The PTSS health service directive is the overarching document, outlining the principles of the Scheme and contains mandatory outcomes and requirements to be achieved by the hospital and health services.
The PTSS protocol supports the health service directive to prescribe the mandatory requirements/steps to be taken by staff administering the Scheme.
The PTSS Guideline (PDF) supports both the health service directive and the protocol, and provides detailed information on the Scheme, including eligibility criteria and the types of assistance available to eligible patients.
Patients may be eligible for PTSS if they are required to travel more than 50 kilometres from the public hospital or health facility closest to their permanent place of residence to access eligible specialist medical services. The specialist medical services that are eligible for PTSS subsidies are:
Allied health - only when provided as an essential component of eligible specialist medical services
Anaesthesia including hyperbaric medicine
Gastroenterology and hepatology
Immunology and allergy
Intensive care medicine
Nephrology (renal medicine)
Obstetrics and gynaecology, including but not limited to gynaecological oncology and in-vitro fertilisation services:
Ante and post-natal appointments are only covered if the patient is referred to a medical specialist i.e. not a general practitioner or midwife.
Maternity and birthing services are covered only if the services or level of care required are not available at the patient's closest public hospital or health facility.
Ophthalmology excluding laser refractive services
Organ transplant (for organ recipients only)
Paediatrics and child health
Radiology, including but not limited to diagnostic radiology, diagnostic ultrasound and nuclear medicine
Rehabilitation medicine including wheelchair fitting services
Respiratory and sleep medicine
Surgery, including but not limited to cardio-thoracic surgery, general surgery, neurosurgery, orthopaedic surgery, otolaryngology (head and neck surgery), otorhinolaryngology (ear, nose and throat), oral and maxillofacial surgery, paediatric surgery, plastic surgery * including transgender services, urology and vascular surgery. * Plastic and reconstructive surgeries - only those attracting a Medicare rebate are eligible.
Patients who have already travelled for specialist medical treatment within the last 12 months and were unaware of PTSS, or required urgent appointments or admissions and did not have adequate time to obtain approval in advance, can submit a retrospective (past) PTSS application. Retrospective applications will be assessed against the same eligibility criteria as PTSS applications submitted prior to a specialist appointment.
If an approved patient's circumstances change, such as they travelled alone to receive treatment and subsequently required an escort to join them, a retrospective application can be submitted to subsidise an escort. Patients are only able to make one retrospective application which may include claims for multiple specialist appointments.
Patients are able to appeal the outcome of their application if they don't agree with the final decision.
An appeal should be lodged at the patient's local hospital or health facility within 30 calendar days of receiving notification of the outcome. Appeals lodged after this time may be accepted at the discretion of the local hospital or health facility.
During the appeals process, patients will be responsible for providing any additional information to support their appeal. This information will be considered along with their original application and assessed using the same criteria. Appeals should be assessed within five working days from the date of lodgement, but may take longer if additional information is required.
Patients can use this appeals form (PDF) or one from their local hospital or health facility.
The following PTSS brochures and posters are available to download and display in local health facilities and community organisations.
Patients can lodge a complaint or provide feedback on the Scheme either verbally or in writing to their local hospital or health facility. Each Hospital and Health Service has a complaints coordinator who reviews feedback for all the facilities in their area. Patients can contact the complaints coordinator to assist, even if a formal complaint has not been lodged.
The circumstances of the feedback/complaint should be clearly described, including times, dates, locations, names of persons involved, the particular issue, details of satisfactory resolution, and patient/carer's contact details.