4.5.37 Public & Private hospitals

4.5.37.1 Inpatient rehabilitation | 4.5.37.2 Psychiatric inpatient admissions | 4.5.37.3 Day surgery | 4.5.37.4 Outpatient rehabilitation services | 4.5.37.5 Epworth concussion program

Public Hospitals

WorkSafe can pay the reasonable costs of public hospital services when required as a result of a work-related An injury/disease is work related if it arose out of or in the course of employment and the scope of employment. injury or illness.

A hospital means:

  1. a public hospital, denominational hospital, private hospital or public health service within the meaning of the Health Services Act 1988, or

  2. a day procedure centre within the meaning of the Health Services Act 1988, or

  3. an approved mental health service within the meaning of the Mental Health Act 1986, or

  4. a hospital within the meaning of a law of another State or of a Territory, or

  5. a place within Australia declared by Order of the Governor in Council to be a hospital for the purposes of this Act, or

  6. a place outside Australia approved by the Authority as a hospital for the purposes of this Act

WorkSafe can pay for the reasonable costs of a medical and like expense where a worker is entitled to provisional payments on a claimed mental injury.

Private Hospitals

WorkSafe can pay the reasonable costs of private hospital services required as a result of a work-related injury or illness.

Written approval is required from the Agent before the provision of the service.

Note: Prior approval is not required for requests relating to emergency psychiatric inpatient treatment. If a hospital seeks prior approval, this must not be delayed.

A private hospital is a private hospital:

  • within the meaning of the Health Services Act 1988 or s178 of the Health Act 1958
  • within the meaning of a law of another State or of a Territory or
  • outside Australia if approved by WorkSafe.
Medications for discharge from inpatient hospital stay

In addition to the bed fee, Agent can pay the reasonable costs of prescribed work-related discharge medication(s) supplied up to 72 hours prior to discharge from hospital. When discharged from a private hospital up to one month's supply is payable.

WorkSafe can pay for the reasonable costs of a medical and like expense where a worker is entitled to provisional payments on a claimed mental injury.

See: 6.5 Provisional payments for a mental injury

This section of the Claims Manual must be read in conjunction with the following policies:

See: Reimbursement Rates for Medical Services | DHA Prescribed List

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