Victorian paramedics are getting a massive pay rise after Labor accepted Fair Work Commission recommendations.

Victorian paramedics will be the highest paid in Australia after winning pay hikes of up to $18,000 because their work has become more demanding.

The state government has accepted a Fair Work Commission recommendation that will boost paramedic pay packets by between 12 and 28 per cent depending on their role or experience.

The referral to the commission was part of an agreement struck between Premier Daniel Andrews' government and the paramedics union after Labor's 2014 election win.

Ambulance Services Minister Jill Hennessy says the deal, which is expected to cost taxpayers close to $54 million, fairly remunerates paramedics.

"Their pay has been adjusted to recognise the work they do," she told reporters on Wednesday.

The opposition called it a "sweetheart deal" between the state government and the union movement.

Under the agreement, paramedic's pay rises from July 1, 2015 - so they will get nine months' back pay.

Additional pay increases will come on July 1, 2016 and December 1, 2016.

Shadow health minister Mary Wooldridge said this was in addition to a 12 per cent rise signed off in 2015 - effectively giving some paramedics a 40 per cent pay increase since the Andrews government came into power.

The commission made its recommendations after finding that paramedics' jobs have become more demanding over the past decade as they are required to administer new drugs and carry out complex procedures.

That includes sedating mental health patients and drug users, administering blood and performing minor surgery to insert chest tubes - procedures once only performed by doctors in a hospital setting.

Victorian Ambulance Union spokesman Steve McGhee said Victorian paramedics would now be the highest paid in Australia.

Examples of pay rises in the first hike:
* A first-year graduate paramedic annual base rate of about $51,000 rises to about $58,000
* An experienced mobile intensive care paramedic's wage increases from about $69,000 to about $87,000

Changes to paramedic work:
* Paramedics will be required to have a bachelor's degree where a diploma level qualification was previously required
* Additional responsibility with mental health patients
* Administration of complex new drugs and procedures that were previously only performed in hospital.