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128
G12-101696—A 35684—1 AIDS HELPLINE: 0800-0123-22 Prevention is the cure Government Gazette Staatskoerant REPUBLIC OF SOUTH AFRICA REPUBLIEK VAN SUID-AFRIKA Vol. 567 Pretoria, 14 September 2012 No. 35684 N.B. The Government Printing Works will not be held responsible for the quality of “Hard Copies” or “Electronic Files” submitted for publication purposes

Transcript of 35684_14-9_HealthBoard_Layout 1 - SAFLII

G12-101696—A 35684—1

AIDS HELPLINE: 0800-0123-22 Prevention is the cure

Government GazetteStaatskoerant

REPUBLIC OF SOUTH AFRICA

REPUBLIEK VAN SUID-AFRIKA

Vol. 567 Pretoria, 14 September 2012 No. 35684

N.B. The Government Printing Works willnot be held responsible for the quality of“Hard Copies” or “Electronic Files”submitted for publication purposes

2 No. 35684 GOVERNMENT GAZETTE, 14 SEPTEMBER 2012

IMPORTANT NOTICE

The Government Printing Works will not be held responsible for faxed documents not received dueto errors on the fax machine or faxes received which are unclear or incomplete. Please be advisedthat an “OK” slip, received from a fax machine, will not be accepted as proof that documents werereceived by the GPW for printing. If documents are faxed to the GPW it will be the sender’s respon-sibility to phone and confirm that the documents were received in good order.

Furthermore the Government Printing Works will also not be held responsible for cancellations andamendments which have not been done on original documents received from clients.

CONTENTS • INHOUD

BOARD NOTICE

152 Health Professions Act (56/1974): Proposed guideline tariffs for Medical Practitioners and Dentists .......................... 3 35684

GazetteNo.

PageNo.No.

MEDICAL AND DENTAL PROFESSIONS BOARD

HEALTH PROFESSIONS ACT, 1974 (ACT NO.56 OF 1974)

PROPOSED GUIDELINE TARIFFS FOR MEDICAL PRACTITIONERS AND DENTISTS

The Medical and Dental Professions Board intends, under section 53 (3) (d) of the

Health Professions Act, 1974 (Act No. 56 of 1974), to determine and publish a fee

("Guideline Tariffs") to be used as a norm in the adjudication of complaints of

overcharging.

Interested persons are invited to submit any substantiated comments or

representations in writing on the proposed Guideline Tariffs to the Registrar, Health

Professions Council of South Africa (for the attention of the General Manager:

Professional Boards) on or before 16h00 of the 19th of October 2012 by:-

(a) posting them to P 0 Box 205, Pretoria, 0001;

(b) delivering them by hand at 553 Madiba Street (previously Vermeulen Street),

Arcadia, Pretoria, 0002; or

(c) e-mailing them to [email protected].

Benefits of the guideline tariffs

To guide the professions and protect the public.

STAATSKOERANT, 14 SEPTEMBER 2012 No. 35684 3

BOARD NOTICE

BOARD NOTICE 152 OF 2012

Minimising complaints of 'overcharging' and fair determination of these

complaints.

The impact of the Guideline tariffs for registered practitioners

Permit practitioners to set individual fee schedules.

Keep record of written informed consent given by patients.

The impact of the Guideline tariffs for members of the public

Patients will be billed only in accordance with the written informed consent

they have given to a practitioner for services received in the event that the

fee charged is more than the Guideline tariff.

Patients must familiarise themselves with the benefits their medical aid

scheme cover for services received from practitioners.

SCHEDULE

Definitions

1. In this notice, "the Act" means the Health Professions Act, 1974 (Act No. 56

of 1974) and any word or phrase to which a meaning has been assigned in

the Notice shall have that meaning, unless the context otherwise indicates;

"Board" means Medical and Dental Professions Board as established in

terms of section 15 of the Act.

MJAMBA-MATSHOBA

REGISTRAR

DATE: 7 I 3`1-",-1:;)(`7.,./

4 No. 35684 GOVERNMENT GAZETTE, 14 SEPTEMBER 2012

GU

IDE

LIN

E T

AR

IFF

S F

OR

SE

RV

ICE

S B

Y M

ED

ICA

L P

RA

CT

ITIO

NE

RS

1000

011

400

1100

0

Pub

lishe

d in

term

s of

Sec

tion

53 (

3) (

d) o

f the

HE

ALT

H P

RO

FE

SS

ION

S A

CT

(56

OF

197

4)

Not

e th

at th

is s

ched

ule

is b

ased

on

the

2006

NH

RP

L w

hich

was

infla

ted

by 4

6.66

%.

Ver

sion

Add

CF

Uni

ts B

FV

alue

Fla

g C

FU

nits

BF

Val

ue F

lag

CF

Uni

ts B

FV

alue

Fla

gT

he 2

006

NH

RP

L is

ava

ilabl

e in

dat

abas

e fo

rmat

at h

ttp://

ww

w.h

pcsa

.co.

za

In te

rms

of s

ectio

n 53

(1)

of th

e H

ealth

Pro

fess

ions

Act

, 197

4 (A

ct N

o. 5

6 of

197

4) e

very

per

son

regi

ster

ed u

nder

the

Act

(in

this

sec

tion

refe

rred

to a

s th

epr

actit

ione

r) s

hall,

unl

ess

the

circ

umst

ance

s re

nder

it im

poss

ible

for

him

or

her

to d

o so

, bef

ore

rend

erin

g an

y pr

ofes

sion

al s

ervi

ces

info

rm th

e pe

rson

to w

hom

the

serv

ices

are

to b

e re

nder

ed o

r an

y pe

rson

res

pons

ible

for

the

mai

nten

ance

of s

uch

pers

on, o

f the

fee

whi

ch h

e or

she

inte

nds

to c

harg

e fo

rsu

ch s

ervi

ces

-

(a)

whe

n so

req

uest

ed b

y th

e pe

rson

con

cern

ed; o

r

(b)

whe

n su

ch fe

e ex

ceed

s th

e G

uide

line

Tar

iffs

for

such

ser

vice

s,

and

shal

l in

a ca

se to

whi

ch p

arag

raph

(b)

rel

ates

, als

o in

form

the

pers

on c

once

rned

of t

he u

sual

fee.

Eve

ry p

erso

n re

gist

ered

und

er th

e A

ct s

hall,

unl

ess

the

circ

umst

ance

s re

nder

it im

poss

ible

for

him

or

her

to d

o so

, bef

ore

rend

erin

g an

y pr

ofes

sion

alse

rvic

es a

lso

info

rm th

e pe

rson

to w

hom

the

serv

ices

are

to b

e re

nder

ed o

r an

y pe

rson

res

pons

ible

for

the

mai

nten

ance

of s

uch

pers

on, o

f the

fee

whi

ch h

e or

she

inte

nds

to c

harg

e fo

r su

ch s

ervi

ces

if su

ch fe

e ex

ceed

s th

e m

edic

al a

id r

ates

.

RU

LES

GO

VE

RN

ING

TH

E S

TR

UC

TU

RE

A.

Con

sulta

tions

: Def

initi

ons:

(a)

New

and

est

ablis

hed

patie

nts:

A c

onsu

ltatio

n/vi

sit r

efer

s to

a20

04.0

0cl

inic

al s

ituat

ion

whe

re a

med

ical

pra

ctiti

oner

per

sona

lly o

btai

ns a

pat

ient

's m

edic

al h

isto

ry,

perf

orm

s an

app

ropr

iate

clin

ical

exa

min

atio

n an

d, if

indi

cate

d, a

dmin

iste

rs tr

eatm

ent,

pres

crib

esor

ass

ists

with

adv

ice.

The

se s

ervi

ces

mus

t be

face

-to-

face

with

the

patie

nt a

nd e

xclu

des

the

time

spen

t doi

ng s

peci

al in

vest

igat

ions

whi

ch r

ecei

ve a

dditi

onal

rem

uner

atio

n. (

b) S

ubse

quen

tvi

sits

: Ref

ers

to a

vol

unta

rily

sche

dule

d vi

sit p

erfo

rmed

with

in fo

ur (

4) m

onth

s af

ter

the

first

vis

it. It

may

impl

y ta

king

dow

n a

med

ical

his

tory

and

/or

a cl

inic

al e

xam

inat

ion

and/

or p

resc

ribin

g or

adm

inis

terin

g of

trea

tmen

t and

/or

coun

selin

g. (

c) H

ospi

tal v

isits

: Whe

re a

pro

cedu

re o

rop

erat

ion

was

don

e, h

ospi

tal v

isits

are

reg

arde

d as

par

t of t

he n

orm

al a

fter-

care

and

no

fees

may

be le

vied

(un

less

oth

erw

ise

indi

cate

d). W

here

no

proc

edur

e or

ope

ratio

n w

as c

arrie

d ou

t, fe

esm

ay b

e ch

arge

d fo

r ho

spita

l vis

its a

ccor

ding

to th

e ap

prop

riate

hos

pita

l or

inpa

tient

follo

w-u

p vi

sit

code

.

B.

Nor

mal

hou

rs a

nd a

fter

hour

s: A

fter-

hour

s se

rvic

es a

re p

aid

at th

e sa

me

rate

as

bene

fits

for

2006

.04

norm

al h

ours

ser

vice

s. B

ona

fide

emer

genc

y m

edic

al s

ervi

ces

rend

ered

to a

pat

ient

, at a

ny ti

me,

may

attr

act a

fee

as s

peci

fied

in m

odifi

er 0

011

and

item

s 01

46 o

r 01

47 (

whi

ch s

houl

d be

add

ed to

the

appr

opria

te c

onsu

ltativ

e se

rvic

es c

ode

sele

cted

from

item

s 01

90-0

192,

017

3-01

75, 0

161-

0164

, 016

6-01

69)

C.

Com

para

ble

serv

ices

: A s

ervi

ce m

ay b

e re

nder

ed th

at is

not

list

ed in

this

edi

tion

of th

e co

ding

2005

.02

stru

ctur

e. T

he fe

e th

at m

ay b

e ch

arge

d in

res

pect

of t

he r

ende

ring

of a

ser

vice

not

list

ed in

this

codi

ng s

truc

ture

sha

ll be

bas

ed o

n th

e fe

e in

res

pect

of a

com

para

ble

serv

ice.

For

thes

epr

oced

ure(

s)/s

ervi

ce(s

), it

em 6

999:

Unl

iste

d pr

oced

ure

or s

ervi

ce c

ode,

sho

uld

be u

sed.

Ple

ase

cont

act t

he S

A M

edic

al A

ssoc

iatio

n (S

AM

A)

Priv

ate

Pra

ctic

e U

nit v

ia e

-mai

l on

codi

ng@

sam

edic

al.o

rg to

obt

ain

a co

mpa

rabl

e co

de fo

r th

e un

liste

d pr

oced

ure/

serv

ice

whi

ch w

illbe

bas

ed o

n th

e fe

e fo

r a

com

para

ble

serv

ice

in th

e co

ding

str

uctu

re. W

hen

item

699

9 is

use

d to

indi

cate

that

an

unlis

ted

serv

ice

was

ren

dere

d, th

e us

e of

the

item

mus

t be

supp

orte

d by

a s

peci

alre

port

. Thi

s re

port

mus

t inc

lude

: (1)

An

adeq

uate

def

initi

on o

r de

scrip

tion

of th

e na

ture

, ext

ent a

ndne

ed fo

r th

e pr

oced

ure/

serv

ice

or "

med

ical

nec

essi

br; (

2) In

whi

ch r

espe

ct is

this

ser

vice

unu

sual

or d

iffer

ent i

n te

chni

que,

com

pare

d to

ava

ilabl

e pr

oced

ures

/ser

vice

s lis

ted

in th

e co

ding

stru

ctur

e? In

form

atio

n re

gard

ing

the

natu

re a

nd e

xten

t of t

he p

roce

dure

/ser

vice

, tim

e an

d ef

fort

,sp

ecia

l/ded

icat

ed e

quip

men

t nee

ded

to p

rovi

de th

is s

ervi

ce, m

ust b

e in

clud

ed in

the

repo

rt; (

3) Is

Pag

e 1

of 8

7

STAATSKOERANT, 14 SEPTEMBER 2012 No. 35684 5

D.

Can

cella

tion

of a

ppoi

ntm

ents

: Unl

ess

timel

y st

eps

are

take

n to

can

cel a

n ap

poin

tmen

t for

a20

04.0

0

cons

ulta

tion,

the

rele

vant

con

sulta

tion

fee

may

be

char

ged.

In th

e ca

se o

f a g

ener

al p

ract

ition

er"t

imel

y" s

hall

mea

n tw

o ho

urs

and

in th

e ca

se o

f a s

peci

alis

t 24

hour

s pr

ior

to th

e ap

poin

tmen

t.E

ach

case

sha

ll, h

owev

er, b

e co

nsid

ered

on

mer

it an

d, if

circ

umst

ance

s w

arra

nt, n

o fe

e sh

all b

ech

arge

d. If

a p

atie

nt h

as n

ot tu

rned

up

for

a pr

oced

ure,

eac

h m

embe

r of

the

surg

ical

team

isen

title

d to

cha

rge

for

a vi

sit a

t or

away

from

doc

tor's

roo

ms

as th

e ca

se m

ay b

e

E.

Pre

-ope

rativ

e vi

sits

: The

app

ropr

iate

fee

may

be

char

ged

for

all p

re-o

pera

tive

visi

ts w

ith th

e20

04.0

0

exce

ptio

n of

a r

outin

e pr

e-op

erat

ive

visi

t at t

he h

ospi

tal

F.

Adm

inis

terin

g of

inje

ctio

ns a

nd/o

r in

fusi

ons:

Whe

re a

pplic

able

, fee

s fo

r ad

min

iste

ring

inje

ctio

ns20

04.0

0an

d/or

infu

sion

s m

ay o

nly

be c

harg

ed w

hen

done

by

the

prac

titio

ner

him

self

G.

Pos

t-op

erat

ive

care

: (a)

Unl

ess

othe

rwis

e st

ated

, the

fee

in r

espe

ct o

f an

oper

atio

n or

pro

cedu

re 2

004.

00sh

all i

nclu

de n

orm

al a

fter-

care

for

a pe

riod

not e

xcee

ding

ON

E m

onth

(af

ter-

care

is e

xclu

ded

from

pur

e di

agno

stic

pro

cedu

res

durin

g w

hich

no

ther

apeu

tic p

roce

dure

s w

ere

perf

orm

ed).

(b)

Ifth

e no

rmal

afte

r-ca

re is

del

egat

ed to

any

oth

er r

egis

tere

d he

alth

pro

fess

iona

l and

not

com

plet

edby

the

surg

eon,

it s

hall

be h

is/h

er o

wn

resp

onsi

bilit

y to

arr

ange

for

this

to b

e do

ne w

ithou

t ext

rach

arge

. (c)

Whe

n po

st-o

pera

tive

care

/trea

tmen

t of a

pro

long

ed o

r sp

ecia

lised

nat

ure

is r

equi

red,

such

fee

as m

ay b

e ag

reed

upo

n be

twee

n th

e su

rgeo

n an

d th

e sc

hem

e or

the

patie

nt (

in c

ase

of a

priv

ate

acco

unt)

may

be

char

ged.

(d)

Nor

mal

afte

r-ca

re r

efer

s to

an

unco

mpl

icat

ed p

ost-

oper

ativ

e pe

riod

not r

equi

ring

any

furt

her

inci

sion

s

H.

Rem

oval

of l

esio

ns: I

tem

s in

volv

ing

rem

oval

of l

esio

ns in

clud

e fo

llow

-up

trea

tmen

t for

10

days

2004

.00

J.D

ispr

opor

tiona

tely

low

fees

,In

exc

eptio

nal c

ases

whe

re th

e fe

e is

dis

prop

ortio

nate

ly lo

w in

2004

.00

rela

tion

to th

e ac

tual

ser

vice

s re

nder

ed b

y a

med

ical

pra

ctiti

oner

, a h

ighe

r fe

e m

ay b

e ne

gotia

ted.

The

use

of t

his

rule

is n

ot in

tend

ed m

erel

y to

incr

ease

the

Med

ical

Sch

emes

Ben

efits

.

KP

ract

ice

of s

peci

alis

ts:

In te

rms

of th

e co

nditi

ons

in r

espe

ct o

f the

pra

ctic

e of

spe

cial

ists

as

2004

.00

publ

ishe

d in

Gov

ernm

ent G

azet

te N

o. 1

2958

of 1

1 Ja

nuar

y 19

91, a

spe

cial

ist m

ay tr

eat a

nype

rson

who

com

es to

him

dire

ct fo

r co

nsul

tatio

n. A

spe

cial

ist w

ho is

con

sulte

d by

a p

atie

nt o

rw

ho tr

eats

a p

atie

nt, s

hall

take

all

reas

onab

le s

teps

to e

nsur

e th

e co

llabo

ratio

n of

the

patie

nt's

gene

ral p

ract

ition

er. M

edic

al p

ract

ition

ers

refe

rrin

g ca

ses

to o

ther

med

ical

pra

ctiti

oner

s sh

all

indi

cate

in th

e re

fere

nce

whe

ther

the

patie

nt is

a m

embe

r of

a m

edic

al s

chem

e or

a d

epen

dant

of

such

mem

ber.

Thi

s al

so a

pplie

s in

res

pect

of s

peci

men

s se

nt to

pat

holo

gist

s

L.P

roce

dure

s pe

rfor

med

at t

ime

of v

isits

:If

a pr

oced

ure

is p

erfo

rmed

at t

he ti

me

of a

2004

.00

cons

ulta

tion/

visi

t, th

e fe

e fo

r th

e vi

sit P

LUS

the

fee

for

the

proc

edur

e is

cha

rged

M.

Pro

cedu

re p

lann

ed to

be

perf

orm

ed la

ter:

In c

ases

whe

re, d

urin

g a

cons

ulta

tion/

visi

t, a

2004

.00

proc

edur

e is

pla

nned

to b

e pe

rfor

med

at a

late

r oc

casi

on, a

vis

it m

ay n

ot b

e ch

arge

d fo

r ag

ain,

at

such

a la

ter

occa

sion

N.

"Per

con

sulta

tion"

: No

addi

tiona

l fee

may

be

char

ged

for

a se

rvic

e fo

r w

hich

the

fee

is in

dica

ted

2004

.00

as "

per

cons

ulta

tion"

. Suc

h se

rvic

es a

re r

egar

ded

as p

art o

f the

con

sulta

tionN

isit

perf

orm

ed a

tth

e tim

e th

e co

nditi

on is

bro

ught

to th

e do

ctor

s at

tent

ion

0.C

ostly

or

prol

onge

d m

edic

al s

ervi

ces

or p

roce

dure

s: In

the

case

of c

ostly

or

prol

onge

d m

edic

al20

04.0

0se

rvic

es o

r pr

oced

ures

, the

med

ical

pra

ctiti

oner

sha

ll fir

st a

scer

tain

from

the

med

ical

sch

eme

for

wha

t am

ount

the

med

ical

sch

eme

will

acc

ept r

espo

nsib

ility

in r

espe

ct o

f suc

h tr

eatm

ent,

shou

ldth

e pr

actit

ione

r w

ish

any

dire

ct p

aym

ent f

rom

the

sche

me

P.

