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4a and 4b Claims
4a and 4b Complex Pain Management claims allow aged care providers to increase revenue in the complex healthcare domain whilst providing an essential service to residents.
4a claims require one-on-one pain management treatments for 20 minutes at least one day per week, which consists of therapeutic massage or use of technical equipment.
4b claims require one-on-one pain management treatments for 80 minutes at least 4 days per week, which consists of therapeutic massage or use of technical equipment.
To be admitted onto the ‘pain management program’, each resident must be assessed using an evidence-based pain assessment undertaken by an allied health professional such as a Physiotherapist or Occupational Therapist. Guide Healthcare clinicians are experts at completing these assessments.
FAQ’s
1. What ‘technical equipment’ is included in the ACFI to satisfy 4a and 4b claims?
Technical Equipment designed specifically for pain management' refers to electro-therapeutic equipment such as TENS, interferential therapy, ultrasonic therapy, laser therapy, acupuncture, dry needling and wax baths; the Department of Health does not maintain an exhaustive list of equipment that can be included as this is subject to change over time.
2. What constitutes therapeutic massage?
According to the ACFI, therapeutic massage involves skin to skin contact (or through/over clothes or towel) between the therapist and the care recipient.
3. Can individual or group exercise programs be used to meet the requirements of 4a and 4b claims?
No – the only treatments that meet the requirements of 4a and 4b complex pain management claims include therapeutic massage and technical equipment specifically designed for pain management.
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