
Residential Aged Care Facilities (RACF)
The provision of allied health services for residents of aged care facilities, including DVA clients, has been increased until 30 June 2022 in response to the Royal Commission into Aged Care’s recommendations on COVID-19.
For full details, please refer to DVA Provider News article, Increased allied health services for DVA clients in residential aged care.Back to top
Visit Provider forms to access all the forms you need to do business with us. This includes forms for prior approvals, RAP orders and claims.Back to top