![](http://www.acts.co.za/resources/images/filetype_pdf.png)
R 385
Compensation for Occupational Injuries and Diseases Act, 1993 (Act No. 130 of 1993)Scale of FeesAnnual Increase in Medical Tariffs for Medical Service Providers - 2023Speech, Audio and Acousticians Gazette 2023Speech Therapy (82), Audiology (82) and Acousticians (83) Tariff of Fees as from 1 April 2023Speech Therapy and Audiology |
SPEECH THERAPY (82), AUDIOLOGY (82) AND ACOUSTICIANS (83) TARIFF OF FEES AS FROM 01 APRIL 2023 |
|
SPEECH THERAPY AND AUDIOLOGY |
|
Rule |
Rule Description |
001 |
Pre-Authorisation are required for all Hearing Aid services |
002 |
A request for hearing aids must be accompanied by a referral letter from the treating medical practitioner. The referral letter must clearly indicate reasons and the relationship to the original injury or disease. |
003 |
Motivation from the treating medical practitioner will be required for renewal of hearing aids outside of warranty. Hearing aids still within the manufacturers warranty should be replaced or repaired at no cost to the patient or the Compensation Fund |
004 |
Referral by the principal doctor with a copy of the referral letter for speech therapy services is required. |
005 |
Newly hospitalised patients will be allowed up 10 sessions without pre-authorisation. If further treatment is necessary after a series of 10 treatment sessions for the same condition, the treating medical practitioner must submit a motivation with treatment plan to the Compensation Fund for considering further authorisation. No pre-authorisation is required for critically ill patients in ICU and High Care Units. |
006 |
Unless timely steps are taken (at least two hours) to cancel an appointment for a consultation the relevant consultation fee shall be payable by the employee. |
007 |
It is recommended that, when such benefits are granted, drugs, consumables and disposable items used during a procedure or issued to a patient on discharge will only be reimbursed by the FUND if the appropriate code is supplied on the medical invoice. |
Code |
Description |
|
1. |
Speech Therapy Consultations, Assessment and Treatment |
|
1020 |
Speech therapy consultation. Duration 5 - 15 mins |
133.40 |
1021 |
Speech therapy consultation. Duration 16 - 30 mins |
300.30 |
1022 |
Speech therapy consultation. Duration 31 - 45 mins |
499.90 |
|
||
1.2 |
Assessment & Treatment |
|
1.2.1 |
Speech Therapy Assessment & Treatment |
|
1050 |
Speech therapy assessment and treatment. Duration 5 - 15 mins |
133.40 |
1051 |
Speech therapy assessment and treatment. Duration 16 - 30 mins |
300.30 |
1052 |
Speech therapy assessment and treatment. Duration 31 - 45 mins |
499.90 |
2. |
Speech, Voice and Language Disorder |
|
0007 |
Group therapy: per patient at rooms (Maximum of 3 patients per therapy per day). Limit of two sessions and thereafter a motivation letter is required. Note: Professional Group Consultations - no fee to be charged. |
195.62 |
0009 |
Preparation of a home programme tariff code can be used once per life-time. Note: This category is to prepare the home programme prior to consultation with patient or care giver. |
195.62 |
|
||
3. |
Audiology |
|
3.1 |
Audiology Assessment, Consultation & Treatment |
|
Audiology consultation. Duration 16 - 30 mins |
295.40 |
|
Audiology consultation. Duration 31 - 45 mins |
492.70 |
|
Audiology consultation. Duration 46 - 60 mins |
689.90 |
|
3.2 |
Audiology Evaluations |
|
A. |
Peripheral Hearing Evaluation |
|
1100 |
Pure Tone Audiogram (Air conduction) (3273- Pure tone audiometry (air conduction)- Doctor's file) tariff code 3273 cannot be used with code 1110 |
222.30 |
1105 |
Pure Tone Audiogram (Bone conduction) (3274 -Pure tone audiometry (bone conduction with masking) Doctor's file) tariff code cannot be used with code 1110 |
177.84 |
1110 |
Full Speech Audiogram including speech reception threshold and discrimination at two or more levels. (3277 - Speech audiometry: Item includes speech audiogram, speech reception threshold, discrimination score Doctor's file) tariff code cannot be used with code 1100 and 1105 |
222.30 |
B. |
Middle Ear Function Evaluation |
|
1200 |
lmmittance Measurements (Impedance / Tympanometry) tariff code cannot be used with code 1205 and 1210 |
118.56 |
1205 |
Immittance Measurements -Impedance / Stapedial reflex (3276- Impedance audiometry (stapedial reflex) - no code for volume, compliance etc.- Doctor's file): Limited reflex spectrum (e.g.: 1-2 frequencies) tariff code cannot be used with code 1200 and 1210 |
59.28 |
1210 |
lmmittance Measurements - Impedance / Stapedial reflex (3276 -Impedance audiometry (stapedial reflex) - no code for volume, compliance etc.- Doctor's file): Extended reflex spectrum (250-8000Hz e.g. 4-8 frequencies) tariff code cannot be used with code 1200 and 1205 |
177.84 |
1220 |