Tra

velli

ng fe

es: (

a) W

here

, in

case

s of

em

erge

ncy,

a p

ract

ition

er w

as c

alle

d ou

t fro

m h

is20

04.0

0

resi

denc

e or

roo

ms

to a

pat

ient

's h

ome

or th

e ho

spita

l, tr

avel

ling

fees

can

be

char

ged

acco

rdin

gto

the

sect

ion

on tr

avel

ling

expe

nses

(se

ctio

n IV

) if

he h

ad to

trav

el m

ore

than

16

kilo

met

res

into

tal.

(b)

If m

ore

than

one

pat

ient

wou

ld b

e at

tend

ed to

dur

ing

the

cour

se o

f a tr

ip, t

he fu

lltr

avel

ling

expe

nses

mus

t be

divi

ded

betw

een

the

rele

vant

pat

ient

s. (

c) A

pra

ctiti

oner

is n

oten

title

d to

cha

rge

for

any

trav

ellin

g ex

pens

es o

r tr

avel

ling

time

to h

is r

oom

s. (

d) W

here

apr

actit

ione

r's r

esid

ence

wou

ld b

e m

ore

than

8 k

ilom

etre

s aw

ay fr

om a

hos

pita

l, no

trav

ellin

g fe

esm

ay b

e ch

arge

d fo

r se

rvic

es r

ende

red

at s

uch

hosp

itals

, exc

ept i

n ca

ses

of e

mer

genc

y (s

ervi

ces

not v

olun

taril

y sc

hedu

led)

. (e)

Whe

re a

pra

ctiti

oner

con

duct

s an

itin

eran

t pra

ctic

e, h

e is

not

entit

led

to c

harg

e fe

es fo

r tr

avel

ling

expe

nses

exc

ept i

n ca

ses

of e

mer

genc

y (s

ervi

ces

not

volu

ntar

ily s

ched

uled

). (

f) F

or v

olun

taril

y sc

hedu

led

serv

ices

, fee

s fo

r tr

avel

ling

expe

nses

may

only

be

char

ged

whe

re th

e pa

tient

and

the

prac

titio

ner

have

ent

ered

into

an

agre

emen

t to

this

Pag

e 2

of 8

7

6 No. 35684 GOVERNMENT GAZETTE, 14 SEPTEMBER 2012

Q.

Inte

nsiv

e ca

re/H

igh

Car

e: U

nits

in r

espe

ct o

f ite

ms

1204

to 1

210

(Cat

egor

ies

1 to

3)

EX

CLU

DE

2006

.05

the

follo

win

g: (

a) A

naes

thet

ic a

nd/o

r su

rgic

al fe

es fo

r an

y co

nditi

on o

r pr

oced

ure,

as

wel

l as

afir

st c

onsu

ltatio

n/vi

sit,

whi

ch is

. reg

arde

d as

the

asse

ssm

ent o

f the

pat

ient

, whi

le th

e da

ilyin

tens

ive

care

/hig

h ca

re fe

e co

vers

the

daily

car

e in

the

inte

nsiv

e/hi

gh c

are

unit.

(b)

Cos

t of a

nydr

ugs

and/

or m

ater

ials

. (c)

Any

oth

er c

ost w

hich

may

be

incu

rred

bef

ore,

dur

ing

or a

fter

the

cons

ulta

tion/

visi

t and

/or

the

ther

apy.

(d)

Blo

od g

ases

and

che

mis

try

test

s, in

clud

ing

the

arte

rial

punc

ture

to o

btai

n th

e sp

ecim

en. (

e) P

roce

dura

l ite

ms

1202

and

121

2 to

122

1. b

ut IN

CLU

DE

the

follo

win

g: (

f) P

erfo

rmin

g an

d in

terp

reta

tion

of a

res

ting

EC

G. (

g) In

terp

reta

tion

of c

hem

istr

y te

sts

and

x-ra

ys. (

h) In

trav

enou

s tr

eatm

ent (

item

s 02

06 a

nd 0

207)

, exc

ept i

ntra

veno

us in

fusi

on in

patie

nts

unde

r th

e ag

e of

thre

e ye

ars

(item

020

5) th

at d

oes

not f

orm

a p

art o

f the

dai

ly IC

U/H

igh

Car

e fe

e an

d m

ay b

e ch

arge

d fo

r se

para

tely

on

a da

ily b

asis

(fe

e in

clud

es th

e in

trod

uctio

n of

the

cann

ula

as w

ell a

s th

e da

ily m

anag

emen

t)R

.M

ultip

le o

rgan

failu

re: U

nits

for

item

s 12

08, 1

209

and

1210

(C

ateg

ory

3: C

ases

with

mul

tiple

2004

.00

orga

n fa

ilure

) in

clud

e re

susc

itatio

n (i.

e. it

em 1

211.

Car

dio-

resp

irato

ry r

esus

cita

tion)

S.

Ven

tilat

ion:

Uni

ts fo

r ite

ms

1212

, 121

3 an

d 12

14 (

vent

ilatio

n) in

clud

e th

e fo

llow

ing:

(a)

2004

.00

Mea

sure

men

t of m

inut

e vo

lum

e, v

ital c

apac

ity, t

ime-

and

vita

l cap

acity

stu

dies

. (b)

Tes

ting

and

conn

ectin

g th

e m

achi

ne. (

c) P

uttin

g pa

tient

on

mac

hine

: set

ting

mac

hine

, syn

chro

nisi

ng p

atie

ntw

ith m

achi

ne. (

d) In

stru

ctio

n to

nur

sing

sta

ff.(e

) A

ll su

bseq

uent

vis

its fo

r 24

hou

rs.

T.

Ven

tilat

ion

(item

s 12

12 to

121

4) d

oes

not f

orm

a p

art o

f nor

mal

pos

t-op

erat

ive

care

, but

may

not

2004

.00

be a

dded

to it

em 1

204:

Cat

egor

y 1:

Cas

es r

equi

ring

inte

nsiv

e m

onito

ring

U.

Obs

tetr

ic p

roce

dure

s: (

a) W

hen

a ge

nera

l pra

ctiti

oner

trea

ts a

pat

ient

in th

e an

te-n

atal

per

iod

2004

.00

and,

afte

r st

artin

g th

e co

nfin

emen

t, re

ques

ts a

n ob

stet

ricia

n to

take

ove

r th

e ca

se, t

he g

ener

alpr

actit

ione

r sh

all b

e en

title

d to

cha

rge

for

all t

he a

nte-

nata

l con

sulta

tions

he/

she

has

perf

orm

ed.

(i)If

the

patie

nt h

as b

een

in la

bour

for

less

than

6 h

ours

, the

gen

eral

pra

ctiti

oner

sha

ll ch

arge

50,0

0 cl

inic

al p

roce

dure

uni

ts a

ccor

ding

to it

em 2

6141

Glo

bal o

bste

tric

car

e.(ii

)If

the

patie

nt h

asbe

en in

labo

ur fo

r m

ore

than

6 h

ours

, the

gen

eral

pra

ctiti

oner

sha

ll ch

arge

80,

00 c

linic

alpr

oced

ure

units

acc

ordi

ng to

item

261

4: G

loba

l obs

tetr

ic c

are.

(b)

Whe

n a

gene

ral p

ract

ition

erca

lls a

n ob

stet

ricia

n to

hel

p w

ith a

con

finem

ent,

take

ove

r th

e m

anag

emen

t of a

con

finem

ent,

and

trea

ts th

e pa

tient

unt

il af

ter

the

post

-par

tum

vis

it, th

e ob

stet

ricia

n sh

all c

harg

e ac

cord

ing

to it

em26

14: G

loba

l obs

tetr

ic c

are.

(c)

Whe

n a

gene

ral p

ract

ition

er c

alls

an

obst

etric

ian

(spe

cial

ist o

rge

nera

l pra

ctiti

oner

) to

hel

p w

ith a

con

finem

ent,

or ta

ke o

ver

the

man

agem

ent o

f a c

onfin

emen

t,bu

t the

gen

eral

pra

ctiti

oner

trea

ts th

e pa

tient

unt

il af

ter

the

post

-par

tum

vis

it, th

e ob

stet

ricia

n sh

all

V.

(a)

Ele

ctro

-con

vuls

ive

trea

tmen

t: V

isits

at h

ospi

tal o

r nu

rsin

g ho

me

durin

g a

cour

se o

f ele

ctro

-20

04.0

0co

nvul

sive

trea

tmen

t are

just

ified

and

may

be

char

ged

for

in a

dditi

on to

the

fees

for

the

proc

edur

e. (

b) E

xcep

t whe

re o

ther

wis

e in

dica

ted,

the

dura

tion

of a

med

ical

psy

chot

hera

peut

icse

ssio

n is

set

at 2

0 m

inut

es o

r pa

rt th

ereo

f, pr

ovid

ed th

at s

uch

a pa

rt c

ompr

ises

50%

or

mor

e of

the

time

of a

ses

sion

. Thi

s se

t dur

atio

n is

als

o ap

plic

able

for

psyc

hiat

ric e

xam

inat

ion

met

hods

Y.

Exc

ept w

here

oth

erw

ise

indi

cate

d, r

adio

logi

sts

are

entit

led

to c

harg

e fo

r co

ntra

st m

ater

ial u

sed

2004

.00

Z.

No

fee

is s

ubje

ct to

mor

e th

an o

ne r

educ

tion

2004

.00

AA

.P

roce

dure

s to

exc

lude

cos

t of i

soto

pe20

04.0

0B

B.

The

fees

in th

is s

ectio

n (r

adia

tion

onco

logy

) do

NO

T in

clud

e th

e co

st o

f rad

ium

or

isot

opes

2004

.00

CC

.A

cupu

nctu

re:

(a)

Whe

n tw

o se

para

te a

cupu

nctu

re te

chni

ques

are

use

d, e

ach

trea

tmen

t sha

ll be

200

4.00

rega

rded

as

a se

para

te tr

eatm

ent f

or w

hich

fees

may

be

char

ged

for

sepa

rate

ly. (

b) N

ot m

ore

than

two

sepa

rate

tech

niqu

es m

ay b

e ch

arge

d fo

r at

eac

h se

ssio

n. (

c) T

he m

axim

um n

umbe

r of

acup

unct

ure

trea

tmen

ts p

er c

ours

e to

be

char

ged

for

is li

mite

d to

20.

If fu

rthe

r tr

eatm

ent i

sre

quire

d at

the

end

of th

is p

erio

d of

trea

tmen

t, it

shou

ld b

e ne

gotia

ted

with

the

patie

nt (

d) It

em03

80 r

efer

s to

sca

lp a

cupu

nctu

re a

s a

trea

tmen

t in

its o

wn

right

and

not

to th

e us

e of

acu

punc

ture

poin

ts o

n th

e sc

alp

Pag

e 3

of 8

7

STAATSKOERANT, 14 SEPTEMBER 2012 No. 35684 7

EE

.U

ltras

ound

exa

min

atio

ns: T

he in

tern

atio

nal n

orm

app

rove

d fo

r us

e in

Sou

th A

fric

a fo

r N

OR

MA

L20

04.0

0

PR

EG

NA

NC

Y is

two

ultr

asou

nd e

xam

s: (

a) T

he fi

rst s

can

shou

ld p

refe

rabl

y in

clud

e a

nuch

alth

ickn

ess

estim

atio

n an

d be

per

form

ed b

etw

een

10 a

nd 1

4 w

eeks

ges

tatio

n. T

he s

econ

d sc

ansh

ould

be

perf

orm

ed b

etw

een

20 a

nd 2

4 w

eeks

and

sho

uld

incl

ude

a fu

ll an

atom

ical

rep

ort.

All

subs

eque

nt u

ltras

ound

sca

ns a

re e

xclu

ded

from

the

bene

fits

of m

edic

al s

chem

es u

nles

sac

com

pani

ed b

y pr

oper

mot

ivat

ion.

An

ultr

asou

nd s

can

to a

sses

s an

abn

orm

al e

arly

pre

gnan

cym

ay b

e fo

rmed

bef

ore

10 w

eeks

but

this

sca

n m

ay n

ot b

e us

ed to

dia

gnos

e a

norm

alun

com

plic

ated

pre

gnan

cy. I

tem

361

8 is

a g

ynae

colo

gica

l sca

n an

d its

use

is n

ot a

ppro

ved

for

use

in p

regn

ancy

. (b)

In c

ases

whe

re th

e sc

an is

per

form

ed b

y th

e at

tend

ing

prac

titio

ner,

a c

lear

indi

catio

n fo

r su

ch a

sca

n m

ust b

e en

tere

d on

the

acco

unt r

ende

red,

or

a le

tter

of m

otiv

atio

n m

ust

be a

ttach

ed to

the

acco

unt (

the

prac

titio

ner

mus

t ele

ct o

ne o

f the

two

optio

ns).

(c)

In c

ase

of a

refe

rral

, the

ref

errin

g do

ctor

mus

t sub

mit

a le

tter

of m

otiv

atio

n to

the

radi

olog

ist o

r ot

her

prac

titio

ner

doin

g th

e sc

an. A

cop

y of

the

lette

r of

mot

ivat

ion

mus

t be

atta

ched

to th

e fir

st a

ccou

ntF

F.

(a)

Whe

n a

cyst

osco

py p

rece

des

a re

late

d op

erat

ion,

Mod

ifier

001

3: E

ndos

copi

c ex

amin

atio

n20

04.0

0

done

at a

n op

erat

ion,

app

lies,

e.g

. cys

tosc

opy

follo

wed

by

tran

sure

thra

l (T

UR

) pr

osta

tect

omy.

(b)

Whe

n a

cyst

osco

py p

rece

des

an u

nrel

ated

ope

ratio

n, M

odifi

er 0

005:

Mul

tiple

proc

edur

es/o

pera

tions

und

er th

e sa

me

anae

sthe

tic, a

pplie

s, e

.g. c

ysto

scop

y fo

r ur

inar

y tr

act

infe

ctio

n fo

llow

ed b

y in

guin

al h

erni

a re

pair.

(c)

No

mod

ifier

app

lies

to it

em 1

949:

Cys

tosc

opy,

whe

n pe

rfor

med

toge

ther

with

any

of i

tem

s 19

51 to

197

3.G

G.

Cap

turin

g an

d re

cord

ing

of e

xam

inat

ions

: Im

ages

from

all

radi

olog

ical

, ultr

asou

nd a

nd m

agne

tic20

04.0

0

reso

nanc

e im

agin

g pr

oced

ures

mus

t be

capt

ured

dur

ing

ever

y ex

amin

atio

n an

d a

perm

anen

tre

cord

gen

erat

ed b

y m

eans

of f

ilm, p

aper

, or

mag

netic

med

ia. A

rep

ort o

f the

exa

min

atio

n,in

clud

ing

the

findi

ngs

and

diag

nost

ic c

omm

ent,

mus

t be

writ

ten

and

stor

ed fo

r fiv

e ye

ars

RR

.T

he r

adio

logy

sec

tion

in th

is p

rice

list i

s no

t for

use

by

regi

ster

ed s

peci

alis

t rad

iolo

gy p

ract

ices

(P

r 20

04.0

0N

o "0

38")

or

nucl

ear

med

icin

e pr

actic

es (

Pr

No

"025

"), b

ut o

nly

for

use

by o

ther

spe

cial

ist

prac

tices

or

gene

ral p

ract

ition

ers.

A s

epar

ate

radi

olog

y sc

hedu

le is

for

the

excl

usiv

e us

e of

reg

iste

red

spec

ialis

t rad

iolo

gy p

ract

ices

(Pr

No

"038

") a

nd n

ucle

ar m

edic

ine

prac

tices

(P

r N

o "0

25")

.X

X.

Dia

gnos

tic s

ervi

ces

rend

ered

to h

ospi

tal i

npat

ient

s: Q

uote

Mod

ifier

009

1 on

all

acco

unts

for

2004

.00

diag

nost

ic s

ervi

ces

(e.g

. MR

I, X

-ray

s, p

atho

logy

test

s) p

erfo

rmed

on

patie

nts

offic

ially

adm

itted

toho

spita

l or

day

clin

icV

Y.

Dia

gnos

tic s

ervi

ces

rend

ered

to o

utpa

tient

s: Q

uote

Mod

ifier

009

2 on

all

acco

unts

for

diag

nost

ic20

04.0

0se

rvic

es (

e.g.

MR

I, X

-ray

s, p

atho

logy

test

s) p

erfo

rmed

on

patie

nts

NO

T o

ffici

ally

adm

itted

toho

spita

l or

day

clin

ic (

coul

d be

with

in th

e co

nfin

es o

f a h

ospi

tal)

MO

DIF

IER

S G

OV

ER

NIN

G T

HE

ST

RU

CT

UR

E00

02W

ritte

n re

port

on

X-r

ays:

The

low

est l

evel

cod

e fo

r a

new

pat

ient

offi

ce (

cons

ultin

g ro

oms)

vis

it, is

200

4.00

appl

icab

le o

nly

whe

re a

rad

iolo

gist

is r

eque

sted

to g

ive

a w

ritte

n re

port

on

X-r

ays

take

nel

sew

here

and

sub

mitt

ed to

him

. The

abo

ve m

entio

ned

item

and

the

low

est l

evel

initi

al h

ospi

tal

visi

t cod

e, a

s ap

prop

riate

are

not

to b

e us

ed fo

r ro

utin

e re

port

ing

of X

-ray

s ta

ken

else

whe

re

0004

Pro

cedu

res

perf

orm

ed in

ow

n pr

oced

ure

room

s: P

roce

dure

s pe

rfor

med

in d

octo

rs' o

wn

2006

.05

proc

edur

e ro

oms

inst

ead

of in

a h

ospi

tal t

heat

re o

r un

atta

ched

thea

tre

unit:

as

per

fee

for

proc

edur

e +

100

% (

the

valu

e of

mod

ifier

000

4 eq

uals

100

% o

f the

val

ue o

f the

pro

cedu

repe

rfor

med

). S

ee S

ectio

n V

(S

ectio

n G

in S

AM

A's

DU

) fo

r a

list o

f pro

cedu

res,

whi

ch a

re o

ften

done

in r

oom

s to

whi

ch M

odifi

er 0

004

shou

ld n

ot b

e ap

plie

d. P

leas

e no

te: O

nly

the

med

ical

prac

titio

ner

who

ow

ns th

e fa

cilit

y an

d th

e eq

uipm

ent m

ay c

harg

e m

odifi

er 0

004.

