QALS Funding Limits

An applicant must be registered as a QALS client and meet eligibility terms prior to any services being approved or completed. All prosthetic services, repairs and maintenance must be completed by an accredited PSPs and a Prosthetic Issue and Acquittal must be signed by the person to acknowledge receipt of the services provided.

Prostheses

One (1) standard artificial limb (prosthesis) for every-day-use and basic mobility per amputation.

  • Expected use of a prosthesis is 30 to 40 months from the date of issue depending on the client’s age and mobility level.
  • Replacement prosthesis requests within 36 months of the previous issue require additional   justification from the provider, especially if undamaged or undue wear is evident.
  • Funding is not based on medical or individual lifestyle needs, client work demands or activities of interest, nor advancements in component technology. QALS does not  fund secondary, spare or emergency, occupational or recreational cosmetic limbs.
  • QALS does not routinely provide a replacement prosthesis in under three years except in special circumstances, however, a socket replacement may be requested if required. A socket for a definitive client is expected to last 12-24 months.
  • Partial foot prostheses may be supplied for partial foot amputations, proximal to the metatarsal phalange joint e.g. custom-made prosthesis for Chopart and Lisfranc amputations. QALS does not fund Orthoses (Refer to MASS Orthoses) or Surgical and/or Medicare Grade Footwear (Refer to MASS Medical Grade Footwear).
  • Partial hand prostheses may be supplied excluding digits only.
  • Prostheses for conditions other than limb differences (eyes, breasts, nose, wigs, etc) are not funded by QALS.
  • PSP labour hours: 
    • Labour funded is in accordance to the QALS schedule of hours on MASS-eApply.
    • The schedule for prosthetic limbs and socket replacements is inclusive of the labour to fit all components (excluding a cosmetic/artistic feature), additional labour (e.g. to fit a pylon, adaptor, foot) is not granted.
  • Osseointegration:
    • funding is up-to $11,500 for component costs.
    • Osseointegration prosthesis are expected to last 36 to 60 months use.
    • Osseointegration clients are not eligible for consumable supply items or cosmetic covers through QALS as the annual limitation costs are allocated to the higher funding level of the initial cost of the Osseo integrated prosthesis.

Components

IMPORTANT: Please refer to the Guidelines for Queensland Artificial Limb Service Supplement for information on temporary funding increases July 2023 to June 2027.

Joints:

  • Feet and Terminal Devices - K1 - $900, K2 or above: $1,500
  • Elbow and Knee units - K1 - $1,500, K2 or above: $3,000
  • Feet, terminal devices, elbows and knees have an expected period of use of 12-36 months, or as per warranty.
  • Non-Standard items such as myoelectric or microprocessor limbs or components are not approved by QALS.

General information:

  • PSPs are to re-use components fitted on their previous prosthesis (funded by the state/federal government) on new prosthetic limbs if the parts are within the warranty periods and/or expected period of use if it is safe to do so.
  • Prosthetic components that do not comply with the Australian Standards and/or devices that are not registered with the Therapeutic Goods Administration are not funded by QALS.
  • QALS does not fund additional specialised labour for non-standard components e.g. extra clinical time
  • QALS must be notified if any upgraded or specially designed components have been added to a prosthesis regardless if fully or partially funded by QALS.

Consumable and Supply Items

IMPORTANT: Please refer to the Guidelines for Queensland Artificial Limb Service Supplement for information on temporary funding increases July 2023 to June 2027.

* Reasonable replacements annually
** Quantity limit dependent on type
*** Interim, Exoskeletal and Osseointegration Prosthetic Limbs are not eligible for Artistic Feature or Cosmetic Limb Covers.

Note:

  • Funding limits apply to a 12-month period.
  • Limits apply per amputated limb, not per prosthesis/socket replacement.
  • Quantity is approximate
  • Consumables must be listed on the QALS Component and Consumables List.
  • Period of expected use and warranty apply for all component and consumables replacements.
  • It is the PSP's responsibility to maintain records of the number of consumables provided to each person in order to comply with the QALS allocations. If a PSP does not have these records or is unsure of a person’s eligibility for further consumable supply, they should contact QALS to confirm the client’s current allocation eligibility.

Repairs and Maintenance

QALS accepts responsibility for the funding costs towards the following:

  • ongoing reasonable repairs and maintenance to a prosthetic limb and standard components that are outside the warranty periods;
  • annual reviews and maintenance, until the prosthesis is replaced/expired, the client is deemed no longer suitable for prosthetic use or as advised by QALS in writing.

    • An additional once off 1-hour initial consultation for definitive clients to discuss their prosthetic needs with their new PSP (once per client, not per amputation) is funded through QALS.

Assistance requests for consultations, or appointments for non-QALS funded services (e.g. appointments regarding client’s self-funded recreational prosthesis, osseointegration surgery) will not be approved.

Important Information regarding Repairs and Maintenance:

  • Clients are prohibited from making changes, alterations and/or repairs which in any way could affect the function of their prosthesis. QALS will not fund any service resulting from a person tampering with the prosthesis or components, nor will it assume any responsibility for any outcome arising from the use of a prosthesis that has been tampered by a client.
  • Items that are broken outside of standard wear-and-tear; are lost; or are stolen will require a statutory declaration and/or police report to be submitted with the application of a replacement item or repairs.
  • Repeated socket replacements due to a client’s medical condition (swelling or ulceration) will require medical intervention and provision of a CPC to QALS before repairs or replacements can be funded.
  • QALS does not fund replacements/repairs for previously replaced or expired items. It is the PSP's responsibility to to scan and check registered identification number against the prosthesis present to ensure it is the client’s current prosthesis before commencing any work on the prosthetic limb. QALS will not pay for any repairs conducted on prosthesis that has been completed for an expired item.

Warranty

Warranty on PSP workmanship and quality of product and components applies to all prosthetic services.

  • Socket warranty has minimum 3 months on fit and minimum 12 months on socket integrity.
  • Components are as per the manufacturers’ specifications for both ‘warranty’ and ‘expected period-of-use’ for each specific item.
  • Repairs or replacements to items within the warranty period may not be funded by QALS.
    • Broken or damaged components will require investigation by the Prosthetist as to the cause of malfunction with the component.
    • Where a component has failed within the manufacturer’s warranty period, the PSP must have the item replaced under warranty. PSPs are required to advise QALS where they reasonably believe that a person has misused their prosthesis contrary to the manufacturer’s guidelines.
    • Repeated repairs to a new prosthesis, socket replacements or major components in the first 12 months of use will require justification as to the reason for replacement and/or if the components failed to meet the warranty period or expected periods of use guidelines.

All items are expected to last the warranty period. When a warranty period is not identified by the manufacturer or supplier it has an implied minimum 6-month warranty period. QALS will only fund replacements or new components that are outside the warranty period.

Other

QALS does not fund:

  • Retrospective funding for prosthetics or associated service, consumables/supplies that have not been approved by QALS
  • Express, same-day or over-night shipping and courier costs
  • Financial assistance for travel, transport or parking to attend a PSP or Amputee Clinic, or for PSPs to visit an applicant’s residence, nursing home, corrective service
  • Consumables, repairs, maintenance, socket and/or component replacements for limb types not funded by QALS (e.g. Interim, secondary, spare or emergency, cosmetic, occupational or recreational limbs)
  • medical procedures/surgeries or medical consumables relating to amputation or osseointegration
  • Education and further training. This is to be conducted through a hospital service.

Last updated: 31 October 2023