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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 - 2021Private Hospital Gazette 2021Private Hospitals (57/58), Psychiatric and Private Rehabilitation Hospitals (55/59)Scale of Fees with effect from 1 April 2021 |
COMPENSATION FUND
SCALE OF FEES FOR PRIVATE HOSPITALS (57/58) (PER DIEM TARIFF)
WITH EFFECT FROM 1 APRIL 2021
SCALE OF FEES FOR PSYCHIATRIC AND PRIVATE REHABILITATION HOSPITALS (55/59) (PER DIEM TARIFF)
WITH EFFECT FROM 1 APRIL 2021
ACCOMMODATION
The day admission fee shall be charged in respect of all patients admitted as day patients and discharged before 23:00 on the same date.
Ward fees shall be charged at the full day rate if admission takes place before 12:00 and at the half daily rate if admission takes place after 12:00. At discharge, ward fees shall be charged at half the daily rate if the discharge takes place before 12:00 and the full daily rate if the discharge takes place after 12:00.
Ward fees are inclusive of all pharmaceuticals and equipment that are provided in the accommodation, theatre, emergency room and procedure rooms.
Note: Fees include VAT
DESCRIPTION |
PRACTICE CODE 57/58 |
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1.1 |
General Wards |
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H001 |
Surgical cases: per day |
3824.04 |
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H002 |
Thoracic and neurosurgical cases (including laminectomies and spinal fusion): per day |
3824.04 |
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H004 |
Medical and neurological cases: per day |
3824.04 |
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H007 |
Day admission which includes all patients discharged by 23:00 on date of admission |
1636.65 |
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PRACTICE CODE 55 |
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H008 |
General Ward for Psychiatric Hospitals (Inclusive fee: Ward fee, Pharmaceuticals, Occupational Therapy) |
2979.11 |
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SCALE OF FEES FOR ACUTE AND SUB-ACUTE REHABILITATION (49) (PER DIEM TARIFF)
General Rules for Rehabilitation Hospitals
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1.2 |
General ward for Rehabilitation Hospitals |
PRACTICE CODE 59 |
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H010 |
General Rehabilitation ward (Inclusive fee: ward fee, general rehabilitation management (Physiotherapy, Doctors, Nursing, Occupational Therapy) |
6388.22 |
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H020 |
General ward for Sub-Acute Rehabilitation Hospitals Sub-Acute Rehabilitation ward (Daily) Professionals are charged separately i.e. Physiotherapy, Rehabilitation Doctors, Nursing, Occupational Therapy, speech Therapist, Clinical Psychologist, social workers)
SCALE OF FEES FOR FRAIL CARE/PALLIATIVE/HOSPICE (79) (PER DIEM TARIFF)
General Rules for Frail care/Hospice
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49 3824.04 |
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H030 |
General ward for Frail care/Hospice Hospitals Frail care/Hospice ward (Daily) (Inclusive fee: ward fee, general care management (Doctors, Nursing staff))
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79 2 109.40 |
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DESCRIPTION |
PRACTICE CODE 57/58 |
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1.3 |
Special Care Units
Hospitals shall obtain a doctor's report stating the reason for accommodation in an intensive care unit or a high care ward from the attending medical practitioner, and such report including the date and time of admission and discharge from the unit shall be forwarded to the Commissioner together with the account. Pre-drafted and standard certificates of authorisation will not be acceptable. |
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H201 |
Intensive Care Unit: per day |
25633.26 |
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H215 |
High Care Ward: per day |
13227.95 |
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2. |
Theatres and Emergency Unit |
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2.1 |
Theatre and Emergency fees are inclusive of all consumables and equipment. The after hours fee are included in the normal theatre fee. |
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Emergency fee Rule: Emergency fee - excluding follow-up visits. |
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H301 |
For all emergencies including those requiring basic nursing input, e.g. BP measurement, urine testing, application of simple bandages, administration of injections. |
917.94 |
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H302 |
For all emergencies which require the use of a procedure room, e.g. for application of plaster, stitching of wounds. |
1862.31 |
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H303 |
Follow-up visits: |
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The Compensation Fund will imburse hospitals for all materials used during follow-up visits. No consultation or facility fee is chargeable. The account is to be billed as for fee for service. |
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H105 |
Resuscitation fee charged only if patient has been resuscitated and intubated in a trauma unit which has been approved by the Board of Healthcare Funders. |
7287.56 |
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2.2 |
Minor Theatre Fee |
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A facility where simple procedures which require limited instrumentation and drapery, minimum nursing input and local anaesthetic procedures are carried out. No sophisticated monitoring is required but resuscitation equipment must be available. |
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DESCRIPTION |
PRACTICE CODE 57/58 |
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The exact time of admission to and discharge from the minor theatre shall be stated, upon which the minor theatre charge shall be calculated as follows: |
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H071 |
Charge per minute |
110.59 |
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2.3 |
Major Theatre |
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The exact time of admission to and discharge from the theatre shall be |
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H081 |
Charge per minute |
327.26 |
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5.9 |
Prosthesis
Prosthesis Pricing:
Note: A ceiling price of R1496.93 per prosthesis is included in the theatre tariff. The combined value of all the components including cement in excess of R1496.93 should be charged separately.
A prosthesis is a fabricated or artificial substitute for a diseased or missing part of the body, surgically implanted, and shall be deemed to include all components such as pins, rods, screws, plates or similar items, forming an integral part of the device so implanted, and shall be charged as a single unit.
Reimbursement will be at the lowest available manufacturer's price (inclusive of VAT).
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H286 |
Internal Fixators (surgically implanted)
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Reimbursement will be at the lowest available manufacturer's price inclusive of VAT.
Hospitals/unattached operating theatre units shall show the name and reference number of each item. The suppliers' invoices, each containing the manufacturer's name, should be attached to the account and the components specified on the account should appear on the invoice.
External Fixators
Reimbursement will be at 33% of the lowest available manufacturer's price inclusive of VAT.
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DESCRIPTION |
PRACTICE CODE 57/58 |
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Hospitals/unattached operating theatre units shall show the name and reference number of each item. The suppliers' invoices, each containing the manufacturer's name, should be attached to the account and the components specified on the account should appear on the invoice. |
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5.10 |
Medical artificial items (non-prosthesis) |
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H287 |
Examples of items included hereunder shall be artificial limbs, wheelchairs, crutches and excretion bags. Copies of invoices shall be supplied to the Commissioner. Reimbursement will be at the lowest available manufacturer's price inclusive of VAT.
Further Non-Prosthetic Medical Artificial items: Sheepskins Abdominal Binders Orthopaedic Braces (ankle, knee, wrist, arm) Anti-Embolism Stockings Futuro Supports Corsets Crutches Clavicle Braces Toilet Seat Raisers Walking Aids Walking Sticks Back Supports Elbow/Hand Cradles |
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5.11 |
Serious Burns Billed at normal fee for service. The following items are applicable and must be accompanied by a written motivation from the treating doctor.
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H289 |
Serious Burns: Fee for service (Inclusive of all services e.g. accommodation, theatre, etc.) except medication whilst hospitalised. |
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H290 |
Serious Burns: Item for medication used during hospitalisation excluding the TTO's. Note : TTO's should be charged according to item H288 |
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5.12 |
TTO |
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H288 |
TTO scripts will be reimbursed by the Commissioner for a period of two (2) weeks. A script that covers a period of more than two (2) weeks must have a doctor's motivation attached. |
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