Onl

y on

e pe

rson

may

cla

im th

is m

odifi

er fo

r pr

oced

ures

per

form

ed in

doc

tors

' ow

n pr

oced

ure

room

s

Pag

e 4

of 8

7

8 No. 35684 GOVERNMENT GAZETTE, 14 SEPTEMBER 2012

0005

Mul

tiple

ther

apeu

tic p

roce

dure

s/op

erat

ions

und

er th

e sa

me

anae

sthe

tic:

2004

.00

a) U

nles

s ot

herw

ise

iden

tifie

d in

the

tarif

f whe

n m

ultip

le th

erap

eutic

pro

cedu

res/

oper

atio

ns a

ddsi

gnifi

cant

tim

e an

d/or

com

plex

ity, a

nd w

hen

each

pro

cedu

re/o

pera

tion

is c

lear

ly id

entif

ied

and

defin

ed, t

he fo

llow

ing

valu

es s

hall

prev

ail:

100%

(fu

ll va

lue)

for

the

first

or

maj

orpr

oced

ure/

oper

atio

n, 7

5% fo

r th

e se

cond

pro

cedu

re/o

pera

tion,

50%

for

the

third

proc

edur

e/op

erat

ion,

25%

for

the

four

th a

nd s

ubse

quen

t pro

cedu

res/

oper

atio

ns. T

his

mod

ifier

does

not

app

ly to

pur

ely

diag

nost

ic p

roce

dure

s.

b) In

the

case

of m

ultip

le fr

actu

res

and/

or d

islo

catio

ns th

e ab

ove

valu

es s

hall

prev

ail.

c) W

hen

pure

ly d

iagn

ostic

end

osco

pic

proc

edur

es o

r di

agno

stic

end

osco

pic

proc

edur

esun

rela

ted

to a

ny th

erap

eutic

pro

cedu

res

perf

orm

ed, a

re p

erfo

rmed

und

er th

e sa

me

gene

ral

anae

sthe

tic, M

odifi

er 0

005

is n

ot a

pplic

able

to th

e fe

es fo

r su

ch d

iagn

ostic

end

osco

pic

proc

edur

es a

s th

e fe

es fo

r en

dosc

opic

pro

cedu

res

do n

ot p

rovi

de fo

r af

ter-

care

. Spe

cify

unr

elat

eden

dosc

opic

pro

cedu

re a

nd p

rovi

de d

iagn

osis

to in

dica

te d

iagn

ostic

end

osco

pic

proc

edur

e(s)

unre

late

d to

oth

er (

ther

apeu

tic)

proc

edur

es p

erfo

rmed

und

er th

e sa

me

anae

sthe

tic.

d) P

leas

e no

te: W

hen

mor

e th

an o

ne s

mal

l pro

cedu

re is

per

form

ed a

nd th

e ta

riff m

akes

prov

isio

n fo

r ite

ms

for

"sub

sequ

ent'

or "

max

imum

for

mul

tiple

add

ition

al p

roce

dure

s" (

see

Sec

tion

2. In

tegu

men

tary

Sys

tem

) M

odifi

er 0

005

is n

ot a

pplic

able

as

the

fee

is a

lread

y a

redu

ced

fee.

0006

Vis

iting

spe

cial

ists

per

form

ing

proc

edur

es: W

here

spe

cial

ists

vis

it sm

alle

r ce

ntre

s to

per

form

2004

.00

proc

edur

es, f

ees

for

thes

e pa

rtic

ular

pro

cedu

res

are

excl

usiv

e of

afte

r-ca

re. T

he r

efer

ring

prac

titio

ner

will

then

be

entit

led

to s

ubse

quen

t hos

pita

l vis

its fo

r af

ter-

care

. If t

he r

efer

ring

prac

titio

ner

is n

ot a

vaila

ble,

the

spec

ialis

t sha

ll, o

n co

nsul

tatio

n w

ith th

e pa

tient

, cho

ose

anap

prop

riate

locu

m te

nens

. Bot

h th

e su

rgeo

n an

d th

e pr

actit

ione

r w

ho h

andl

ed th

e af

ter-

care

, mus

tin

suc

h in

stan

ces

quot

e M

odifi

er 0

006

with

the

part

icul

ar it

ems

whi

ch th

ey u

se00

07a)

Use

of o

wn

mon

itorin

g eq

uipm

ent i

n th

e ro

oms:

Rem

uner

atio

n fo

r th

e us

e of

any

type

of o

wn

2004

.00

2015

.000

1.0

R13

9.85

2015

.000

1.0

R13

9.85

mon

itorin

g eq

uipm

ent i

n th

e ro

oms

for

proc

edur

es p

erfo

rmed

und

er in

trav

enou

s se

datio

n -

15,0

0cl

inic

al p

roce

dure

uni

ts ir

resp

ectiv

e of

the

num

ber

of it

ems

of e

quip

men

t pro

vide

d.

b) U

se o

f ow

n eq

uipm

ent i

n ho

spita

l the

atre

or

unat

tach

ed th

eatr

e un

it R

emun

erat

ion

for

the

use

of a

ny ty

pe o

f ow

n eq

uipm

ent f

or p

roce

dure

s pe

rfor

med

in a

hos

pita

l the

atre

or

unat

tach

edth

eatr

e un

it w

hen

appr

opria

te e

quip

men

t is

not p

rovi

ded

by th

e ho

spita

l - 1

5,00

clin

ical

pro

cedu

reun

its ir

resp

ectiv

e of

the

num

ber

of it

ems

of e

quip

men

t pro

vide

d.00

08S

peci

alis

t sur

geon

ass

ista

nt: W

here

a p

roce

dure

req

uire

s a

regi

ster

ed s

peci

alis

t sur

geon

2004

.00

assi

stan

t, th

e fe

e is

33,

33%

(1/

3) o

f the

fee

for

the

spec

ialis

t sur

geon

0009

Ass

ista

nt: T

he fe

e fo

r an

ass

ista

nt is

20%

of t

he fe

e fo

r th

e sp

ecia

list s

urge

on, w

ith a

min

imum

of

2004

.00

36,0

0 cl

inic

al p

roce

dure

uni

ts. T

he m

inim

um fe

e pa

yabl

e m

ay n

ot b

e le

ss th

an 3

6,00

clin

ical

proc

edur

es u

nits

0010

Loca

l ana

esth

etic

: (a)

A fe

e fo

r a

loca

l ana

esth

etic

adm

inis

tere

d by

the

oper

ator

may

onl

y be

2004

.00

char

ged

for

(1)

an o

pera

tion

or p

roce

dure

hav

ing

a va

lue

grea

ter

than

30,

00 c

linic

al p

roce

dure

units

(i.e

. 31,

00 o

r m

ore

clin

ical

pro

cedu

re u

nits

allo

cate

d to

a s

ingl

e ite

m)

or (

2) w

here

mor

e th

anon

e op

erat

ion

or p

roce

dure

is d

one

at th

e sa

me

time

with

a c

ombi

ned

valu

e gr

eate

r th

an 5

0,00

clin

ical

pro

cedu

re u

nits

. (b)

The

fee

shal

l be

calc

ulat

ed a

ccor

ding

to th

e ba

sic

anae

sthe

tic u

nits

for

the

spec

ific

oper

atio

n. A

naes

thet

ic ti

me

may

not

be

char

ged

for,

but

the

min

imum

fee

as p

erM

odifi

er 0

036:

Ana

esth

etic

adm

inis

tere

d by

a g

ener

al p

ract

ition

er, s

hall

be a

pplic

able

in s

uch

aca

se. (

c) N

ot a

pplic

able

to r

adio

logi

cal p

roce

dure

s (s

uch

as a

ngio

grap

hy a

nd m

yelo

grap

hy. (

d)N

o fe

e m

ay b

e le

vied

for

topi

cal a

pplic

atio

n of

loca

l ana

esth

etic

. (e)

Ple

ase

note

: Mod

ifier

001

0:Lo

cal a

naes

thet

ic a

dmin

iste

red

by th

e op

erat

or, m

ay n

ot b

e ad

ded

on th

e su

rgeo

n's

acco

unt f

orpr

oced

ures

that

wer

e pe

rfor

med

und

er g

ener

al a

naes

thet

ic.

0011

Em

erge

ncy

proc

edur

es: A

ny b

ona

fide,

just

ifiab

le e

mer

genc

y pr

oced

ure

(all

hour

s) u

nder

take

n in

200

6.04

an o

pera

ting

thea

tre

and/

or in

ano

ther

set

ting

in li

eu o

f an

oper

atin

g th

eatr

e, w

ill a

ttrac

t an

addi

tiona

l 12,

00 c

linic

al p

roce

dure

uni

ts p

er h

alf-

hour

or

part

ther

eof o

f the

ope

ratin

g tim

e fo

r al

lm

embe

rs o

f the

sur

gica

l tea

m. M

odifi

er 0

011

does

not

app

ly in

res

pect

of p

atie

nts

on s

ched

uled

lists

. (A

med

ical

em

erge

ncy

is a

ny c

ondi

tion

whe

re d

eath

or

irrep

arab

le h

arm

to th

e pa

tient

will

resu

lt if

ther

e ar

e un

due

dela

ys in

rec

eivi

ng a

ppro

pria

te m

edic

al tr

eatm

ent)

Pag

e 5

of

STAATSKOERANT, 14 SEPTEMBER 2012 No. 35684 9

0013

End

osco

pic

exam

inat

ions

don

e at

ope

ratio

ns: W

here

a r

elat

ed e

ndos

copi

c ex

amin

atio

n is

don

e at

200

4.00

an o

pera

tion

by th

e op

erat

ing

surg

eon

or th

e at

tend

ing

anae

sthe

siol

ogis

t, on

ly 5

0% o

f the

fee

for

the

endo

scop

ic e

xam

inat

ion

may

be

char

ged

0014

Ope

ratio

ns p

revi

ousl

y pe

rfor

med

by

othe

r su

rgeo

ns: W

here

an

oper

atio

n is

per

form

ed w

hich

has

200

4.00

been

pre

viou

sly

perf

orm

ed b

y an

othe

r su

rgeo

n, e

.g. a

rev

isio

n or

rep

eat o

pera

tion,

the

fee

shal

lbe

cal

cula

ted

acco

rdin

g to

the

tarif

f for

the

full

oper

atio

n pl

us a

n ad

ditio

nal f

ee to

be

nego

tiate

dun

der

gene

ral R

ule

J: In

exc

eptio

nal c

ases

whe

re th

e fe

e is

dis

prop

ortio

nate

ly lo

w in

rel

atio

n to

actu

al s

ervi

ce r

ende

red,

exc

ept w

here

alre

ady

spec

ified

in th

e ta

riff

0015

Intr

aven

ous

infu

sion

s: W

here

intr

aven

ous

infu

sion

s (in

clud

ing

bloo

d an

d bl

ood

cellu

lar

prod

ucts

)20

04.0

0ar

e ad

min

iste

red

as p

art o

f the

afte

r-tr

eatm

ent a

fter

the

oper

atio

n or

con

finem

ent,

no e

xtra

fees

shal

l be

char

ged

as th

is is

incl

uded

in th

e gl

obal

ope

rativ

e or

mat

erni

ty fe

es. S

houl

d th

epr

actit

ione

r do

ing

the

oper

atio

n or

atte

ndin

g to

the

mat

erni

ty c

ase

pref

er to

ask

ano

ther

prac

titio

ner

to p

erfo

rm p

ost-

oper

ativ

e or

pos

t-co

nfin

emen

t int

rave

nous

infu

sion

s, th

en th

epr

actit

ione

r hi

mse

lf (a

nd n

ot th

e pa

tient

) sh

all b

e re

spon

sibl

e fo

r re

mun

erat

ing

such

pra

ctiti

oner

for

the

infu

sion

s00

17In

ject

ions

adm

inis

tere

d by

pra

ctiti

oner

s: W

hen

dese

nsiti

satio

n, in

trav

enou

s, in

tram

uscu

lar

or20

05.0

610

7.50

01.

0R

112.

9110

7.50

01.

0 R

112.

91

subc

utan

eous

inje

ctio

ns a

re a

dmin

iste

red

by th

e pr

actit

ione

r hi

m-/

hers

elf t

o pa

tient

s w

ho a

ttend

the

cons

ultin

g ro

oms,

a fi

rst i

njec

tion

form

s pa

rt o

f the

con

sulta

tion/

visi

t and

onl

y al

l sub

sequ

ent

inje

ctio

ns fo

r th

e sa

me

cond

ition

sho

uld

be c

harg

ed a

t 7.5

0 co

nsul

tativ

e se

rvic

es u

nits

usi

ngm

odifi

er 0

017

to r

efle

ct th

e am

ount

(no

t cha

rgea

ble

toge

ther

with

a c

onsu

ltatio

n ite

m)

0018

Sur

gica

l mod

ifier

for

pers

ons

with

a B

MI o

f 35>

(ca

lcul

ated

acc

ordi

ng to

kg/

m2)

: Fee

for

2004

.00

proc

edur

e +

50%

for

surg

eons

and

a 5

0% in

crea

se in

ana

esth

etic

tim

e un

its fo

r an

aest

hesi

olog

ists

0019

Sur

gery

on

neon

ates

(up

to a

nd in

clud

ing

28 d

ays

afte

r bi

rth)

and

low

birt

h w

eigh

t inf

ants

(le

ss20

04.0

0th

an 2

500g

) un

der

gene

ral a

naes

thes

ia (

excl

udin

g ci

rcum

cisi

on):

per

fee

for

proc

edur

e +

50%

for

surg

eons

and

a 5

0% in

crea

se in

ana

esth

etic

tim

e un

its fo

r an

aest

hesi

olog

ists

0046

Whe

re in

the

trea

tmen

t of a

spe

cific

frac

ture

or

disl

ocat

ion

(com

poun

d or

dos

ed)

an in

itial

2004

.00

proc

edur

e is

follo

wed

with

in o

ne m

onth

by

an o

pen

redu

ctio

n, in

tern

al fi

xatio

n, e

xtem

al s

kele

tal

fixat

ion

or b

one

graf

ting

on th

e sa

me

bone

, the

fee

for

the

initi

al tr

eatm

ent o

f tha

t fra

ctur

e or

disl

ocat

ion

shal

l be

redu

ced

by 5

0%. P

leas

e no

te: T

his

redu

ctio

n do

es n

ot in

clud

e th

eas

sist

ant's

fee

whe

re a

pplic

able

. Afte

r on

e m

onth

, a fu

ll fe

e as

for

the

initi

al tr

eatm

ent,

isap

plic

able

0047

A fr

actu

re N

OT

req

uirin

g re

duct

ion

shal

l be

char

ged

on a

fee

per

serv

ice

basi

s20

04.0

000

48W

here

in th

e tr

eatm

ent o

f a fr

actu

re o

r di

sloc

atio

n, a

n in

itial

dos

ed r

educ

tion

is fo

llow

ed w

ithin

2004

.00

one

mon

th b

y fu

rthe

r do

sed

redu

ctio

ns u

nder

gen

eral

ana

esth

esia

, the

fee

for

such

sub

sequ

ent

redu

ctio

ns w

ill b

e 27

,00

clin

ical

pro

cedu

re u

nits

(no

t inc

ludi

ng a

fter-

care

)00

49E

xcep

t whe

re o

ther

wis

e sp

ecifi

ed, i

n ca

ses

of c

ompo

und

frac

ture

s, 7

7,00

clin

ical

pro

cedu

re u

nits

200

4.11

(spe

cial

ists

) an

d 77

,00

clin

ical

pro

cedu

re u

nits

(ge

nera

l pra

ctiti

oner

s) a

re to

be

adde

d to

the

units

for

the

frac

ture

s in

clud

ing

debr

idem

ent

0050

In c

ases

of a

com

poun

d fr

actu

re w

here

a d

ebrid

emen

t is

follo

wed

by

inte

rnal

fixa

tion

(exc

ludi

ng20

04.0

0fix

atio

n w

ith K

irsch

ner

wire

s, a

s w

ell a

s fr

actu

res

of h

ands

and

feet

), th

e fu

ll am

ount

acc

ordi

ng to

eith

er M

odifi

er 0

049:

Cas

es o

f com

poun

d fr

actu

res,

or

Mod

ifier

005

1: F

ract

ures

req

uirin

g op

enre

duct

ion,

inte

rnal

fixa

tion,

ext

emal

ske

leta

l fix

atio

n an

d/or

bon

e gr

aftin

g, m

ay b

e ad

ded

to th

e fe

efo

r th

e pr

oced

ure

invo

lved

, plu

s ha

lf of

the

amou

nt a

ccor

ding

to th

e se

cond

mod

ifier

(ei

ther

Mod

ifier

004

9: C

ases

of c

ompo

und

frac

ture

s or

Mod

ifier

005

1: F

ract

ures

req

uirin

g op

enre

duct

ion,

inte

rnal

fixa

tion,

ext

erna

l ske

leta

l fix

atio

n an

d/or

bon

e gr

aftin

g, a

s ap

plic

able

)

0051

Fra

ctur

es r

equi

ring

open

red

uctio

n, in

tern

al fi

xatio

n, e

xter

nal s

kele

tal f

ixat

ion

and/

or b

one

graf

ting:

200

4.11

Spe

cial

ists

add

77,

00 c

linic

al p

roce

dure

uni

ts. G

ener

al p

ract

ition

ers

add

77,0

0 cl

inic

al p

roce

dure

units

0053

Fra

ctur

e re

quiri

ng p

ercu

tane

ous

inte

rnal

fixa

tion

(inse

rtio

n an

d re

mov

al o

f fix

ativ

es (

wire

s) in

2004

.00

resp

ect o

f fin

gers

and

toes

incl

uded

]: S

peci

alis

ts a

nd g

ener

al p

ract

ition

ers

add

32,0

0 cl

inic

alpr

oced

ure

units

0055

Dis

loca

tion

requ

iring

ope

n re

duct

ion:

Uni

ts fo

r th

e sp

ecifi

c jo

int p

lus

77,0

0 cl

inic

al p

roce

dure

uni

ts 2

004.

11fo

r sp

ecia

lists

. Gen

eral

pra

ctiti

oner

s ad

d 77

,00

clin

ical

pro

cedu

re u

nits

2027

.000

1.0

R25

1.72

2027

.000

1.0

R25

1.72

2077

.000

1.0

R71

7.87

2077

.000

1.0

R71

7.87

20 1

15.5

001.

0R

107

6.79

2011

5.50

01.