Eustachian Tube Function Test - multiple tympanograms - bilateral tariff code can only be used once during a consultation or visit |
177.84 |
1225 |
Rinné & Weber tests |
59.28 |
C. |
Diagnostic Audiological Tests for Differential Diagnosis between Cochlear; Retro-cochlear; Central; Functional and/or Vestibular Pathology |
|
1300 |
Tone Decay (for retro cochlear pathology) tariff code can only be used for head trauma related to COIDA Motivation letter required |
118.56 |
1305 |
Reflex decay (for retro cochlear pathology) tariff code can only be used for head trauma related to COIDA Motivation letter required |
118.56 |
1310 |
SISI (for cochlear pathology) tariff code can on y be used for head trauma related to COIDA |
74.10 |
1315 |
Air conduction MCL (Most comfortable levels) & UCL (Uncomfortable levels) - for cochlear pathology and/or for purposes of selection of hearing aid technology or hearing aid programming tariff code can onlv be used for head trauma related to COIDA |
118.56 |
1320 |
Speech conduction MCL & UCL (for cochlear pathology) tariff code can only be used for head trauma related to COIDA |
59.28 |
D. |
Electro-Physiological Examinations/Auditory Evoked Potentials (AEP) |
|
1515 |
Diagnostic Audiological Click ABR (Auditory Brainstem Evoked Response) - Bilateral Air conduction threshold determination using click stimuli |
958.57 |
1520 |
Diagnostic Audiological Click ABR-(Auditory Brainstem Response) - Bilateral Bone conduction threshold determination using click stimuli |
1278.06 |
1534 |
Diagnostic Audiological Tone Burst ABR (Auditory Brainstem Response) - Bilateral Frequency specific threshold determination using tone-burst stimuli at : 4 frequencies |
1917.34 |
1581 |
OAE (Oto-acoustic emissions) - comprehensive diagnostic evaluation |
443.14 |
E. |
Balance/Vestibular Examinations and Treatment |
|
1600 |
Spontaneous and positional nystagmus using electro-nystagmography (ENG) (3253). Cannot use with tariff code 1605. |
878.90 |
1605 |
Spontaneous and positional nystagmus using Video-nystagmography (VNG). Cannot use with tariff code 1600. |
924.98 |
1610 |
Eye Visualization - spontaneous and positional nystagmus - monocular |
497.85 |
1615 |
Eye Visualization - spontaneous and positional nystagmus - binocular |
517.40 |
4. |
Material |
|
0300 |
Medication |
- |
0301 |
Material |
- |
F. |
Hearing Amplification / Hearing Aids |
|
Rules |
|
|
Product warranties should be honoured by the supplier |
||
Only out of warranty costs may be considered for funding |
||
Prices excludes professional fee for evaluation, measuring, fitting and adjusting & follow ups |
||
Each description includes the necessary accessories and hardware to make the prescribed hearing aid/accessory/replacement/repair functional as intended by the products IFU (Instruction For Use) |
||
Accessories to new hearing aids should be motivated and clinically relevant |
||
Patients are eligible for new hearing aids every 5 years. Taking the following into account: The quality of the hearing aid, how well it's maintained and wear and tear |
||
Product must be obtained, maintained and serviced in the country at an affordable cost. |
||
A limit of two (2) applies in instances were both ears (Bilateral) require hearing aid devices |
||
Criteria for Hearing Aids |
||
Baseline hearing test of employee (i.e.baseline test should been done within 30 days of employment and on employees who are going to work in a noise zone for the first time or on employees working in a newly identified noise zone) |
||
A full assessment / evaluation from medical professional i.e. ENT surgeon, Audiologist. |
||
Hearing Tests: Weber Hearing test or Audiogram hearing test or Rinné hearing test or Tympanometry test or Otoacoustic Emissions Hearing loss test and or Auditory brainstem Response Hearing loss test. |
||
More than 40 decibels is considered to be a hearing impairment for hearing aids. |
||
Less than 40 decibels needs to be motivated |
||
Confirmation of hearing loss being work related from medical professional |
||
|
||
Code |
Code Description |
Rand |
1800 |
Hearing aid evaluation - per ear |
213.75 |
1805 |
Free Field Hearing Aid Evaluation : Pure tone and speech (with and without lipreading) item cannot be used with code 1100, 1105 and 1110 |
185.25 |
1810 |
Insertion gain measurement, per ear |
142.50 |
1815 |
Re-programming of hearing aid, per ear |
142.50 |
1820 |
Technical adjustment of hearing aid/device, per ear. |
85.50 |
1824 |
Hearing Aid Batteries (4) |
261.55 |
1825 |
Repairs to hearing aids. |
0.00 |
1830 |
Global charge for supply and fitting of hearing aid and follow-up Refer to Rule 001 No other tariff code can be billed with tariff code 1830 |
0.00 |
1831 |
Basic hearing aid limit |
14834.00 |
1832 |
Standard hearing aid limit |
15134.15 |
1833 |
Intermediate hearing aid limit |
21189.37 |
1834 |
Essential hearing aid limit |
17282.20 |
1835 |
Advanced hearing aid limit |
31771.05 |