How to engage with medicos- SA ReturnToWork and fees

How to engage with medicos- SA ReturnToWork and fees

February 26, 2018

I was surprised and pleased to receive the following paper from SA .  What a contrast to the situation in Victoria!

Medical fees


ReturnToWorkSA is seeking to gazette fees for medical services for 2018-19, to be effective 1st July 2018.

The Return to Work Act 2014 requires us to consult with stakeholders prior to a fee schedule being published and this paper forms part of the formal consultation process. We regard this as a valuable process, and all feedback is carefully considered.

This paper describes the proposed changes and fee calculation methodology for provider services and invites feedback. The formal consultation process will be for a four week period commencing on Wednesday, 7th February 2018.

Please provide your feedback to ReturnToWorkSA by close of business on 7th March 2018 to

If you have any questions regarding this document, please contact Simon Hynes, Program Lead, Provider Regulation and Support on 8238 5757 or email before the closing date so these can be considered within the consultation timeframe.

Current fee calculation methodology

The Return to Work Act (2014) requires ReturnToWorkSA to set fees based on the average charge to private patients for the relevant service. The amount fixed for the service must not exceed the amount recommended by the   relevant professional association.

ReturnToWorkSA obtains data from Medicare Australia to calculate average private charges for provider groups. Fees are then adjusted relative to this benchmark, based on Scheme needs.

The fee increases recommended in this paper (excluding GP consultations) have been calculated after taking this information into consideration.

Medical Practitioner fees

ReturnToWorkSA with the Australian Medical Association (AMA) through a Memorandum of Understanding has agreed to parity with published AMA rates for General Practitioner Attendance fees up to but not exceeding an annual 5% increase.

The following table illustrates the Average Private Charge (APC) changes, the percentage differences for APC and Medicare charges and the proposed changes for the ReturntoWorkSA medical fees:


APC change for 2017-18 RTWSA vs

APC for 2017-18


Medicare Charge for 2017-18

Proposed RTWSA Change
General Practitioner Attendance fees (Within Schedule 1A) -0.2% 41.1% higher 96.5% higher 1.8% increase (AMA rate equivalent)
Remaining Schedule 1A and 1B fees -0.2% 41.1% higher 96.5% higher No increase


Given there has not been an increase in average private charges for medical fees during 2017-18, there is no proposed increase to medical fees (excluding General Practitioner Attendances) for 2018-19.


Next Steps

To enable fees to take effect from 1st July 2018, ReturnToWorkSA will:

  • consider and respond to feedback provided by stakeholders; and
  • seek the approval of the ReturnToWorkSA Board and the Minister for Industrial Relations for publishing in the South Australian Government


Further information

If you have any questions or comments regarding this paper, please contact Simon Hynes, Program Lead, Regulation and Scheme Support on 8238 5757 or email by close of business on 7th of March 2018.


Leave a Comment