0R

107

6.79

2077

.000

1.0

R71

7.87

2077

.000

1.0

R71

7.87

2032

.000

1.0

R29

8.33

2032

.000

1.0

R29

8.33

2077

.000

1.0

R71

7.87

2077

.000

1.0

R71

7.87

Pag

e 6

of 8

7

10 No. 35684 GOVERNMENT GAZETTE, 14 SEPTEMBER 2012

0057

Mul

tiple

pro

cedu

res

on fe

et: I

n m

ultip

le p

roce

dure

s on

feet

, fee

s fo

r th

e fir

st fo

ot a

re c

alcu

late

d20

04.0

0ac

cord

ing

to M

odifi

er 0

005:

Mul

tiple

pro

cedu

res/

oper

atio

ns u

nder

the

sam

e an

aest

hetic

.C

alcu

late

fees

for

the

seco

nd fo

ot in

the

sam

e w

ay, r

educ

e th

e to

tal t

o 75

% a

nd a

dd to

the

tota

l for

the

first

foot

0058

Rev

isio

n op

erat

ion

for

tota

l joi

nt r

epla

cem

ent a

nd im

med

iate

re-

subs

titut

ion

(infe

cted

or

non-

2004

.00

infe

cted

): p

er fe

e fo

r to

tal j

oint

rep

lace

men

t + 1

00%

0061

Com

bine

d pr

oced

ures

on

the

spin

e: In

cas

es o

f com

bine

d pr

oced

ures

on

the

spin

e, b

oth

the

2004

.00

orth

opae

dic

surg

eon

and

the

neur

osur

geon

are

ent

itled

to th

e fu

ll fe

e fo

r th

e re

leva

nt p

art o

f the

oper

atio

n pe

rfor

med

0063

Whe

re tw

o sp

ecia

lists

wor

k to

geth

er o

n a

repl

anta

tion

proc

edur

e, e

ach

shal

l be

entit

led

to tw

o-20

04.0

0th

irds

of th

e fe

e fo

r th

e pr

oced

ure

0064

Whe

re th

e re

plan

tatio

n is

uns

ucce

ssfu

l, no

furt

her

surg

ical

fee

is p

ayab

le fo

r am

puta

tion

of th

e20

04.0

0no

n-vi

able

par

ts00

65A

dditi

onal

ope

rativ

e pr

oced

ures

by

sam

e su

rgeo

n, u

nder

sec

tion

3.8.

6: S

pina

l def

orm

ities

, with

in 2

004.

00a

perio

d of

12

mon

ths:

75%

of s

ched

uled

fee

for

the

less

er p

roce

dure

, exc

ept w

here

oth

erw

ise

spec

ified

els

ewhe

re00

66M

icro

surg

ery

of th

e fa

llopi

an-t

ubes

and

ova

ries:

Whe

re m

icro

-sur

gica

l tec

hniq

ues

are

used

, with

2004

.00

the

aid

of a

mic

rosc

ope,

25%

may

be

adde

d to

the

fee

0067

Mic

rosu

rger

y of

the

lary

nx: A

dd 2

5% to

the

fee

of th

e op

erat

ion

perf

orm

ed (

for

othe

r op

erat

ions

2004

.00

requ

iring

the

use

of a

n op

erat

ion

mic

rosc

ope,

the

fee

incl

ude

the

use

of th

e m

icro

scop

e, e

xcep

tw

here

oth

erw

ise

spec

ified

els

ewhe

re In

the

Tar

iff)

0069

Whe

n en

dosc

opic

inst

rum

ents

are

use

d du

ring

intr

anas

al s

urge

ry: A

dd 1

0% o

f the

fee

of th

e20

04.0

0pr

oced

ure

perf

orm

ed. O

nly

appl

icab

le to

item

s 10

25, 1

027,

103

0, 1

033,

103

5, 1

036,

103

9, 1

047,

1054

and

108

300

70A

dd 4

5,00

clin

ical

pro

cedu

re u

nits

to p

roce

dure

(s)

perf

orm

ed th

roug

h a

thor

asco

pe20

04.0

000

72N

on in

vasi

ve p

erip

hera

l vas

cula

r te

sts:

The

num

ber

of te

sts

in a

sin

gle

case

is r

estr

icte

d to

two

2004

.00

(2)

per

diag

nosi

s. T

ests

are

not

just

ified

in c

ases

of u

ncom

plic

ated

var

icos

e ve

ins

0073

Whe

n ite

m 1

288

(Car

diac

cat

hete

risat

ion

for

cong

enita

l hea

rt d

isea

se: A

ll ag

es a

bove

1 y

ear

old)

200

4.00

or it

em 1

289

(Pae

diat

ric c

ardi

ac c

athe

teris

atio

n: In

fant

s be

low

the

age

of o

ne y

ear)

is p

erfo

rmed

by p

aedi

atric

car

diol

ogis

ts c

331:

fee

for

proc

edur

e +

100

%00

74E

ndos

copi

c pr

oced

ures

per

form

ed w

ith o

wn

equi

pmen

t: T

he b

asic

pro

cedu

re fe

e pl

us 3

3.33

%20

04.0

0(1

/3)

of th

at fe

e ("

+"

code

s ex

clud

ed)

will

app

ly w

here

end

osco

pic

proc

edur

es a

re p

erfo

rmed

with

own

equi

pmen

t.00

75E

ndos

copi

c pr

oced

ures

per

form

ed in

ow

n pr

oced

ure

room

: The

fee

plus

21,

00 c

linic

al p

roce

dure

200

4.00

units

will

app

ly w

here

end

osco

pic

proc

edur

es a

re p

erfo

rmed

in r

oom

s w

ith o

wn

equi

pmen

t Thi

sfe

e is

cha

rgea

ble

by m

edic

al p

ract

ition

ers

who

ow

n or

ren

t the

faci

lity.

Ple

ase

note

: Mod

ifier

007

5is

not

app

licab

le to

any

of t

he it

ems

for

diag

nost

ic p

roce

dure

s in

the

otor

hino

lary

ngol

ogy

sect

ions

of th

e ta

riff.

0077

Phy

sica

l tre

atm

ent:

Whe

n tw

o se

para

te a

reas

are

trea

ted

sim

ulta

neou

sly

for

tota

lly d

iffer

ent

2004

.00

cond

ition

s, s

uch

trea

tmen

t sha

ll be

reg

arde

d as

two

trea

tmen

ts fo

r w

hich

sep

arat

e fe

es m

ay b

ech

arge

d. (

Onl

y ap

plic

able

if s

ervi

ces

are

prov

ided

by

a sp

ecia

list i

n ph

ysic

al m

edic

ine)

0078

Whe

n a

test

is b

iops

y is

don

e co

mbi

ned

with

vas

ogra

m o

r se

min

al v

esic

ulog

ram

or

2004

.00

epid

idym

ogra

m, a

dd 5

0% o

f the

uni

ts fo

r th

e ap

prop

riate

pro

cedu

re00

79 W

hen

a fir

st c

onsu

ltatio

nNis

it pr

ocee

ds in

to, o

r is

imm

edia

tely

follo

wed

by

a m

edic

al20

04.0

0ps

ycho

ther

apeu

tic p

roce

dure

, fee

s fo

r th

e pr

oced

ure

are

calc

ulat

ed a

ccor

ding

to th

e ap

prop

riate

indi

vidu

al p

sych

othe

rapy

cod

e (it

ems

2957

, 297

4 or

297

5)00

80M

ultip

le e

xam

inat

ions

: Ful

l Fee

2004

.00

0081

Rep

eat e

xam

inat

ions

: No

redu

ctio

n20

04.0

0

0082

"+"

Mea

ns th

at th

is it

em is

com

plem

enta

ry to

a p

rece

ding

item

and

is th

eref

ore

not s

ubje

ct to

2004

.00

redu

ctio

n00

83A

red

uctio

n of

33,

33%

(1/

3) in

the

fee

will

app

ly to

rad

iolo

gica

l exa

min

atio

ns a

s in

dica

ted

in20

04.0

0se

ctio

n 19

: Rad

iolo

gy w

here

hos

pita

l equ

ipm

ent i

s us

ed00

84F

ilm c

osts

: In

the

case

of r

adio

logi

cal i

tem

s w

here

film

s ar

e us

ed, p

ract

ition

ers

shou

ld a

djus

t the

2004

.00

fee

upw

ards

or

dow

nwar

ds in

acc

orda

nce

with

cha

nges

in th

e pr

ice

of fi

lms

in c

ompa

rison

with

Nov

embe

r 19

79; t

he c

alcu

latio

n m

ust b

e do

ne o

n th

e ba

sis

that

film

cos

ts c

ompr

ise

10%

of t

hem

onet

ary

valu

e of

the

unit

(Thi

s in

form

atio

n is

obt

aina

ble

from

the

Rad

iolo

gica

l Soc

iety

of S

A)

2045

.000

1.0

R41

9.54

2045

.000

1.0

R41

9.54

2021

.000

1.0

R19

5.79

2021

.000

1.0

R19

5.79

Pag

e 7

of 8

7

STAATSKOERANT, 14 SEPTEMBER 2012 No. 35684 11

0085

Left

Sid

e' m

odifi

er to

be

adde

d to

whe

n ite

ms

6500

to 6

519

are

used

whe

n th

e le

ft si

de is

2004

.00

exam

ined

. Ple

ase

note

that

the

abse

nce

of th

is m

odifi

er in

dica

tes

that

the

right

sid

e w

asex

amin

ed00

86V

ascu

lar

grou

ps: "

Film

ser

ies"

and

"In

trod

uctio

n of

Con

tras

t Med

ia"

are

com

plem

enta

ry a

nd20

04.0

0to

geth

er c

onst

itute

a s

ingl

e ex

amin

atio

n: n

eith

er fe

e is

ther

efor

e su

bjec

t to

incr

ease

in te

rms

ofM

odifi

er 0

080:

Mul

tiple

exa

min

atio

ns00

90R

adio

logi

st's

fee

for

part

icip

atio

n in

a te

am: 3

0,00

rad

iolo

gy u

nits

per

% h

our

or p

art t

here

of fo

r al

l 200

4.00

inte

rven

tiona

l rad

iolo

gica

l pro

cedu

res,

exc

ludi

ng a

ny p

re-

or p

ost-

oper

ativ

e an

giog

raph

y,ca

thet

eris

atio

n, C

T-s

cann

ing,

ultr

asou

nd-s

cann

ing

or x

-ray

pro

cedu

res.

(O

nly

to b

e ch

arge

d if

radi

olog

ist i

s ha

nds-

on, a

nd n

ot fo

r in

terp

reta

tion

of im

ages

onl

y)00

91D

iagn

ostic

ser

vice

s re

nder

ed to

hos

pita

l inp

atie

nts:

Quo

te M

odifi

er 0

091

on a

ll ac

coun

ts fo

rdi

agno

stic

ser

vice

s (e

.g. M

RI,

X-r

ays,

pat

holo

gy te

sts)

per

form

ed o

n pa

tient

s of

ficia

lly a

dmitt

ed to

hosp

ital o

r da

y cl

inic

(re

fer

to R

ule

XX

)00

92D

iagn

ostic

ser

vice

s re

nder

ed to

out

patie

nts:

Quo

te M

odifi

er 0

092

on a

ll ac

coun

ts fo

r di

agno

stic

serv

ices

(e.

g. M

RI,

X-r

ays,

pat

holo

gy te

sts)

per

form

ed o

n pa

tient

s N

OT

offi

cial

ly a

dmitt

ed to

hosp

ital o

r da

y cl

inic

(co

uld

be w

ithin

the

conf

ines

of a

hos

pita

l) (r

efer

to R

ule

YY

)00

95R

adia

tion

mat

eria

ls: E

xclu

sive

ly fo

r us

e w

here

rad

iatio

n m

ater

ials

sup

plie

d by

the

prac

tice

are

used

by

clin

ical

and

rad

iatio

n on

colo

gist

s, m

odifi

er 0

095

shou

ld b

e us

ed to

iden

tify

thes

em

ater

ials

. A m

ater

ial c

ode

list w

ith d

escr

iptio

ns a

nd g

uide

line

cost

s fo

r th

ese

mat

eria

ls,

mai

ntai

ned

and

upda

ted

on a

reg

ular

bas

is, w

ill b

e su

pplie

d by

the

Soc

iety

of C

linic

al a

ndR

adia

tion

Onc

olog

y. T

his

mod

ifier

is o

nly

char

geab

le b

y th

e pr

actic

e re

spon

sibl

e fo

r th

e co

st o

fth

is m

ater

ial a

nd w

here

the

hosp

ital d

id n

ot c

harg

e th

eref

ore.

Ple

ase

note

that

item

020

1 sh

ould

not b

e us

ed fo

r th

ese

mat

eria

ls00

96R

adio

-isot

ope

ther

apy

patie

nts

who

fail

to k

eep

thei

r ap

poin

tmen

ts: F

ee w

ill in

clud

e co

st o

fis

otop

e00

97P

atho

logy

test

s pe

rfor

med

by

non-

path

olog

ists

: Whe

re it

ems

unde

r C

linic

al P

atho

logy

(se

ctio

n21

) an

d A

nato

mic

al P

atho

logy

(se

ctio

n 22

) fa

ll w

ithin

the

prov

ince

of o

ther

spe

cial

ists

or

gene

ral

prac

titio

ners

, the

fee

is to

be

char

ged

at tw

o-th

irds

of th

e pa

thol

ogis

ts fe

e01

60A

spira

tion

of b

iops

y pr

oced

ure

perf

orm

ed u

nder

dire

ct u

ltras

ound

con

trol

by

an u

ltras

ound

aspi

ratio

n bi

opsy

tran

sduc

er (

Sta

tic R

ealti

me)

: Fee

for

part

exa

min

ed p

lus

30%

of t

he u

nits

0165

Use

of c

ontr

ast d

urin

g ul

tras

ound

stu

dy: a

dd 6

.00

ultr

asou

nd u

nits

5104

Ultr

asou

nd in

pre

gnan

cy, m

ultip

le g

esta

tion,

afte

r tw

enty

wee

ks: p

lus

30%

6100

In o

rder

to c

harg

e th

e fu

ll fe

e (6

00,0

0 m

agne

tic r

eson

ance

uni

ts)

for

an e

xam

inat

ion

of a

spe

cific

sing

le a

nato

mic

al r

egio

n, it

sho

uld

be p

erfo

rmed

with

the

appl

icab

le r

adio

freq

uenc

y co

il in

clud

ing

T1

and

T2

wei

ghte

d im

ages

on

at le

ast t

wo

plan

es61

01W

here

a li

mite

d se

ries

of a

spe

cific

ana

tom

ical

reg

ion

is p

erfo

rmed

(ex

cept

bon

e tu

mou

r), e

.g. a

T2

wei

ghte

d im

age

of a

bon

e fo

r an

occ

ult s

tres

s fr

actu

re, n

ot m

ore

than

two-

third

s (2

/3)

of th

efe

e m

ay b

e ch

arge

d. A

lso

appl

icab

le to

all

radi

othe

rapy

pla

nnin

g st

udie

s, p

er r

egio

n61

02A

ll po

st-c

ontr

ast s

tudi

es (

exce

pt b

one

tum

our)

, inc

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12 No. 35684 GOVERNMENT GAZETTE, 14 SEPTEMBER 2012

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MR

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Pag

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of 8

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130

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253.

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91

STAATSKOERANT, 14 SEPTEMBER 2012 No. 35684 13

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s (n

on-e

mer

genc

y): A

DD

onl

y to

the

2006

.04

cons

ulta

tion/

visi

t ite

ms

0190

-019

2, it

ems

0173

-017

5, it

ems

0161

-016

4 or

item

s 01

66-0

169,

as

appr

opria

te. N

ote:

Onl

y on

e of

item

s 01

45, 0

146

or 0

147

may

be

char

ged

and

not c

ombi

natio

nsth

ereo

f01

46F

or a

n un

sche

dule

d em

erge

ncy

cons

ulta

tion/

visi

t at t

he d

octo

rs' h

ome

or r

oom

s, a

ll ho

urs:

AD

D20

06.0

5on

ly to

the

cons

ulta

tion/

visi

t ite

ms

0190

-019

2, it

ems

0161

-016

4 or

item

s 01

51-0

153,

as

appr

opria

te (

refe

r to

gen

eral

rul

e B

). N

ote:

Onl

y on

e of

item

s 01

45, 0

146

or 0

147

may

be

char

ged

and

not c

ombi

natio

ns th

ereo

f01

47F

or a

n un

sche

dule

d em

erge

ncy

cons

ulta

tion/

visi

t aw

ay fr

om th

e do

ctor

's h

ome

or r

oom

s, a

ll20

06.0

5ho

urs:

AD

D o

nly

to th

e co

nsul

tatio

n/vi

sit i

tem

s 01

90-0

192,

item

s 01

73-0

175,

item

s 01

61-0

164,

item

s 01

66-0

169

or it

ems

0151

-015

3, a

s ap

prop

riate

. Not

e: O

nly

one

of it

ems

0145

, 014

6 or

014

7m

ay b

e ch

arge

d an

d no

t com

bina

tions

ther

eof

0148

For

ele

ctiv

e af

ter-

hour

s se

rvic

es o

n re

ques

t of t

he p

atie

nt o

r fa

mily

(no

n em

erge

ncy)

(re

fer

to20

06.0

5

gene

ral r

ule

B):

AD

D 5

0% o

f the

fee

for

the

appr

opria

te c

onsu

ltatio

n/vi

sit i

tem

(on

ly to

be

used

with

item

s 01

90-0

192,

item

s 01

73-0

175,

item

s 01

61-0

164,

item

s 01

66-0

169

or it

ems

0151

-015

3)an

d re

flect

this

as

a se

para

te it

em 0

148.

Usa

ge: T

his

item

is u

sed

whe

n, fo

r ex

ampl

e, a

pat

ient

or

the

fam

ily r

eque

st th

e do

ctor

for

a no

n-em

erge

ncy

cons

ulta

tion/

visi

t out

side

of t

he n

orm

al h

ours

perio

d as

ref

lect

ed in

gen

eral

rul

e B

.01

49A

fter-

hour

s bo

na fi

de e

mer

genc

y co

nsul

tatio

n/vi

sit (

21:0

0-6:

00 d

aily

): A

DD

25%

of t

he fe

e fo

r th

e20

06.0

5ap

prop

riate

con

sulta

tion/

visi

t ite

m (

only

to b

e us

ed w

ith it

ems

0190

-019

2, it

ems

0173

-017

5, it

ems

0161

-016

4, it

ems

0166

-016

9 or

item

s 01

51-0

153)

and

ref

lect

this

as

a se

para

te it

em 0

149.

Not

e:T

he a

fter-

hour

per

iod

appl

icab

le to

this

item

is fr

om M

onda

y to

Sun

day

21:0

0-6:

00le

Pre

-ana

esth

etic

ass

essm

ent

130

15.0

001.

