DVA arrangements for speech pathologists

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Find the information you need to deliver and claim for speech pathology services to Veteran Card holders.

If you’re a member of the veteran community, see Speech pathology services.

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COVID-19 arrangements

Visit COVID-19 information for healthcare providers for details about DVA arrangements during the pandemic, including access to telehealth services.

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Become a DVA health care provider

Register as a DVA health care provider so you can provide and claim services for DVA clients.  

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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 speech pathology treatment that is clinically necessary:

If you are unsure whether a DVA client is eligible to receive chiropractic services, contact us on 1800 550 457.

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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.

Please note the treatment cycle does not apply to ‘LSVT LOUD’ item numbers SH28 and SH29, which cover 18 speech pathology sessions for eligible DVA clients. ‘Evaluate Clinical Assessment’ items  SH21-27 are also exempt. 

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.

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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

Section 2: Notes specific to speech pathologists

Please also refer to:

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Schedule of Fees

The Schedule of Fees – Speech Pathologists 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

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Claiming

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.

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Your obligations

Each year we review unusual provider claiming, which may result in an education process or financial recoveries.

For full details about complying with DVA requirements, please refer to Provider compliance.

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Common compliance issues

Before you treat a DVA client, please check the Schedule of Fees and Notes for full details about limits and restrictions on speech pathology services.

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.

Location of services

The item numbers are different depending on whether you treat the client at:

  • your clinic
  • the client’s home
  • other locations such as a residential aged care facility (RACF) or hospital.

You need to use the correct item number for the location where the service was provided.

For example, if you assess a DVA client who lives in a RACF, use item number SH15 for conducting the assessment, and:

  • SH25 if you complete the evaluation at the RACF
  • SH21 if you return to your clinic to complete the evaluation.

Initial consultation and assessment services

You can only use the ‘Conduct clinical assessment’ item number for initial consultations and other assessments, such as when you are conducting a:

  • detailed case history
  • language assessment
  • swallowing assessment.

This item must not be used for treatment services.

You can only use the ‘Evaluate clinical assessment’ item number for evaluation and reporting services such as:

  • scoring, analysing and evaluating assessments
  • writing in-hospital and RACF charts
  • formulating patient care plans
  • writing letters back to the GP.  

You can only claim an ‘Evaluate clinical assessment’ item number along with a ‘Conduct clinical assessment’ claim.

After the initial consultation, you can use the clinical assessment item numbers again if a client clinically requires further assessment or evaluation, such as:

  • a high level language assessment
  • a review swallowing assessment.

Treatment Services

You can use the ‘Consultation’ item number to:

  • prepare for a treatment session
  • conduct a treatment session
  • write up progress notes.

You cannot claim for any treatment services using the ‘Evaluate clinical assessment’ and ‘Conduct clinical assessment’ item numbers.

‘Out of rooms’ loading

If you need to provide a service away from your clinic, we will pay you an ‘Out of rooms’ loading.

We will pay the loading automatically as long as you use the correct item number for the client’s location (such as the client’s home or an aged care facility).

You do not need to claim separately for the loading.

Kilometre allowance

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 speech pathology 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.

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Prior approvals

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

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Rehabilitation Appliances Program (RAP)

Speech pathologists 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.

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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.

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DVA Forms

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.

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Health programs and services for DVA clients

Open Arms – Veterans & Families Counselling

Travel for a client's treatment

Training for providers

Research 

Health Providers' Partnership Forum (HPPF)

Contact us

 

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