676GOVERNMENT GAZETTE, WA 5 April 2024

676 GOVERNMENT GAZETTE, WA 5 April 2024 Schedule 1—Medical Service Fees: Workers Compensation Ancillary Services N/A Certificate of capacity Issuing a certificate of capacity. To be charged and billed as part of a time- based or content based AMA Fees List consultation item. WS001 Medical mins WG010 Return to work case conference Preparation for and attendance at a return to work case conference arranged by the worker’s employer, the employer’s insurer, the worker’s treating medical practitioner or an approved workplace rehabilitation provider for the purpose of supporting the worker’s recovery and enhancing opportunities for the worker’s return to work. mins WS010 Medical mins WG020 Medical report Any requested or required report other than a certificate of capacity that provides information about any or all of the following— • the worker’s diagnosis and present condition • any medical co-morbidities that are likely to impact on the management of the worker’s condition • treatment/management services provided, and results obtained • recommendations for further treatment/management • progress, functional and objective improvements • likely treatment duration required • the worker’s capacity for work. mins WS020 Medical mins WG030 Return to work program Activities associated with a worker’s treating medical practitioner recommending a return to work program be established for the worker. Activities associated with a worker’s treating medical practitioner reviewing a worker’s return to work program and any amended return to work program. mins WS030 Medical mins WG040 Services additional to usual medical management Activities associated with time spent by the medical practitioner (in addition to usual medical management) relating to— • discussions with a worker, an employer, insurer, approved workplace rehabilitation provider, medical practitioner, medical specialist, or other health professional about the treatment of an injured worker, a worker’s capacity for work or strategies to overcome barriers to return to work. • visiting work sites • providing additional reports, documents or records that are requested or required by an mins WS040 Medical mins

5 April 2024 GOVERNMENT GAZETTE, WA 677 Schedule 2—Medical Service Fees: Diagnostic Imaging Services Ultrasound 55028 $243.80 55700 $133.90 55029 $84.55 55703 $78.25 55030 $243.80 55704 $156.40 55031 $84.55 55705 $78.25 55032 $243.80 55706 $223.35 55033 $84.55 55707 $156.40 55036 $248.50 55708 $78.25 55037 $84.55 55709 $84.90 55038 $243.80 55712 $256.95 55039 $84.55 55715 $89.40 55048 $243.80 55718 $223.35 55049 $84.55 55721 $256.95 55054 $243.80 55723 $84.90 55070 $219.45 55725 $89.40 55073 $76.05 55729 $60.90 55076 $243.80 55736 $283.60 55079 $84.55 55739 $127.25 55084 $219.45 55759 $335.15 55085 $76.05 55762 $133.90 55118 $615.35 55764 $357.40 55130 $379.90 55766 $145.10 55135 $789.90 55768 $335.15 55238 $378.60 55770 $133.90 55244 $378.60 55772 $357.40 55246 $378.60 55774 $145.10 55248 $378.60 55812 $243.80 55252 $378.60 55814 $84.55 55274 $378.60 55844 $195.10 55276 $378.60 55846 $84.55 55278 $378.60 55848 $243.80 55280 $378.60 55850 $341.45 55282 $378.60 55852 $243.80 55284 $378.60 55854 $84.55 55292 $378.60 55294 $378.60 55296 $248.10 55600 $243.80 55603 $243.80