0R

253.

1310

17.0

001.

0R

255.

91

130

15.0

001.

0R

253.

1310

17.0

001.

0R

255.

91

130

15.0

001.

0R

253.

1310

17.0

001.

0R

255.

91

130

15.0

001.

0R

253.

1310

17.0

001.

0R

255.

91

130

15.0

001.

0R

253.

1310

17.0

001.

0R

255.

91

1015

.000

1.0

R22

5.85

1015

.000

1.0

R22

5.85

+10

15.0

00 1

.0R

225.

8510

15.0

001.

0R

225.

85

+10

6.00

01.

0R

90.3

410

6.00

01.

0R

90.3

4

+10

8.00

01.

0R

120.

4010

8.00

01.

0R

120.

40

+10

14.0

001.

0R

210.

7410

14,0

001.

0R

210.

74

+10

-1.

010

-1.

0

10-

1,0

10-

1.0

Pag

e 10

of 8

7

14 No. 35684 GOVERNMENT GAZETTE, 14 SEPTEMBER 2012

0151

Pre

-ana

esth

etic

ass

essm

ent P

re-a

naes

thet

ic a

sses

smen

t of p

atie

nt (

all h

ours

). P

robl

em fo

cuse

d 20

06.0

4hi

stor

y an

d cl

inic

al e

xam

inat

ion

and

stra

ight

forw

ard

deci

sion

mak

ing

for

min

or p

robl

em. T

ypic

ally

occu

pies

the

doct

or fa

ce-t

o-fa

ce w

ith th

e pa

tient

for

betw

een

10 a

nd 2

0 m

inut

es

0152

Pre

-ana

esth

etic

ass

essm

ent:

Pre

-ana

esth

etic

ass

essm

ent o

f pat

ient

(al

l hou

rs).

Det

aile

d hi

stor

y20

06.0

4an

d cl

inic

al e

xam

inat

ion

and

stra

ight

forw

ard

deci

sion

mak

ing

and

coun

selli

ng. T

ypic

ally

occ

upie

sth

e do

ctor

face

-to-

face

with

the

patie

nt fo

r be

twee

n 20

and

35

min

utes

0153

Pre

-ana

esth

etic

ass

essm

ent:

Pre

-ana

esth

etic

ass

essm

ent o

f pat

ient

or

othe

r co

nsul

tativ

e se

rvic

e. 2

006.

04C

onsu

ltatio

n w

ith d

etai

led

hist

ory,

com

plet

e ex

amin

atio

n an

d m

oder

ate

com

plex

dec

isio

n m

akin

gan

d co

unse

lling

. Typ

ical

ly o

ccup

ies

the

doct

or fa

ce-t

o-fa

ce fo

r be

twee

n 30

and

45

min

utes

I.fP

rena

tal v

isits

and

new

bor

n at

tend

ance

0107

New

bor

n at

tend

ance

: Exc

lusi

ve a

ttend

ance

to b

aby

at C

aesa

rean

sec

tion,

nor

mal

del

iver

y or

vis

it 20

06.0

2in

the

war

d (o

nce

per

patie

nt)

(item

s 01

09, 0

111,

011

3, 0

145,

014

6 an

d/or

014

7 m

ay n

ot b

ead

ded

to it

em 0

107)

Item

010

7 ca

n be

use

d on

ce o

nly

for

give

n co

nfin

emen

t20

04.0

001

13N

ew b

orn

atte

ndan

ce: E

mer

genc

y at

tend

ance

to n

ewbo

rn a

t all

hour

s (o

nce

per

patie

nt)

(item

s20

06.0

201

07, 0

109,

011

1, 0

145,

014

6 an

d/or

014

7 m

ay n

ot b

e ad

ded

to it

em 0

113)

1.9

Con

sulta

tive

serv

ices

: Mis

cella

neou

s01

30T

elep

hone

con

sulta

tion

(all

hour

s)20

04.0

001

32C

onsu

lting

ser

vice

e.g

. writ

ing

of r

epea

t scr

ipts

or

requ

estin

g ro

utin

e pr

e-au

thor

isat

ion

with

out t

he 2

004.

00ph

ysic

al p

rese

nce

of th

e pa

tient

(ne

eds

not b

e fa

ce-t

o-fa

ce c

onta

ct)

("C

onsu

ltatio

n" v

ia S

MS

or

elec

tron

ic m

edia

incl

uded

)01

33W

ritin

g of

spe

cial

mot

ivat

ions

for

proc

edur

es a

nd tr

eatm

ent w

ithou

t the

phy

sica

l pre

senc

e of

a20

04.0

0

patie

nt (

incl

udes

rep

ort o

n th

e cl

inic

al c

ondi

tion

of a

pat

ient

) re

ques

ted

by o

r on

beh

alf o

f a th

irdpa

rty

fund

er o

r its

age

nt01

99C

ompl

etio

n of

chr

onic

med

icat

ion

form

s by

med

ical

pra

ctiti

oner

s w

ith o

r w

ithou

t the

phy

sica

l20

04.0

0pr

esen

ce o

f the

pat

ient

req

uest

ed b

y or

on

beha

lf of

a th

ird p

arty

fund

er o

r its

age

ntII.

Med

icin

e, m

ater

ial,

supp

lies

and

use

of o

wn

equi

pmen

tII.

aM

edic

ine

code

sII.

a.1

Dis

pens

ing

of m

edic

ine

by li

cens

ed d

ispe

nsin

g m

edic

al p

ract

ition

ers

0197

Lice

nsed

dis

pens

ing

med

ical

pra

ctiti

oner

s: D

ispe

nsin

g co

st -

R16

.00

for

med

icin

e w

ith a

cos

t of

2006

.02

R10

0,00

or

mor

e (V

AT

incl

usiv

e), o

r 16

% fo

r m

edic

ine

cost

ing

less

than

R10

0,00

(V

AT

incl

usiv

e).

Add

to e

ach

Nap

pi c

ode

to p

rovi

de fo

r th

e di

spen

sing

cos

tII.

a.2

Onc

e-of

f adm

inis

trat

ion

of m

edid

ne u

sed

durin

g a

cons

ulta

tion

0198

Onc

e-of

f adm

inis

trat

ion

of m

edic

ines

: Thi

s ite

m p

rovi

des

for

med

icin

es u

sed

at a

con

sulta

tion,

2006

.02

viz,

onc

e of

f adm

inis

trat

ion

of m

edic

ine,

spe

cial

med

icin

e us

ed in

trea

tmen

t, or

em

erge

ncy

disp

ensi

ng. C

harg

e fo

r m

edic

ine

used

acc

ordi

ng to

the

Sin

gle

Exi

t Pric

e (S

EP

) P

LUS

R16

,00

for

med

icin

e w

ith a

cos

t of R

100,

00 o

r m

ore,

or

16%

for

med

icin

e co

stin

g le

ss th

an R

100,

00 P

LUS

VA

T o

n th

e 16

% /R

16,0

0. (

Whe

re a

pplic

able

, VA

T s

houl

d be

add

ed to

the

16%

/R 1

6,00

onl

y an

dno

t to

the

SE

P, s

ince

the

SE

P is

VA

T in

clus

ive)

. [A

ccor

ding

to S

ectio

n 18

(8)

of th

e M

edic

ines

and

Rel

ated

Sub

stan

ces

Act

(A

ct 1

01 o

f 196

5) c

ompo

undi

ng a

nd d

ispe

nsin

g do

es n

ot r

efer

to a

med

icin

e re

quiri

ng p

repa

ratio

n fo

r a

once

-off

adm

inis

trat

ion

to a

pat

ient

dur

ing

a co

nsul

tatio

n].

The

app

ropr

iate

Eth

ical

Med

icin

e N

appi

cod

e(s)

, sel

ecte

d fr

om th

ose

code

s co

mm

enci

ng w

ith 7

,8

or 9

(pr

ovid

ed th

at it

is n

ot a

ref

eren

ce c

ode)

, sho

uld

be a

dded

app

licab

le to

the

med

icin

e us

ed.

Ple

ase

note

: Ref

er to

item

020

1 fo

r co

st o

f mat

eria

l use

d in

trea

tmen

t.

II.a.

3C

ost o

f che

mot

hera

py d

rugs

0212

Cos

t of c

hem

othe

rapy

dru

gs: T

his

item

pro

vide

s fo

r a

char

ge fo

r ch

emot

hera

py d

rugs

use

d in

2006

.02

trea

tmen

t Cha

rge

for

chem

othe

rapy

dru

gs u

sed

in tr

eatm

ent a

t cos

t pric

e P

LUS

16%

(w

ith a

max

imum

of R

16,0

0). (

Whe

re a

pplic

able

, VA

T s

houl

d be

add

ed to

the

abov

e). T

he a

ppro

pria

teE

thic

al M

edic

ine

Nap

pi c

ode(

s), s

elec

ted

from

thos

e co

des

com

men

cing

with

7, 8

or

9 (p

rovi

ded

that

it is

not

a r

efer

ence

cod

e), s

houl

d be

add

ed a

pplic

able

to th

e ch

emot

hera

py d

rugs

use

d.

!Lb

Mat

eria

l cod

esII.

b.1

Pro

sthe

sis

and/

or in

tern

al fi

xatio

n

1016

.000

1.0

R24

0.81

1016

.000

1.0

R24

0.81

1016

.000

1.0

R24

0.81

1016

.000

1.0

R24

0.81

1016

.000

1.0

R24

0.81

1016

.000

1.0

R24

0.81

1233

.000

1.0

R49

6.72

1233

.000

1.0

R49

6.72

1245

.000

1.0

R67

7.40

1245

.000

1.0

R67

7.40

1012

.000

1.0

R18

0.68

1012

.000

1.0

R18

0.68

105.

000

1.0

R75

.23

105.

000

1.0

R75

.23

109.

000

1.0

R13

5.51

109.

000

1.0

R13

5.51

1021

.430

1.0

R32

2.64

1021

.430

1.0

R32

2.64

Pag

e 11

of 8

7

STAATSKOERANT, 14 SEPTEMBER 2012 No. 35684 15

0200

Pro

sthe

sis

and/

or in

tern

al fi

xatio

n: T

his

item

pro

vide

s fo

r a

char

ge fo

r pr

osth

esis

and

/or

inte

rnal

2006

.02

fixat

ion.

Cha

rge

for

pros

thes

is a

nd/o

r in

tern

al fi

xatio

n at

cos

t pric

e P

LUS

26%

(up

to a

max

imum

of R

26,

00).

(W

here

app

licab

le, V

AT

sho

uld

be a

dded

to th

e ab

ove)

. The

app

ropr

iate

Nap

pico

de(s

), w

here

app

licab

le, f

or th

e pr

osth

esis

and

/or

inte

rnal

fixa

tion

used

, mus

t be

prov

ided

.

II.b.

2M

ater

ial u

sed

durin

g a

cons

ulta

tion

0201

Cos

t of m

ater

ial i

n tr

eatm

ent T

his

item

pro

vide

s fo

r a

char

ge fo

r m

ater

ial u

sed

in tr

eatm

ent

2006

.02

Cha

rge

for

mat

eria

l at c

ost p

rice

PLU

S 2

6% (

up to

a m

axim

um o

f R26

,00)

. (W

here

app

licab

le,

VA

T s

houl

d be

add

ed to

the

abov

e). T

he a

ppro

pria

te S

urgi

cal a

nd M

ater

ial N

appi

cod

e(s)

,se

lect

ed fr

om th

ose

code

s co

mm

enci

ng w

ith 4

, 5, 6

, whe

re a

pplic

able

, for

the

mat

eria

l use

d,m

ust b

e pr

ovid

ed. P

leas

e no

te: R

efer

to it

em 0

198

for

once

off

adm

inis

trat

ion

of m

edic

ine.

ll.c

Set

ting

of s

teril

e tr

ay02

02S

ettin

g of

ste

rile

tray

: A fe

e of

10,

00 c

linic

al p

roce

dure

uni

ts m

ay b

e ch

arge

d fo

r th

e se

tting

of a

2005

.06

ster

ile tr

ay w

here

a s

teril

e pr

oced

ure

is p

erfo

rmed

in th

e ro

oms.

Cos

t of s

titch

ing

mat

eria

l, if

appl

icab

le, s

hall

be c

harg

ed fo

r ac

cord

ing

to it

em 0

201,

as

appr

opria

teII.

dO

wn

equi

pmen

t use

d in

trea

tmen

t59

30S

urgi

cal l

aser

app

arat

us: H

ire fe

e fo

r ow

n eq

uipm

ent

2004

.00

5932

Can

della

lase

r ap

para

tus:

Hire

fee

for

own

equi

pmen

t (R

ates

by

arra

ngem

ent w

ith th

e sc

hem

e20

04.0

0

conc

erne

d)III

.P

RO

CE

DU

RE

S69

99U

nlis

ted

proc

edur

e/se

rvic

e: A

pro

cedu

re/s

ervi

ce m

ay b

e pr

ovid

ed th

at is

not

list

ed in

this

edi

tion

2005

.03

of th

e co

ding

str

uctu

re. R

efer

to G

ener

al R

ule

C fo

r th

e cr

iteria

to u

se it

em 6

999

GE

NE

RA

L M

OD

IFIE

RS

GO

VE

RN

ING

TH

IS S

EC

TIO

N00

11E

mer

genc

y pr

oced

ures

: Any

bon

a fid

e, ju

stifi

able

em

erge

ncy

proc

edur

e (a

ll ho

urs)

und

erta

ken

in 2

006.

04an

ope

ratin

g th

eatr

e an

d/or

in a

noth

er s

ettin

g in

lieu

of a

n op

erat

ing

thea

tre,

will

attr

act a

nad

ditio

nal 1

2,00

clin

ical

pro

cedu

re u

nits

per

hal

f-ho

ur o

r pa

rt th

ereo

f of t

he o

pera

ting

time

for

all

mem

bers

of t

he s

urgi

cal t

eam

. Mod

ifier

001

1 do

es n

ot a

pply

in r

espe

ct o

f pat

ient

s on

sch

edul

edlis

ts. (

A m

edic

al e

mer

genc

y is

any

con

ditio

n w

here

dea

th o

r irr

epar

able

har

m to

the

patie

nt w

illre

sult

if th

ere

are

undu

e de

lays

in r

ecei

ving

app

ropr

iate

med

ical

trea

tmen

t)00

13E

ndos

copi

c ex

amin

atio

ns d

one

at o

pera

tions

: Whe

re a

rel

ated

end

osco

pic

exam

inat

ion

is d

one

at 2

004.

00an

ope

ratio

n by

the

oper

atin

g su

rgeo

n or

the

atte

ndin

g an

aest

hesi

olog

ist,

only

50%

of t

he fe

e fo

rth

e en

dosc

opic

exa

min

atio

n m

ay b

e ch

arge

d00

14O

pera

tions

pre

viou

sly

perf

orm

ed b

y ot

her

surg

eons

: Whe

re a

n op

erat

ion

is p

erfo

rmed

whi

ch h

as 2

004.

00be

en p

revi

ousl

y pe

rfor

med

by

anot

her

surg

eon,

e.g

. a r

evis

ion

or r

epea

t ope

ratio

n, th

e fe

e sh

all

be c

alcu

late

d ac

cord

ing

to th

e ta

riff f

or th

e fu

ll op

erat

ion

plus

an

addi

tiona

l fee

to b

e ne

gotia

ted

unde

r ge

nera

l Rul

e J:

In e

xcep

tiona

l cas

es w

here

the

fee

is d

ispr

opor

tiona

tely

low

in r

elat

ion

toac

tual

ser

vice

ren

dere

d, e

xcep

t whe

re a

lread

y sp

ecifi

ed in

the

tarif

fM

OD

IFIE

RS

GO

VE

RN

ING

SE

CT

ION

100

15In

trav

enou

s in

fusi

ons:

Whe

re in

trav

enou

s in

fusi

ons

(incl

udin

g bl

ood

and

bloo

d ce

llula

r pr

oduc

ts)

2004

.00

are

adm

inis

tere

d as

par

t of t

he a

fter-

trea

tmen

t afte

r th

e op

erat

ion

or c

onfin

emen

t, no

ext

ra fe

essh

all b

e ch

arge

d as

this

is in

clud

ed in

the

glob

al o

pera

tive

or m

ater

nity

fees

. Sho

uld

the

prac

titio

ner

doin

g th

e op

erat

ion

or a

ttend

ing

to th

e m

ater

nity

cas

e pr

efer

to a

sk a

noth

erpr

actit

ione

r to

per

form

pos

t-op

erat

ive

or p

ost-

conf

inem

ent i

ntra

veno

us in

fusi

ons,

then

the

prac

titio

ner

him

self

(and

not

the

patie

nt)

shal

l be

resp

onsi

ble

for

rem

uner

atin

g su

ch p

ract

ition

erfo

r th

e in

fusi

ons

0017

Inje

ctio

ns a

dmin

iste

red

by p

ract

ition

ers:

Whe

n de

sens

itisa

tion,

intr

aven

ous,

intr

amus

cula

r or

2005

,06

subc

utan

eous

inje

ctio

ns a

re a

dmin

iste

red

by th

e pr

actit

ione

r hi

m-/

hers

elf t

o pa

tient

s w

ho a

ttend

the

cons

ultin

g ro

oms,

a fi

rst i

njec

tion

form

s pa

rt o

f the

con

sulta

tion/

visi

t and

onl

y al

l sub

sequ

ent

inje

ctio

ns fo

r th

e sa

me

cond

ition

sho

uld

be c

harg

ed a

t 7.5

0 co

nsul

tativ

e se

rvic

es u

nits

usi

ngm

odifi

er 0

017

to r

efle

ct th

e am

ount

(no

t cha

rgea

ble

toge

ther

with

a c

onsu

ltatio

n ite

m)

1G

ener

al1.

1In

ject

ions

, Inf

usio

ns a

nd In

hala

tion

Sed

atio

n T

reat

men

t02

03In

hala

tion

seda

tion:

Use

of a

nalg

esic

nitr

ous

oxid

e fo

r al

coho

l and

oth

er w

ithdr

awal

sta

tes:

Firs

t20

04.0

0qu

arte

r-ho

ur o

r pa

rt th

ereo

f02

04In

hala

tion

seda

tion:

Per

add

ition

al q

uart

er-h

our

or p

art t

here

of20

04.0

002

05In

trav

enou

s tr

eatm

ent I

ntra

veno

us in

fusi

ons

(cut

-dow

n or

pus

h-in

) (p

atie

nts

unde

r th

ree

year

s):

2004

.00

Cut

-dow

n an

d/or

inse

rtio

n of

can

nula

- c

harg

eabl

e on

ce p

er 2

4 ho

urs

2010

.000

1.0

R93

.27

2010

.000

1.0

R93

.27

2010

9.00

01.

