What Treatment Does ACC Cover?
Once your ACC claim is accepted, ACC covers the cost of treatment that is necessary and appropriate for your covered injury. This includes a wide range of medical services.
GP Visits
If you have an accepted ACC claim, the cost of GP visits related to that injury is covered by ACC. You should tell the receptionist the visit is an ACC visit — your GP is not allowed to charge you for the consultation or treatment for the covered ACC injury.
Physiotherapy and Chiropractic
ACC funds up to a certain number of physiotherapy or chiropractic sessions for acute injuries. Typically, ACC will fund the first few visits without needing prior approval (under the "Treatment Profile" system). Your physio or chiropractor can lodge the claim directly.
- For many acute injuries (e.g., sprains, strains): up to 6 sessions funded without prior approval.
- Beyond that: your practitioner needs to request approval from ACC for further sessions.
Surgery and Hospital Treatment
If you need surgery for your covered injury, ACC covers the full cost — including surgeon fees, anaesthetist fees, hospital stay, and follow-up care. This applies to both public and private hospitals (subject to ACC's approval).
ACC has an Elective Surgery programme: if you need surgery and would otherwise wait in the public system, ACC may fund it in a private hospital to reduce wait times.
Specialist Consultations
If your GP refers you to a specialist (e.g., orthopaedic surgeon, neurologist, pain specialist), ACC covers the cost of the consultation if it relates to your covered injury. The specialist needs to be registered with ACC to claim directly.
Diagnostic Tests
ACC covers the cost of diagnostic imaging and tests related to your injury, including X-rays, CT scans, MRI scans, and blood tests, when deemed clinically necessary.
Prescription Medications
Prescriptions related to your ACC injury are covered at the standard New Zealand prescription charge ($5 per item as of 2025). In some cases, if a medication is not fully funded by Pharmac, ACC may cover the full cost if it is necessary for your injury.
What is NOT Covered?
ACC covers treatment directly related to the covered injury only. It does not cover:
- Treatment for unrelated medical conditions
- Preventive care
- Treatment that is not deemed "necessary and appropriate" for the injury
- Experimental or unproven treatments (without specific approval)