DVA Prior Financial Approval Items

DVA may sometimes approve charges above those listed in the Repatriation Medical Fee Schedule if there are exceptional circumstances justifying the payment of a higher fee for a particular patient. They will issue the provider (e.g the surgeon) with a letter stating who the approval is for, the item number to be used (eg MT04 or MT06) and the approved fee.

To claim this service on an electronic DVA claim, first set the Fee Calculation to "FIXED FEE" and enter the approved amount. Then enter the approved MT0x item number in place of the usual items. It should be the only item on the invoice. You will get an error if you forget this step.

      

If you are a surgical assistant, you will need to manually calculate one fifth of the surgeon's fee and enter that as the fixed fee. Note that CE will not calculate an assist item (513xx).

Submit the claim in the usual way to DVA.

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