0R

101

6.18

2010

9.00

01.

0R

101

6.18

107.

500

1.0

R11

2.91

107.

500

1.0

R11

2.91

206.

000

1.0

R55

.88

206.

000

1.0

R55

.88

203.

000

1.0

R28

.01

203.

000

1.0

R28

.01

2012

.000

1.0

R11

1.90

2012

.000

1.0

R11

1.90

Pag

e 12

of 8

7

16 No. 35684 GOVERNMENT GAZETTE, 14 SEPTEMBER 2012

0206

Intr

aven

ous

trea

tmen

t: In

trav

enou

s in

fusi

ons

(pus

h-in

) (p

atie

nts

over

thre

e ye

ars)

: Ins

ertio

n of

2004

.00

cann

ula

- ch

arge

able

onc

e pe

r 24

hou

rs02

07In

trav

enou

s tr

eatm

ent:

Intr

aven

ous

infu

sion

s (c

ut-d

own)

(pa

tient

s ov

er th

ree

year

s): C

ut-d

own

2004

.00

and

inse

rtio

n of

can

nula

- c

harg

eabl

e on

ce p

er 2

4 ho

urs

0208

Ven

esec

tionl

The

rape

utic

ven

esec

tion

(Not

to b

e us

ed w

hen

bloo

d is

dra

wn

for

the

purp

ose

of20

04.0

0la

bora

tory

inve

stig

atio

ns)

0209

Um

bilic

al a

rter

y ca

nnul

atio

n at

birt

h02

10C

olle

ctio

n of

blo

od s

peci

men

(s)

by m

edic

al p

ract

ition

er fo

r pa

thol

ogy

exam

inat

ion,

per

vene

sect

ion

(not

to b

e us

ed b

y pa

thol

ogis

ts)

0211

Exc

hang

e tr

ansf

usio

n: F

irst a

nd s

ubse

quen

t (in

clud

ing

afte

r-ca

re)

Not

e: H

OW

TO

CH

AR

GE

FO

R IN

TR

AV

EN

OU

S IN

FU

SIO

NS

:20

04.0

0P

ract

ition

ers

are

entit

led

to c

harg

e ac

cord

ing

to th

e ap

prop

riate

item

whe

neve

r th

ey p

erso

nally

inse

rt th

e ca

nnul

a (b

ut m

ay o

nly

char

ge fo

r th

is s

ervi

ce o

nce

ever

y 24

hou

rs).

For

man

agin

g th

ein

fusi

on a

s su

ch, e

.g. c

heck

ing

it w

hen

visi

ting

the

patie

nt o

r pr

escr

ibin

g th

e su

bsta

nce,

no

fee

may

be

char

ged

sinc

e th

is s

ervi

ce is

reg

arde

d as

par

t of t

he s

ervi

ces

the

doct

or r

ende

rs d

urin

gco

nsul

tatio

ns (

not a

pplic

able

to it

em 0

205)

1.2

Che

mot

hera

py tr

eatm

ent (

not i

n ch

emot

hera

py fa

cilit

ies)

0213

Tre

atm

ent w

ith c

ytos

tatic

age

nts:

Adm

inis

terin

g of

Che

mot

hera

py: I

ntra

mus

cula

r or

subc

utan

eous

: Per

inje

ctio

n. F

or u

se b

y pr

ovid

ers

who

do

not m

ake

use

of r

ecog

nise

dch

emot

hera

py fa

cilit

ies

and/

or w

ho a

re n

ot p

rimar

ily r

espo

nsib

le fo

r m

anag

ing

the

chem

othe

rapy

trea

tmen

t02

14In

trav

enou

s tr

eatm

ent w

ith c

ytos

tatic

age

nts:

Adm

inis

terin

g of

Che

mot

hera

py: I

ntra

veno

us b

olus

2004

.00

tech

niqu

e: P

er in

ject

ion.

For

use

by

prov

ider

s w

ho d

o no

t mak

e us

e of

rec

ogni

sed

chem

othe

rapy

faci

litie

s an

d/or

who

are

not

prim

arily

res

pons

ible

for

man

agin

g th

e ch

emot

hera

py tr

eatm

ent

2004

.00

2004

.00

2004

.00

2004

.00

0215

Intr

aven

ous

trea

tmen

t with

cyt

osta

tic a

gent

s: A

dmin

iste

ring

of C

hem

othe

rapy

: Int

rave

nous

infu

sion

tech

niqu

e: P

er in

ject

ion.

For

use

by

prov

ider

s w

ho d

o no

t mak

e us

e of

rec

ogni

sed

chem

othe

rapy

faci

litie

s an

d/or

who

are

not

prim

arily

res

pons

ible

for

man

agin

g th

e ch

emot

hera

pytr

eatm

ent

1.3

Onc

olog

y re

late

d se

rvic

es in

non

-onc

olog

y fa

cilit

ies

5780

Inte

rstit

ial i

mpl

ants

: Pla

ting

of g

uide

tube

s fo

r in

ters

titia

l im

plan

ts u

nder

loca

l or

gene

ral

anae

sthe

tic. T

he c

ost o

f mat

eria

ls is

not

incl

uded

5781

Intr

acav

itary

app

licat

ions

: Pla

cing

of g

uide

tube

s un

der

loca

l or

gene

ral a

naes

thet

ic fo

r m

anua

l or

2006

.02

rem

ote

afte

rload

ing

brac

hyth

erap

y. T

he c

ost o

f mat

eria

ls is

not

incl

uded

5782

Isot

ope

The

rapy

: Adm

inis

trat

ion

of lo

w d

ose

surf

ace

appl

icat

ors,

up

to fi

ve a

pplic

atio

ns. T

ypic

ally

200

6.02

an o

ut p

atie

nt p

roce

dure

. The

cos

t of m

ater

ials

is n

ot in

clud

ed57

83In

fusi

onal

pha

rmac

othe

rapy

: Fee

for

the

trea

tmen

t of n

on c

ance

rous

con

ditio

ns w

ith b

olus

or

2006

.02

infu

sion

al p

harm

acot

hera

py p

er tr

eatm

ent d

ay (

cons

ulta

tions

to b

e ch

arge

d se

para

tely

)M

OD

IFIE

RS

GO

VE

RN

ING

TH

E A

DM

INIS

TR

AT

ION

OF

AN

AE

ST

HE

TIC

S F

OR

ALL

PR

OC

ED

UR

ES

AN

D O

PE

RA

TIO

NS

0020

Con

scio

us s

edat

ion:

Any

cas

e th

at is

con

duct

ed o

utsi

de o

f a h

ospi

tal t

heat

re s

hall

be c

oded

with

2006

.06

the

rele

vant

pro

cedu

re c

ode.

To

iden

tify

thes

e ca

ses

the

abov

e m

odifi

er s

houl

d be

use

d to

indi

cate

to th

e m

edic

al s

chem

e th

at th

ere

will

be

no h

ospi

tal/t

heat

re a

ccou

nt.

0021

Det

erm

inat

ion

of a

naes

thet

ic fe

es: A

naes

thet

ic fe

es a

re d

eter

min

ed b

y ob

tain

ing

the

sum

of t

he20

06.0

4ba

sic

anae

sthe

tic u

nits

(al

loca

ted

to e

ach

proc

edur

e th

at m

ight

be

perf

orm

ed u

nder

ana

esth

etic

as in

dica

ted

in th

e "A

naes

thet

ic P

erfo

rmed

" co

lum

n) p

lus

the

time

units

(ca

lcul

ated

acc

ordi

ng to

the

form

ula

in M

odifi

er 0

023)

and

the

appr

opria

te m

odifi

ers

(see

Mod

ifier

s 00

37-0

044)

. In

case

sof

ope

rativ

e pr

oced

ures

on

the

mus

culo

skel

etal

sys

tem

, ope

n fr

actu

res

and

open

red

uctio

n of

frac

ture

s or

dis

loca

tions

add

uni

ts a

s la

id d

own

by M

odifi

ers

5441

to 5

448

0023

The

bas

ic a

naes

thet

ic u

nits

are

laid

dow

n in

the

tarif

f and

are

ref

lect

ed in

the

anae

sthe

tic c

olum

n. 2

006.

05T

hese

bas

ic a

naes

thet

ic u

nits

ref

lect

the

addi

tiona

l ana

esth

etic

ris

k, th

e te

chni

cal s

kill

requ

ired

ofth

e an

aest

hesi

olog

ist/a

naes

thet

ist a

nd th

e sc

ope

of th

e su

rgic

al p

roce

dure

, but

exc

lude

the

valu

eof

the

actu

al ti

me

spen

t adm

inis

terin

g th

e an

aest

hetic

. The

tim

e un

its (

indi

cate

d by

"T

) w

ill b

ead

ded

to th

e lis

ted

basi

c an

aest

hetic

uni

ts in

all

case

s on

the

follo

win

g ba

sis:

Ana

esth

etic

tim

e:T

he r

emun

erat

ion

for

anae

sthe

tic ti

me

shal

l be

per

15 m

inut

e pe

riod

or p

art t

here

of, c

alcu

late

dfr

om th

e co

mm

ence

men

t of t

he a

naes

thet

ic, i

.e. 2

,00

anae

sthe

tic u

nits

per

15

min

ute

perio

d or

part

ther

eof,

prov

ided

that

sho

uld

the

dura

tion

of th

e an

aest

hetic

be

long

er th

an o

ne (

1) h

our

the

num

ber

of u

nits

sha

ll, a

fter

one

(1)

hour

, be

3,00

ana

esth

etic

uni

ts p

er 1

5 m

inut

e pe

riod

or p

art

ther

eof.

2004

.00

2006

.06

206.

000

1.0

R55

.88

206.

000

1.0

R55

.88

208.

000

1.0

R74

.65

208.

000

1.0

R74

.65

206.

000

1.0

R55

.88

206.

000

1.0

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.88

2018

.000

1.0

R16

7.77

2018

.000

1.0

R16

7.77

203.

250

1.0

R30

.36

203.

250

1.0

R30

.36

2080

.000

1.0

R74

5.89

2080

.000

1.0

R74

5.89

205.

000

1.0

R46

.64

205.

000

1.0

R46

.64

209.

000

1.0

R83

.89

209.

000

1.0

R83

.89

2014

.000

1.0

R13

0.52

2014

.000

1.0

R13

0.52

20 3

94.8

601.

0R

368

1.21

Z20

315.

890

1.0

R 2

945.

00Z

20 2

62.4

101.

0R

244

6.37

Z20

209.

930

1.0

R1

957.

12Z

2077

.810

1.0

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5.36

Z20

77.8

101.

0R

725.

36Z

2042

.650

1.0

R39

7.58

Z20

42.6

501.

0R

397.

58Z

Pag

e 13

of 8

7

STAATSKOERANT, 14 SEPTEMBER 2012 No. 35684 17

G12-101696—B

0024

Pre

-ope

rativ

e as

sess

men

ts n

ot fo

llow

ed b

y pr

oced

ures

: If a

pre

-ope

rativ

e as

sess

men

t of a

2006

.05

patie

nt b

y th

e an

aest

hesi

olog

ist/a

naes

thet

ist i

s no

t fol

low

ed b

y an

ope

ratio

n, it

will

be

rega

rded

as

a vi

sit a

t hos

pita

l or

nurs

ing

hom

e an

d th

e ap

prop

riate

hos

pita

l vis

it ite

m s

houl

d be

cha

rged

.

0025

Cal

cula

tion

of a

naes

thet

ic ti

me:

Ana

esth

etic

tim

e is

cal

cula

ted

from

the

time

the

2006

.05

anae

sthe

siol

ogis

t/ana

esth

etis

t beg

ins

to p

repa

re th

e pa

tient

for

the

indu

ctio

n of

ana

esth

esia

in th

eop

erat

ing

thea

tre

or in

a s

imila

r eq

uiva

lent

are

a an

d en

ds w

hen

the

anae

sthe

siol

ogis

t/ana

esth

etis

tis

no

long

er r

equi

red

to g

ive

his/

her

pers

onal

pro

fess

iona

l atte

ntio

n to

the

patie

nt, i

.e. w

hen

the

patie

nt m

ay, w

ith r

easo

nabl

e sa

fety

, be

plac

ed u

nder

the

cust

omar

y po

st-o

pera

tive

supe

rvis

ion.

Whe

re p

rolo

nged

per

sona

l pro

fess

iona

l atte

ntio

n is

nec

essa

ry fo

r th

e w

ell-b

eing

and

saf

ety

ofsu

ch p

atie

nt, t

he n

eces

sary

tim

e w

ill b

e va

lued

on

the

sam

e ba

sis

as in

dica

ted

abov

e fo

r th

ean

aest

hetic

tim

e. T

he a

naes

thes

iolo

gist

/ana

esth

etis

t mus

t sho

w o

n hi

s/he

r ac

coun

t the

exa

ctan

aest

hetic

tim

e, in

clud

ing

the

supe

rvis

ion

time

spen

t with

the

patie

nt.

0027

Mor

e th

an o

ne p

roce

dure

und

er th

e sa

me

anae

sthe

tic: W

here

mor

e th

an o

ne o

pera

tion

is20

06.0

4

perf

orm

ed u

nder

the

sam

e an

aest

hetic

, the

bas

ic a

naes

thet

ic u

nits

will

be

that

of t

he m

ajor

oper

atio

n w

ith th

e hi

ghes

t num

ber

of u

nits

0028

Indi

cato

r fo

r us

e of

low

flow

ana

esth

etic

tech

niqu

e le

ss th

an ll

itre/

min

ute:

Fre

sh g

as fl

ow o

f les

s20

06.0

6

than

1 li

tre/

min

ute

0029

Ass

ista

nt a

naes

thes

iolo

gist

s: W

hen

rend

ered

nec

essa

ry b

y th

e sc

ope

of th

e an

aest

hetic

, an

2006

.04

assi

stan

t ana

esth

esio

logi

st m

ay b

e em

ploy

ed. T

he r

emun

erat

ion

of th

e as

sist

ant

anae

sthe

siol

ogis

t sha

ll be

cal

cula

ted

on th

e sa

me

basi

s as

in th

e ca

se w

here

a g

ener

alpr

actit

ione

r ad

min

iste

rs th

e an

aest

hetic

0030

Indi

cato

r fo

r us

e of

low

flow

ana

esth

etic

tech

niqu

e 1-

2 lit

re/m

inut

e: F

resh

gas

flow

of 1

to 2

2006

.06

litre

/min

ute

0031

Intr

aven

ous

drip

s an

d tr

ansf

usio

ns: T

reat

men

t with

intr

aven

ous

drip

s an

d tr

ansf

usio

ns is

2006

.04

cons

ider

ed p

art o

f the

nor

mal

trea

tmen

t in

adm

inis

terin

g an

ana

esth

etic

. No

addi

tiona

l fee

s m

aybe

cha

rged

for

such

ser

vice

s w

hen

rend

ered

eith

er p

rior

to, o

r du

ring

actu

al th

eatr

e or

ope

ratin

gtim

e00

32P

atie

nts

in p

rone

pos

ition

: Ana

esth

esia

adm

inis

tere

d to

pat

ient

s in

the

pron

e po

sitio

n sh

all h

ave

a 20

06.0

4m

inim

um o

f 4,0

0 ba

sic

anae

sthe

tic u

nits

. Whe

n th

e ba

sic

anae

sthe

tic u

nits

for

the

proc

edur

e is

3,00

, one

ext

ra a

naes

thet

ic u

nit s

houl

d be

add

ed. I

f the

bas

ic a

naes

thet

ic u

nits

for

the

proc

edur

eis

4,0

0 or

mor

e, n

o ex

tra

units

sho

uld

be a

dded

0033

Par

ticip

atin

g in

gen

eral

car

e of

pat

ient

s. W

hen

an a

naes

thes

iolo

gist

/ana

esth

etis

t is

requ

ired

to20

06.0

5pa

rtic

ipat

e in

the

gene

ral c

are

of a

pat

ient

dur

ing

a su

rgic

al p

roce

dure

, but

doe

s no

t adm

inis

ter

the

anae

sthe

tic, s

uch

serv

ices

may

be

rem

uner

ated

at f

ull a

naes

thet

ic r

ate.

sub

ject

to th

epr

ovis

os o

f mod

ifier

003

5: A

naes

thet

ic a

dmin

iste

red

by a

n an

aest

hesi

olog

ist/a

naes

thet

ist a

ndm

odifi

er 0

036:

Ana

esth

etic

adm

inis

tere

d by

gen

eral

pra

ctiti

oner

s.00

34H

ead

and

neck

pro

cedu

res:

All

anae

sthe

tics

adm

inis

tere

d fo

r di

agno

stic

, sur

gica

l or

X-r

ay20

06.0

4pr

oced

ures

on

the

head

and

nec

k sh

all h

ave

a m

inim

um o

f 4,0

0 ba

sic

anae

sthe

tic u

nits

. Whe

nth

e ba

sic

anae

sthe

tic u

nits

for

the

proc

edur

e is

3,0

0, o

ne e

xtra

ana

esth

etic

uni

t sho

uld

be a

dded

.If

the

basi

c an

aest

hetic

uni

ts fo

r th

e pr

oced

ure

is 4

,00

or m

ore.

no

extr

a un

its s

houl

d be

add

ed

0035

Ana

esth

etic

adm

inis

tere

d by

an

anae

sthe

siol

ogis

t/ana

esth

etis

t: N

o an

aest

hetic

adm

inis

tere

d sh

all 2

006.

05ha

ve a

tota

l val

ue o

f les

s th

an 7

,00

anae

sthe

tic u

nits

(ba

sic

units

, tim

e un

its p

lus

appr

opria

tem

odifi

ers)

.00

36A

naes

thet

ic a

dmin

iste

red

by g

ener

al p

ract

ition

ers:

The

uni

ts (

basi

c un

its p

lus

time

plus

the

2006

.05

appr

opria

te m

odifi

ers)

use

d to

cal

cula

te th

e fe

e fo

r an

ana

esth

etic

adm

inis

tere

d by

a g

ener

alpr

actit

ione

r la

stin

g on

e ho

ur o

r le

ss, s

hall

be th

e sa

me

as th

at fo

r an

ana

esth

esio

logi

st. F

oran

aest

hetic

last

ing

mor

e th

an o

ne h

our,

the

units

use

d to

cal

cula

te th

e fe

e fo

r an

ana

esth

etic

adm

inis

tere

d by

a g

ener

al p

ract

ition

er w

ill b

e 4/

5 (8

0%)

of th

e to

tal n

umbe

r of

uni

ts (

basi

c un

itspl

us ti

me

[ref

er to

mod

ifier

002

3] p

lus

the

appr

opria

te m

odifi

ers)

app

licab

le to

an

anae

sthe

siol

ogis

t. P

leas

e no

te th

at th

e 4/

5 (8

0%)

prin

cipl

e w

ill b

e ap

plie

d to

all

anae

sthe

tics

adm

inis

tere

d by

gen

eral

pra

ctiti

oner

s w

ith th

e pr

ovis

o th

at n

o an

aest

hetic

with

a to

tal n

umbe

r of

units

hig

her

than

11.

