Medical treatment costs and WorkCover Queensland's table of costs
For an accepted claim, treatment the insurer accepts as reasonable and necessary is paid according to the insurer's table of costs, with no gap payment described in WorkCover Queensland's own guidance.
s 211(1)(a) of the Workers’ Compensation and Rehabilitation Act 2003 sets an insurer's liability for medical treatment by a registered person at the cost the insurer accepts as reasonable, having regard to the relevant table of costs. In practice, once a claim is accepted, WorkCover Queensland's own worker guidance describes treatment that is reasonable and necessary for the accepted injury as covered according to the insurer's table of costs.
Neither official guide describes a gap payment for accepted treatment
This is a real difference from the Medicare Better Access pathway many readers may be more familiar with, where a gap payment above the Medicare rebate is common for a psychologist's fee. Neither of WorkCover Queensland's worker-facing PDFs on mental health treatment describes a co-payment or out-of-pocket gap for treatment the insurer has accepted as reasonable and necessary under an accepted claim.
What happens outside an accepted claim
WorkCover Queensland's own guidance notes that if a claim is not accepted, "there are fees for most mental health treatments," and advises asking a GP about Medicare rebates instead. This implies, without stating a specific figure, that outside an accepted WorkCover claim, a worker is in the ordinary Medicare and private-fee situation rather than a WorkCover-funded one.