Our services are available to insurers (including ACC) and employers.

We are a tertiary level provider under the ACC pain management contracts.  Through this we can provide a full specialist-lead interdisciplinary pain management program, with no costs to the client.  Referrals must have been approved by an ACC case manager or Assisted Recovery team.  These specialist programs are sometimes used as an alternative to surgery.

Health insurers do not specifically cover these specialist programs.  They will usually cover the majority of specialist appointments costs, but not  a coordinated program.  Coverage of other components of a program such as the key worker, psychology, physiotherapy, counselling, nursing input have variable levels of coverage depending on the policy.  Typically these costs need to be partly or fully met by the client.

If you have an ACC claim and wish to come to our clinic, please note the following:

• Referrals must come from or be approved for funding by ACC
• Usually it is not possible to utilise health insurance when there is also a related ACC claim. Most health insurance requires ACC to have declined to cover treatment before you are able to utilise the insurance cover.
• Therefore it is important to first clarify whether ACC will be covering your claim or treatment before being referred

There are two parts to a tertiary pain management service - Comprehensive Pain Assessment and Pain Management Program.

The assessment process aims to clarify pain mechanisms, develop a biopsychosocial formulation, establish goals and design a treatment program (if indicated).  The assessment costs begin at $2100 for a Specialist Pain Medicine Physician only assessment, but more complex assessments may involve other team members and multiple appointments and investigations.

A tertiary pain management program can range from a single specialty program consisting of a series of appointments with a Specialist Pain Medicine Physician, to a full interdisciplinary program costing up to $20,000 and lasting up to 6 months depending on the team members involved and the intensity and duration of treatment.  Every program is unique to the patient and their individual situation, and depends on the specific goals that are being targeted.  All of our programs involve a Specialist Pain Medicine Physician. These programs are available to insurers and employers.

That is why the assessment process is so important and detailed - this is what determines the program design, and the associated cost.

Health insurance may cover a proportion of the cost of tertiary pain service, though this is typically relatively low due to the limited coverage of the non-medical disciplines involved with our programs.

For patients who are considering privately funded tertiary pain management at Australis, in the South Island the Burwood Pain Management Centre offers a half day seminar course (available in-person or online) called BASE. We recommend considering this course before committing to the cost of privately funded treatment, as it provides a good background to chronic pain.  Please ask your GP to refer you to Burwood for that course.