00 w

ill b

e re

duce

d to

less

than

11,

00 u

nits

in to

tal.

The

mon

etar

y va

lue

of th

eun

it is

the

sam

e fo

r bo

th a

n an

aest

hesi

olog

ist/a

naes

thet

ist.

0037

Bod

y hy

poth

erm

ia: U

tilis

atio

n of

tota

l bod

y hy

poth

erm

ia: A

dd 3

,00

anae

sthe

tic u

nits

2006

.04

0038

Per

i-ope

rativ

e bl

ood

salv

age:

Add

4,0

0 an

aest

hetic

uni

ts fo

r in

tra-

oper

ativ

e bl

ood

salv

age

and

2006

.04

4,00

ana

esth

etic

uni

ts fo

r po

st-o

pera

tive

bloo

d sa

lvag

e

Pag

e 14

of 8

7

303.

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1.0

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50 No. 35684 GOVERNMENT GAZETTE, 14 SEPTEMBER 2012

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al b

one

2004

.00

407.

800

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R10

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toid

: Bila

tera

l20

04.0

040

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001.

0R

237.

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th: O

ne q

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ant

2004

.00

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700

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th: T

wo

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rant

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th: F

ull m

outh

2004

.00

4011

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5.34

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th: R

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ion

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ogra

phy

of th

e te

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175.

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ts: P

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2004

.00

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th: T

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y: P

er s

ide

2004

.00

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3371

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lisat

ion

of fo

reig

n bo

dy in

the

eye

2004

.00

4015

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tric

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t-na

sal s

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es: L

ater

al n

eck

2004

.00

406.

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3387

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illo-

faci

al c

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lom

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2004

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408.

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04.0

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intr

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tion

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ontr

ast m

ediu

m: A

DD

2004

.00

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001.

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145.

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Alim

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act

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(pl

us 8

0% fo

r ea

ch a

dditi

onal

gla

nd)

2004

,00

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T

3397

Intr

oduc

tion

of c

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ediu

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plus

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for

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al g

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: AD

D)

2004

.00

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Pag

e 61

of 8

7

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66 No. 35684 GOVERNMENT GAZETTE, 14 SEPTEMBER 2012

The

follo

win

g ru

les

are

appl

icab

le to

Sec

tion

19.8

(V

ascu

lar

stud

ies)

and

Sec

tion

19.1

420

04.0

0(I

nter

vent

iona

l Rad

iolo

gica

l Pro

cedu

res)

:

a.T

he m

achi

ne fe

e (it

ems

3536

to 3

550

incl

udes

the

cost

of t

he fo

llow

ing

i.A

ll ru

ns (

runs

may

not

be

bille

d fo

r se

para

tely

).ii.

All

him

cos

ts (

mod

ifier

008

4 is

not

app

licab

le).

iiiA

ll flu

oros

copy

(ite

m 3

601

does

not

app

ly).

iv A

ll m

inor

con

sum

able

s (d

efin

ed a

s an

y ite

m o

ther

than

cat

hete

rs, g

uide

wire

s, in

trod

ucer

set

s,sp

ecia

lised

cat

hete

rs, b

allo

on c

athe

ters

, ste

nts,

em

bolic

age

nts,

dru

gs a

nd c

ontr

ast m

edia

).

b. T

he m

achi

ne fe

e (it

ems

3536

to 3

550)

may

onl

y be

bill

ed fo

r as

a o

nce

off f

ee p

er c

ase

per

day

by th

e ow

ner

of th

e eq

uipm

ent a

nd is

onl

y ap

plic

able

to r

adio

logy

pra

ctic

es.

c.If

a pr

oced

ure

is p

erfo

rmed

by

a no

n-ra

diol

ogis

t tog

ethe

r w

ith a

rad

iolo

gist

as

a te

am, i

n a

faci

lity

owne

d by

the

radi

olog

ist,

each

mem

ber

of th

e te

am w

ill fe

e at

thei

r re

spec

tive

full

rate

s as

per

mod

ifier

s an

d th

e ap

plic

able

item

s.

d.If

a pr

oced

ure

is p

erfo

rmed

by

a no

n-ra

diol

ogis

ts a

nd a

rad

iolo

gist

as

a te

am, i

n a

faci

lity

not

owne

d by

the

radi

olog

ist,

mod

ifier

s 63

01 a

nd 6

302

appl

ies.

Ple

ase

note

: M

odifi

er 0

083

is n

ot a

pplic

able

to s

ectio

n 19

.8 (

Vas

cula

r S

tudi

es)

and

sect

ion

19.1

4(I

nter

vent

iona

l Rad

iolo

gica

l Pro

cedu

res)

MO

DIF

IER

GO

VE

RN

ING

VA

SC

ULA

R S

TU

DIE

S00

86V

ascu

lar

grou

ps: "

Film

ser

ies"

and

"In

trod

uctio

n of

Con

tras

t Med

ia"

are

com

plem

enta

ry a

ndto

geth

er c

onst

itute

a s

ingl

e ex

amin

atio

n: n

eith

er fe

e is

ther

efor

e su

bjec

t to

incr

ease

in te

rms

ofM

odifi

er 0

080:

Mul

tiple

exa

min

atio

ns63

00If

a pr

oced

ure

last

s le

ss th

an 3

0 m

inut

es, o

nly

50%

of t

he m

achi

ne fe

es fo

r ite

ms

3536

-355

0 w

illbe

allo

wed

(sp

ecify

tim

e of

pro

cedu

re o

n ac

coun

t)63

01If

a pr

oced

ure

is p

erfo

rmed

by

a ra

diol

ogis

t in

a fa

cilit

y no

t ow

ned

by h

imse

lf, th

e fe

e w

ill b

ere

duce

d by

40%

(i.e

. 60%

of t

he fe

e w

ill b

e ch

arge

d)63

02W

hen

the

proc

edur

e is

per

form

ed b

y a

non-

radi

olog

ist,

the

fee

will

be

redu

ced

by 4

0% (

i.e. 6

0%of

the

fee

will

be

char

ged)

6303

Whe

n a

proc

edur

e is

per

form

ed e

ntire

ly b

y a

non-

radi

olog

ist i

n a

faci

lity

owne

d by

a r

adio

logi

st,

the

radi

olog

ist o

wni

ng th

e fa

cilit

y m

ay c

harg

e 55

% o

f the

pro

cedu

re u

nits

use

d. M

odifi

er 6

302

appl

ies

to th

e no

n ra

diol

ogis

t per

form

ing

the

proc

edur

e63

05W

hen

mul

tiple

cat

hete

risat

ion

proc

edur

es a

re u

sed

(item

s 35

57, 3

559,

356

0, 3

562)

and

an

angi

ogra

m in

vest

igat

ion

is p

erfo

rmed

at e

ach

leve

l, th

e un

it va

lue

of e

ach

such

mul

tiple

proc

edur

e w

ill b

e re

duce

d by

20,

00 r

adio

logi

cal u

nits

for

each

pro

cedu

re a

fter

the

initi

alca

thet

eris

atio

n. T

he fi

rst c

athe

teris

atio

n is

cha

rged

at 1

00%

of t

he u

nit v

alue

19.8

.1 V

ascu

lar

stud

ies:

Film

Ser

ies

Not

e: In

the

case

of s

elec

tive

cath

eter

isat

ion

of a

bra

nch

of th

e ao

rta,

the

fee

for

cath

eter

isat

ion

ofth

e ao

rta

is n

ot a

dded

.35

36D

edic

ated

ang

iogr

aphy

sui

te: A

nalo

gue

mon

opla

ne u

nit.

Onc

e of

f cha

rge

per

patie

nt b

y ow

ner

ofeq

uipm

ent

3537

Ded

icat

ed a

ngio

grap

hy s

uite

: Dig

ital m

onop

lane

uni

t. O

nce

off c

harg

e pe

r pa

tient

by

owne

r of

equi

pmen

t35

38A

nalo

gue

mon

opla

ne ta

ble

with

GS

A a

ttach

men

t35

39D

edic

ated

ang

iogr

aphy

sui

te: D

igita

l bi-p

lane

uni

t Onc

e of

f cha

rge

per

patie

nt b

y ow

ner

ofeq

uipm

ent

3540

Rad

iogr

aphy

fee

for

coro

nary

cat

hete

risat

ion

labo

rato

ry, p

er r

adio

grap

her,

per

hal

f hou

r or

par

tth

ereo

f35

45V

enog

raph

y: P

er li

mb

3548

Ana

logu

e m

onop

lane

scr

eeni

ng ta

ble

3550

Dig

ital m

onop

lane

scr

eeni

ng ta

ble

3551

Lym

phan

giog

ram

per

lim

b (g

loba

l fee

) in

clud

ing

lym

phat

ic c

athe

teris

atio

n (n

o m

achi

ne fe

eap

plic

able

)35

57C

athe

teris

atio

n ao

rta

or v

ena

cava

, any

leve

l, an

y ro

ute,

with

aor

togr

am/c

avog

ram

3558

Tra

nslu

mba

r ao

rtic

pun

ctur

e, w

ith fu

ll st

udy

2004

.00

2004

.00

2004

.00

2004

.00

2004

,00

2004

.00

2004

.00

2004

.00

2004

.00

2004

.00

2004

.00

2004

.00

2004

.00

4016

.500

1.0

R21

7.93

2004

.00

2004

.00

2004

.00

4016

6.80

01.

0 R

2 20

2.77

2004

.00

4048

.600

1.0

R64

1.77

304.

000

1.0

R23

4.06

T

2004

.00

4069

.600

1.0

R91

9.09

305.

000

1.0

R29

2.58

T

Pag

e 63

of 8

7

STAATSKOERANT, 14 SEPTEMBER 2012 No. 35684 67

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rS

AS

CR

O (

to b

e us

ed in

con

junc

tion

with

item

579

0) -

(no

t app

licab

le to

ora

l hor

mon

al th

erap

y) -

only

one

of t

he p

artie

s ar

e to

cha

rge

this

fee

Non

-infu

sion

al c

hem

othe

rapy

: Con

sulta

tions

are

cha

rged

sep

arat

ely.

Non

-infu

sion

al c

hem

othe

rapy

: In

the

case

of i

ntra

mus

cula

r (I

MO

, sub

cuta

neou

s, in

trat

heca

l or

bolu

s ch

emot

hera

py a

dmin

istr

atio

n th

e m

anag

emen

t fee

can

onl

y be

cha

rged

onc

e pe

r tr

eatm

ent

day.

Con

sulta

tions

are

cha

rged

sep

arat

ely.

2004

.00

2004

.00

2004

.00

2004

.00

2005

.03

2004

.11

2004

.11

2004

.11

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1.0

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2005

.03

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8.34

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24.4

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2005

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30.6

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0R

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39Z

2005

.05

2004

.11

Pag

e 71

of 8

7

STAATSKOERANT, 14 SEPTEMBER 2012 No. 35684 75

5793

Infu

sion

al C

hem

othe

rapy

: Glo

bal f

ee fo

r th

e m

anag

emen

t of a

nd fo

r se

rvic

es d

eliv

ered

dur

ing

2004

.11

infu

sion

al c

hem

othe

rapy

per

trea

tmen

t day

- fo

r ex

clus

ive

use

by d

octo

rs w

ith a

ppro

pria

teon

colo

gy tr

aini

ng u

sing

rec

ogni

sed

chem

othe

rapy

faci

litie

s(co

nsul

tatio

ns to

be

char

ged

sepa

rate

ly)

5794

Infu

sion

al C

hem

othe

rapy

Fac

ility

Fee

: A fa

cilit

y w

here

onc

olog

y m

edic

ines

are

pro

cure

d, s

tore

d,20

05.0

3

adm

ixed

and

adm

inis

tere

d, a

nd in

whi

ch a

ppro

pria

tely

-tra

ined

med

ical

, nur

sing

and

sup

port

sta

ffar

e in

atte

ndan

ce. T

his

fee

is c

harg

eabl

e by

doc

tors

with

app

ropr

iate

onc

olog

y tr

aini

ng w

ho o

wns

or r

ents

the

faci

lity,

and

by

othe

rs e

.g. h

ospi

tals

or

clin

ics

that

pro

vide

the

serv

ices

as

per

the

appr

opria

te b

illin

g st

ruct

ure.

Sai

d fa

cilit

ies

are

to b

e ac

cred

ited

unde

r th

e au

spic

es o

f SA

SM

Oan

d/or

SA

SC

RO

(to

be

used

in c

onju

nctio

n w

ith it

em 5

793)

- o

nly

one

of th

e pa

rtie

s ar

e to

cha

rge

this

fee

5795

Infu

sion

al C

hem

othe

rapy

Fac

ility

Fee

: A fa

cilit

y w

here

onc

olog

y m

edic

ines

are

pur

chas

ed, s

tore

d, 2

004.

11di

spen

sed,

adm

ixed

and

adm

inis

tere

d an

d in

whi

ch a

ppro

pria

tely

-tra

ined

med

ical

, nur

sing

and

supp

ort s

taff

are

in a

ttend

ance

. Thi

s fe

e is

cha

rgea

ble

by d

octo

rs w

ith a

ppro

pria

te o

ncol

ogy

trai

ning

who

ow

ns o

r re

nts

the

faci

lity,

and

by

othe

rs e

.g. h

ospi

tals

or

clin

ics

that

pro

vide

the

serv

ices

as

per

the

appr

opria

te b

illin

g st

ruct

ure.

Sai

d fa

cilit

ies

are

to b

e ac

cred

ited

unde

r th

eau

spic

es o

f SA

SM

O a

nd/o

r S

AS

CR

O (

to b

e us

ed in

con

junc

tion

with

item

579

3) -

onl

y on

e of

the

part

ies

are

to c

harg

e th

is fe

eIte

m 5

795

is c

harg

eabl

e in

add

ition

to it

em 5

793

by th

e O

ncol

ogis

t who

ow

ns o

r re

nts

the

2004

.11

chem

othe

rapy

faci

lity,

and

by

othe

rs e

.g. h

ospi

tals

or

clin

ics

that

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vide

the

serv

ices

as

per

the

appr

opria

te b

illin

g st

ruct

ure.

Sai

d fa

cilit

ies

are

to b

e ac

cred

ited

unde

r th

e au

spic

es o

f SA

SM

Oan

d/or

SA

SC

RO

(on

ly to

be

adde

d to

item

579

3 if

own

or r

ente

d fa

cilit

y is

use

d).

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rapy

Pla

nnin

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ume

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CH

NIC

AL

CO

MP

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OM

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CH

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phic

Pla

nnin

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.03

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5610

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.11.

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Pag

e 72

of 8

7

76 No. 35684 GOVERNMENT GAZETTE, 14 SEPTEMBER 2012

5621

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STAATSKOERANT, 14 SEPTEMBER 2012 No. 35684 91

Medical Practitioners 2006

GUIDELINE TARIFFS FOR SERVICES BY MEDICAL PRACTITIONERS

Published in terms of Section 53 (3) (d) of the HEALTH PROFESSIONS ACT (56 OF 1974)

Note that this schedule is based on the 2006 NHRPL which was inflated by 46.66%.The 2006 NHRPL is available in database format at http://www.hpcsa.co.za

Rand Conversion FactorsCode Description RCF

10 Consultative Services 15.0542211 Psychiatrists 17.9536112 Consultative Services (Paediatrics and Paediatric Cardiologists) 15.0542220 Clinical Procedures 9.32291130 Anaesthesiologists 58.5083540 Radiology 13.2063650 Radiation Oncology 11.3291660 Ultrasound 8.88587770 Computed Tomography 10.4873675 Magnetic Resonance Imaging 10.0503280 Clinical Pathology 10.7777490 Anatomical Pathology - Cytology 12.4290895 Anatomical Pathology - Histology 11.7662

100 Human Genetics 11.03878130 GP Consultative Services (items 0190 - 0192, 0173-0175) 16.87569

20 Feb 2006 Page 1 of 1 Version 2006,06

92 No. 35684 GOVERNMENT GAZETTE, 14 SEPTEMBER 2012

Medical Practitioners 2006

Code Description10000 Specialists10008 Specialist Radiologist/Nuclear Physicians10099 General Practitioners / non-designated Specialists11000 Anaesthesiology11200 Dermatology11400 General Medical Practice11600 Obstetrics and Gynaecology11700 Pulmonology11800 Medicine (Specialist Physician)11900 Gastroenterology12000 Neurology12100 Cardiology12200 Psychiatry12300 Medical Oncology12400 Neurosurgery12500 Nuclear Medicine12600 Opthalmology12800 Orthopaedics13000 Otorhinolaryngology13100 Rheumatology13200 Paediatrics13300 Paediatric Cardiology13400 Physical Medicine13600 Plastic and Reconstructive Surgery13800 Radiology14000 Radiation Oncology14200 Surgery14400 Cardiothoracic Surgery14600 Urology15200 Pathology (Clinical)15300 Pathology (Anatomical)

STAATSKOERANT, 14 SEPTEMBER 2012 No. 35684 93

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CT

ITIO

NE

RS

2540

026

200

2640

029

200

2940

029

800

Pub

lishe

d In

term

s of

Sec

tion

53 (

3) (

d) o

f the

HE

ALT

H P

RO

FE

SS

ION

S A

CT

(56

OF

197

4)

Not

e th

at th

is s

ched

ule

is b

ased

on

the

2006

NH

RP

L w

hich

was

infla

ted

by 4

6.66

%.

Ver

sion

Add

Val

ueV

alue

Val

ueV

alue

Val

ueV

alue

MP

Lab

TC

The

200

6 N

HR

PL

is a

vaila

ble

in d

atab

ase

form

at a

t http

://w

ww

.hpc

sa.c

o.za

In te

rms

of s

ectio

n 53

(1)

of th

e H

ealth

Pro

fess

ions

Act

, 197

4 (A

ct N

o. 5

6 of

197

4) e

very

per

son

regi

ster

ed u

nder

the

Act

(in

this

sec

tion

refe

rred

to a

s th

e pr

actit

ione

r) s

hall,

unl

ess

the

circ

umst

ance

s re

nder

it im

poss

ible

for

him

or

her

to d

o so

, bef

ore

rend

erin

g an

y pr

ofes

sion

al s

ervi

ces

info

rm th

e pe

rson

to w

hom

the

serv

ices

are

to b

e re

nder

ed o

r an

y pe

rson

resp

onsi

ble

for

the

mai

nten

ance

of s

uch

pers

on, o

f the

fee

whi

ch h

e or

she

inte

nds

to c

harg

e fo

r su

ch s

ervi

ces

-

(a)

whe

n so

req

uest

ed b

y th

e pe

rson

con

cern

ed; o

r

(b)

whe

n su

ch fe

e ex

ceed

s th

e G

uide

line

Tar

iffs

for

such

ser

vice

s,

and

shal

l in

a ca

se to

whi

ch p

arag

raph

(b)

rel

ates

, als

o in

form

the

pers

on c

once

rned

of t

he u

sual

fee.

