Remote treatment and regional access
Can telehealth treatment be funded in a NSW CTP claim?
Telehealth may be funded when it is clinically suitable, accident-related and reasonably necessary
Yes. Telehealth can be used to deliver some approved health and rehabilitation services by video or telephone. It remains subject to the same NSW CTP requirements as in-person treatment: relation to the accident injury, reasonable necessity, an appropriate qualified provider, cost and compliance with professional standards. Telehealth is not automatically equivalent to an in-person examination, and the person’s technology, privacy, language, disability and clinical risk must be considered.
Telehealth can improve access for regional claimants, people unable to travel, those balancing work or care responsibilities, and people continuing treatment while temporarily away. It can also be unsuitable where physical examination, hands-on treatment, equipment fitting, cognitive testing, acute risk assessment or reliable private communication is required. The treating provider should choose the mode on clinical grounds, not convenience alone.
A request should identify the service, provider, platform or telephone method, frequency, fee, clinical reason and review plan. If the same provider switches an approved in-person program to telehealth, confirm whether the insurer requires a revised request or item code. Do not assume that a general treatment approval covers every delivery mode or fee.
Reviewed by Herman Chan, Stephen Young Lawyers
When is telehealth clinically suitable?
Suitable examples may include some psychology, counselling, education, exercise review, vocational rehabilitation, case conferencing or follow-up appointments. The provider should consider whether observation, physical testing, safety monitoring and therapeutic rapport can be achieved remotely. The decision may change over time or alternate with in-person sessions.
For physiotherapy or exercise treatment, telehealth may support education, exercise demonstration and progression, but some injuries require manual examination or supervised testing. For psychological treatment, privacy, crisis response and the patient’s location must be known. For an interpreter-supported session, the platform must safely accommodate three-way communication.
SIRA’s health-service standards require telehealth providers to consider whether the injured person has the capacity and capability to access the service. Poor internet, hearing impairment, cognitive difficulty, lack of a private room or inability to use the platform should be addressed rather than treated as non-cooperation.
What should the approval request include?
The provider should state why telehealth is suitable for the accident injury, what will be delivered, how risk and progress will be monitored and when in-person review is required. Identify the billing item, fee and whether any interpreter or technology support is included. Record the claimant’s informed agreement and the physical location from which the service will be provided.
Clinical notes should be as complete as for an in-person appointment. Record participants, mode, identity checks, consent, assessment limits, treatment, home program, adverse events and follow-up. A call log alone is not a treatment record. Claims for missed sessions or technical failure should follow the applicable fee and cancellation rules.
Use a secure platform and private setting. Do not record a session without lawful consent and a clear clinical reason. Avoid sending medical records or meeting links through insecure public channels. Privacy concerns should be raised with the provider and insurer before the session where possible.
What if telehealth is refused or does not work?
Ask whether the insurer disputes the treatment itself, remote delivery, provider, fee or clinical evidence. A focused provider response can explain why travel or in-person access is impractical, why remote delivery is safe, and what outcomes will be measured. Regional distance alone does not establish necessity, but it may be an important accessibility factor.
If telehealth fails because of technology, language or clinical limitations, document the problem and request a suitable alternative. Repeatedly billing ineffective sessions without adapting the plan can weaken the request. A hybrid program, local provider, travel support or interpreter may be more appropriate.
A refusal about reasonable necessity or accident relation is generally a medical issue; a fee question may be merit review. Preserve the written decision and review rights. A complaint about platform or provider conduct is separate from the entitlement dispute.
Practical next steps
Making a telehealth treatment request
Show that remote delivery is a clinical plan, not simply a video-call preference.
Confirm the treatment need
Identify the accident-related condition, treatment goal and why the service remains required.
Assess remote suitability
Address examination needs, safety, privacy, technology, language, cognition and when in-person review is needed.
Specify service and cost
Provide provider, mode, frequency, duration, item code, fee and interpreter or technology requirements.
Test access before the first session
Check device, connection, private space, documents and three-way interpreting where applicable.
Review effectiveness
Use clinical outcomes and functional progress to continue, modify or replace the remote plan.
Evidence
Telehealth funding evidence checklist
The request should address both the treatment and why remote delivery is appropriate.
- Treating referral and diagnosis connected to the motor accident.
- Provider rationale for telehealth and any hybrid arrangement.
- Risk, privacy, emergency and in-person review plan.
- Claimant technology, language, disability and access considerations.
- Provider registration, location, billing item, frequency and fee.
- Session notes, attendance, outcomes and technical failures.
- Regional travel distance or other practical access evidence where relevant.
- Insurer approval or refusal and stated review rights.
Telehealth limitations
- Telehealth is not suitable for every examination, treatment or person.
- An approved in-person service does not necessarily authorise a different fee or remote mode without confirmation.
- A recorded call or ordinary video platform may create privacy and consent risks.
- Technical failure should be documented and the plan adapted rather than treated as completed treatment.
- Remote attendance does not prove the person can perform work or travel without restriction.
Timing
Approval and continuity
Plan remote access before an appointment or treatment gap occurs.
- Submit or confirm the telehealth mode before service where approval is required, with enough information for the Guidelines 10-day treatment decision process.
- If the mode is refused, act from the written decision and its review instructions rather than continuing on the assumption of later reimbursement.
- Where technology failure interrupts a Certificate of Fitness or another time-sensitive appointment, notify the provider and insurer promptly and arrange a replacement.
- Regional or overseas delivery can raise provider and regulatory issues beyond ordinary telehealth; obtain case-specific approval.
Frequently asked questions
- Can CTP pay telehealth psychology?
- Potentially, where the psychological treatment is approved, remote delivery is clinically suitable and the provider, cost, privacy and risk arrangements are appropriate.
- Can I choose telephone instead of video?
- The provider should decide whether telephone is clinically adequate. Some assessment and treatment requires visual observation or in-person contact.
- Can a regional claimant insist on telehealth?
- No automatic right applies, but distance and access are relevant. The request should compare safe remote delivery, local providers and travel options.
- Can an interpreter join the telehealth session?
- Yes where appropriately arranged and clinically suitable. Confirm the interpreter, platform, privacy and funding before the appointment.
- Can the insurer use telehealth attendance to prove work capacity?
- Attendance at one remote appointment does not establish capacity for employment. Work capacity requires its own medical and vocational evidence.
- What if the connection fails?
- Record the failure, whether treatment occurred and the replacement plan. Do not allow an incomplete session to be inaccurately described as full treatment.
Related NSW CTP guides
Official sources
- Motor Accident Injuries Act 2017 (NSW), current in-force version
- SIRA Motor Accident Guidelines, current published version
- SIRA: allied health providers in NSW CTP schemes - frequently asked questions
- SIRA: guidelines for the provision of relevant health and related services, including telehealth
- SIRA: medical expenses after a NSW motor crash
- Personal Injury Commission: medical disputes
The current legislation, SIRA Guidelines and official CTP Care material linked above are the public-source basis for this page. Treatment and care decisions remain fact-specific and should be checked against the written request, clinical evidence, accident date and insurer reasons.
Remote-treatment review
Has telehealth treatment been refused or treated as unsuitable?
Send the request, provider rationale, access evidence and insurer decision. We can identify whether the dispute concerns treatment need, delivery mode, cost or another claim issue.
General information only: This page explains the NSW motor accidents scheme in general terms and is not legal or medical advice. It does not guarantee approval, reimbursement, continued funding, a review outcome or damages. Keep acting on any date stated in an insurer, CTP Care or PIC notice while obtaining advice.