Eve

ry p

erso

n re

gist

ered

und

er th

e A

ct s

hall,

unl

ess

the

circ

umst

ance

s re

nder

it im

poss

ible

for

him

or

her

to d

o so

, bef

ore

rend

erin

g an

y pr

ofes

sion

al s

ervi

ces

also

info

rm th

epe

rson

to w

hom

the

serv

ices

are

to b

e re

nder

ed o

r an

y pe

rson

res

pons

ible

for

the

mai

nten

ance

of s

uch

pers

on, o

f the

fee

whi

ch h

e or

she

inte

nds

to c

harg

e fo

r su

ch s

ervi

ces

ifsu

ch fe

e ex

ceed

s th

e m

edic

al a

id r

ates

.

The

follo

win

g gu

idel

ine

tarif

f lis

t is

not a

set

of t

ariff

s th

at m

ust b

e ap

plie

d by

med

ical

sch

emes

2005

.02

and/

or p

rovi

ders

. It i

s ra

ther

inte

nded

to s

erve

as

a no

rm fo

r th

e de

term

inat

ion

of th

e et

hica

l fee

sch

arge

d by

med

ical

pra

ctiti

oner

s. T

hese

tarif

fs r

efle

cts

the

opin

ion

of th

e M

edic

al a

nd D

enta

lB

oard

on

the

amou

nts

that

sho

uld

be c

harg

ed fo

r th

e re

spec

tive

serv

ices

in in

stan

ces

whe

re a

prac

titio

ner

and

a pa

tient

hav

e no

t agr

eed

to a

n al

tern

ativ

e fe

e.T

he e

xist

ence

of a

cod

e in

this

pub

licat

ion

does

not

mea

n th

at th

e pr

oced

ure

will

be

reim

burs

ed b

y 20

05.0

2m

edic

al s

chem

es. M

edic

al s

chem

es h

ave

the

right

to li

mit

the

scop

e, th

e fr

eque

ncy

and/

orco

mbi

natio

ns o

f den

tal p

roce

dure

s th

at is

cov

ered

or

reim

burs

ed. I

t is

the

resp

onsi

bilit

y of

the

patie

nt to

kno

w w

hat p

roce

dure

s ar

e co

vere

d an

d w

hat a

re e

xclu

ded

from

his

/her

den

tal b

enef

itpl

an, a

nd n

ot th

at o

f the

den

tal o

ffice

. Cer

tain

med

ical

sch

emes

may

req

uire

pre

dete

rmin

atio

n fo

rpa

rtic

ular

pro

cedu

res

and/

or w

hen

char

ges

are

expe

cted

to e

xcee

d a

cert

ain

amou

nt,

The

sch

edul

e in

clud

es p

roce

dure

s an

d se

rvic

es fo

r us

e by

Ora

l Hea

lth C

are

Pro

vide

rs fo

rpu

rpos

es o

f kee

ping

acc

urat

e pa

tient

rec

ords

, rep

ortin

g pr

oced

ures

on

patie

nts,

and

pro

cess

ing

oral

hea

lth c

are

rela

ted

insu

ranc

e cl

aim

s. T

he p

roce

dure

s ar

e th

ose

perf

orm

ed b

y ge

nera

l den

tal

prac

titio

ners

, ora

l pat

holo

gist

s, p

rost

hodo

ntis

ts, p

erio

dont

ists

, ort

hodo

ntis

ts, m

axilt

o -f

acia

l and

ora

lsu

rgeo

ns a

nd d

enta

l the

rapi

sts.

The

pro

cedu

res

code

s lis

ted

in th

e sc

hedu

le h

ave,

for

the

conv

enie

nce

in u

sing

the

sche

dule

, bee

ndi

vide

d in

to c

ateg

orie

s of

ser

vice

s, b

ased

on

the

bran

ches

of c

linic

al d

enta

l pra

ctic

e. T

hepr

oced

ures

are

gro

uped

und

er th

e ca

tego

ry o

f ser

vice

with

whi

ch th

e pr

oced

ures

are

mos

tfr

eque

ntly

iden

tifie

d an

d sh

ould

not

be

inte

rpre

ted

as e

xclu

ding

cer

tain

cat

egor

ies

of O

ral H

ealth

Car

e P

rovi

ders

from

per

form

ing

such

pro

cedu

res.

Indi

vidu

al p

roce

dure

cod

es c

onsi

st o

f apr

oced

ure

code

, pro

cedu

re d

escr

iptio

n (n

omen

clat

ure)

, and

whe

n ne

cess

ary,

a d

escr

ipto

r, th

atpr

ovid

es fu

rthe

r de

finiti

on a

nd/o

r gu

idel

ines

to c

larif

y th

e in

tend

ed u

se o

f the

pro

cedu

re c

ode.

I.IN

TR

OD

UC

TIO

NA

.A

dmin

istr

ativ

e an

d in

voic

ing

nile

s00

1In

voic

es:

a.A

pra

ctiti

oner

sha

ll re

nder

a m

onth

ly in

voic

e fo

r ev

ery

proc

edur

e w

hich

has

bee

n co

mpl

eted

irres

pect

ive

of w

heth

er th

e to

tal t

reat

men

t pla

n ha

s be

en c

oncl

uded

.

2006

.03

2005

.02

2005

.02

b.A

n in

voic

e sh

all c

onta

in th

e fo

llow

ing

part

icul

ars:

2005

.02

Pag

e 1

of 2

6

94 No. 35684 GOVERNMENT GAZETTE, 14 SEPTEMBER 2012

GU

IDE

LIN

E T

AR

IFF

S F

OR

SE

RV

ICE

S B

Y D

EN

TA

L P

RA

CT

ITIO

NE

RS

2540

026

200

2640

029

200

2940

029

800

Pub

lishe

d in

term

s of

Sec

tion

53 (

3) (

d) o

f the

HE

ALT

H P

RO

FE

SS

ION

S A

CT

(56

OF

197

4)

Not

e th

at th

is s

ched

ule

is b

ased

on

the

2006

NH

RP

L w

hich

was

infla

ted

by 4

6.66

%.

Ver

sion

Add

Val

ueV

alue

Val

ueV

alue

Val

ueT

he 2

006

NH

RP

L is

ava

ilabl

e in

dat

abas

e fo

rmat

at h

ttp://

ww

w.h

pcsa

.co.

zai.

The

sur

nam

e an

d in

itial

s of

the

mem

ber;

2006

.03

-

ii. T

he fi

rst n

ame

of th

e pa

tient

;iii

. The

nam

e of

the

sche

me;

iv. T

he m

embe

rshi

p nu

mbe

r of

the

mem

ber;

v. T

he p

ract

ice

num

ber;

vi. T

he d

ate

on w

hich

eve

ry s

ervi

ce w

as r

ende

red;

vii.

The

cod

e nu

mbe

r, d

escr

iptio

n an

d fe

e/be

nefit

of t

he p

roce

dure

or

serv

ice;

viii.

The

nam

e of

the

dent

ist r

ende

ring

the

serv

ice;

ix. T

he n

ame

of th

e ge

nera

l den

tal p

ract

ition

er/s

peci

alis

t ass

ista

nt (

whe

n ap

plic

able

);x.

The

app

ropr

iate

ICD

-10

code

(s)

for

the

proc

edur

es p

erfo

rmed

.N

ote:

Pho

toco

pies

of o

rigin

al in

voic

es s

hall

be c

ertif

ied

by w

ay o

f a r

ubbe

r st

amp

or th

e si

gnat

ure

2005

.02

of th

e de

ntis

t.00

2C

ost o

f dire

ct m

ater

ials

:20

05.0

2

The

exp

ense

s in

curr

ed fo

r di

rect

mat

eria

ls id

entif

ied

in th

e S

ched

ule

may

be

bille

d in

add

ition

toth

e pr

oced

ure

code

. The

se e

xpen

ses

are

limite

d to

the

net a

cqui

sitio

n co

st o

f the

mat

eria

ls a

nd a

hand

ling

fee.

The

pric

e of

the

mat

eria

ls s

houl

d be

VA

T in

clus

ive.

Use

Mod

ifier

802

5 fo

r ha

ndlin

gfe

e.00

3D

enta

l lab

orat

ory

serv

ices

:20

05.0

2

Man

ual s

ubm

issi

on o

f inv

oice

s. F

ees

char

ged

by d

enta

l tec

hnic

ians

for

labo

rato

ry s

ervi

ces

(PLU

S20

05.0

2

L) s

hall

be in

dica

ted

on th

e de

ntis

t's in

voic

e by

rep

ortin

g co

de 8

099

- D

enta

l lab

orat

ory

serv

ice

with

the

appr

opria

te la

bora

tory

fee

on th

e lin

e fo

llow

ing

the

rele

vant

den

tal p

roce

dure

cod

e.T

he te

chni

cian

's in

voic

e sh

all b

e ce

rtifi

ed b

y th

e de

ntis

t (or

a p

erso

n ap

poin

ted

by th

e de

ntis

t) fo

rco

rrec

tnes

s by

mea

ns o

f a s

igna

ture

. The

orig

inal

invo

ice

of th

e de

ntal

tech

nici

an (

or a

cop

yth

ereo

f) s

hall

acco

mpa

ny th

e in

voic

e of

the

dent

ist a

nd a

cop

y (o

r th

e or

igin

al)

shal

l be

filed

by

the

dent

ist f

or r

ecor

d pu

rpos

es.

Ele

ctro

nic

subm

issi

on o

f inv

oice

s. F

ees

char

ged

by d

enta

l tec

hnic

ians

for

labo

rato

ry s

ervi

ces

2005

.02

(PLU

S L

) sh

all b

e in

dica

ted

on th

e de

ntis

t's in

voic

e by

sub

mitt

ing

code

809

9 -

Den

tal l

abor

ator

yse

rvic

e w

ith th

e ap

prop

riate

labo

rato

ry fe

e on

the

line

follo

win

g th

e re

leva

nt d

enta

l pro

cedu

re c

ode

on th

e da

te o

n w

hich

the

dent

al p

roce

dure

was

ren

dere

d. T

he la

bora

tory

fee

shal

l be

subm

itted

for

paym

ent o

n th

e da

te o

n w

hich

the

proc

edur

e co

de is

sub

mitt

ed fo

r pa

ymen

t, an

d th

e ap

prop

riate

dent

al la

bora

tory

ser

vice

cod

es s

hall

be r

epor

ted

on th

e lin

es fo

llow

ing

code

809

9.T

he te

chni

cian

's in

voic

e sh

all b

e ce

rtifi

ed b

y th

e de

ntis

t (or

a p

erso

n ap

poin

ted

by th

e de

ntis

t) fo

rco

rrec

tnes

s by

mea

ns o

f a s

igna

ture

. The

orig

inal

invo

ice

of th

e de

ntal

tech

nici

an s

hall

be fi

led

byth

e de

ntis

t for

rec

ord

purp

oses

.

005

Pro

cedu

re a

ccom

pani

ed b

y un

usua

l circ

umst

ance

s:In

exc

eptio

nal c

ases

whe

re th

e pr

opos

ed fe

e/be

nefit

is d

ispr

opor

tiona

tely

low

in r

elat

ion

to th

eac

tual

ser

vice

s re

nder

ed b

y a

prac

titio

ner,

suc

h hi

gher

fee

as m

ay b

e m

utua

lly a

gree

d up

onbe

twee

n th

e de

ntal

pra

ctiti

oner

and

the

patie

nt/m

edic

al s

chem

e m

ay b

e bi

lled.

Use

Mod

ifier

801

1w

ith a

nar

rativ

e de

scrip

tion.

Und

er c

erta

in c

ircum

stan

ces

a se

rvic

e or

pro

cedu

re is

par

tially

red

uced

or

elim

inat

ed a

t the

prac

titio

ner's

ele

ctio

n. U

nder

thes

e ci

rcum

stan

ces

a lo

wer

fee

may

be

bille

d. T

he s

ervi

ce p

rovi

ded

can

be id

entif

ied

by it

s us

ual p

roce

dure

cod

e an

d th

e ad

ditio

n of

Mod

ifier

801

2, s

igni

fyin

g th

ese

rvic

e is

red

uced

.

B.

Gen

eral

cod

ing

rule

s

2005

.02

Pag

e 2

of 2

6

Val

ueM

P L

ab T

C

STAATSKOERANT, 14 SEPTEMBER 2012 No. 35684 95

GU

IDE

LIN

E T

AR

IFF

S F

OR

SE

RV

ICE

S B

Y D

EN

TA

L P

RA

CT

ITIO

NE

RS

2540

026

200

2640

029

200

2940

029

800

Pub

lishe

d in

term

s of

Sec

tion

53 (

3) (

d) o

f the

HE

ALT

H P

RO

FE

SS

ION

S A

CT

(56

OF

197

4)

Not

e th

at th

is s

ched

ule

is b

ased

on

the

2006

NH

RP

L w

hich

was

infla

ted

by 4

6.66

%.

Ver

sion

Add

Val

ueV

alue

Val

ueV

alue

Val

ueT

he 2

006

NH

RP

L is

ava

ilabl

e in

dat

abas

e fo

rmat

at h

ttp://

ww

w.h

pcsa

.co.

za00

6T

he s

ched

ule

does

not

pre

scrib

e th

e sc

ope

of p

ract

ice

of a

par

ticul

ar c

ateg

ory

of O

ral H

ealth

Car

e 20

06.0

3P

rovi

der;

nei

ther

doe

s it

conf

ine

the

perf

orm

ing

of p

roce

dure

s or

ser

vice

s to

a r

egis

tere

d sp

ecia

lity.

Fee

s lis

ted

with

in a

col

umn

of a

par

ticul

ar c

ateg

ory

of O

ral H

ealth

Car

e P

rovi

der

are

cust

omar

yfe

es, s

houl

d th

e pr

oced

ure

or s

ervi

ce b

e re

nder

ed b

y th

at p

rovi

der

cate

gory

.S

peci

alis

ts a

re h

owev

er e

ncou

rage

d to

con

fine

thei

r pr

actic

e to

the

spec

ialit

y or

rel

ated

spe

cial

ities

in w

hich

they

are

reg

iste

red.

Spe

cial

ist m

ay c

harg

e fe

es fo

r pr

oced

ures

or

serv

ices

whi

ch u

sual

lype

rtai

n to

som

e ot

her

spec

ialit

y, if

suc

h pr

oced

ures

or

serv

ices

are

als

o re

cogn

ised

in th

eir

spec

ialit

y, a

nd if

it is

car

ried

out o

nly

for

thei

r bo

na fi

de p

atie

nts.

Suc

h fe

es s

hall

not b

e hi

gher

than

thos

e ch

arge

d by

gen

eral

pra

ctiti

oner

s fo

r th

e sa

me

proc

edur

es o

r se

rvic

es (

HP

CS

A, R

ule

25).

Fee

s fo

r pr

oced

ures

or

serv

ices

not

list

ed w

ithin

the

colu

mn

of d

enta

l the

rapi

sts

that

do

fall

with

inth

e fie

ld o

f den

tal t

hera

py in

term

s of

thei

r sc

ope

of p

ract

ice

are

rega

rded

as

bein

g "b

yar

rang

emen

t" u

ntil

such

fees

are

list

ed.

007

Pro

cedu

res

not l

iste

d in

the

Den

tal S

ched

ule

2005

.02

Whe

n a

proc

edur

e is

per

form

ed th

at is

not

list

ed in

the

sche

dule

, an

appr

opria

te p

roce

dure

cod

e,20

06.0

3lis

ted

in th

e N

HR

PL

for

med

ical

pra

ctiti

oner

s m

ay b

e re

port

ed.

Unl

iste

d pr

oced

ures

. Any

pro

cedu

re th

at is

nei

ther

des

crib

ed in

the

sche

dule

, nor

in th

e m

edic

al20

06.0

3sc

hedu

le, s

houl

d be

rep

orte

d us

ing

code

909

9 -

Unl

iste

d de

ntal

pro

cedu

re o

r se

rvic

e. T

he fe

e fo

ran

unl

iste

d de

ntal

pro

cedu

re o

r se

rvic

e sh

ould

be

base

d on

the

fee

of a

com

para

ble

proc

edur

e.C

ode

9099

cod

es s

houl

d no

t be

used

to r

epor

t pro

cedu

res

whe

re th

e fe

e is

det

erm

ined

"by

arra

ngem

ent"

with

the

patie

nt a

nd/o

r m

edic

al s

chem

e.C

.S

ervi

ces

rule

s00

8O

ral e

valu

atio

ns a

nd c

ompl

etio

n of

trea

tmen

t pla

ns:

2006

.03

Ora

l exa

min

atio

ns in

clud

e an

exa

min

atio

n, d

iagn

osis

and

trea

tmen

t pla

nnin

g (w

hen

trea

tmen

t is

requ

ired)

. No

furt

her

fees

/ben

efits

sha

ll be

levi

ed fo

r an

ora

l exa

min

atio

n (c

ode

8101

) or

com

preh

ensi

ve e

xam

inat

ion

(cod

e 81

02)

until

the

trea

tmen

t pla

n re

sulti

ng fr

om th

ese

type

of

exam

inat

ions

is c

ompl

eted

.T

he c

ompl

etio

n of

a tr

eatm

ent p

lan

effe

cted

from

an

oral

exa

min

atio

n an

d/or

com

preh

ensi

veex

amin

atio

n sh

ould

be

indi

cate

d by

rep

ortin

g co

de 8

120

- T

reat

men

t pla

n co

mpl

eted

.

Ora

l dia

gnos

is d

efin

ed. T

he d

eter

min

atio

n by

the

dent

ist o

f the

ora

l hea

lth c

ondi

tion

of a

nin

divi

dual

pat

ient

ach

ieve

d th

roug

h th

e ev

alua

tion

of d

ata

gath

ered

by

mea

ns o

f his

tory

taki

ng,

dire

ct e

xam

inat

ion,

pat

ient

con

fere

nce,

and

suc

h cl

inic

al a

ids

and

test

s as

may

be

nece

ssar

y in

the

judg

emen

t of t

he d

entis

t.

Tre

atm

ent p

lan

defin

ed. T

he tr

eatm

ent p

lan

is th

e se

quen

tial g

uide

for

the

patie

nt's

car

e as

dete

rmin

ed b

y th

e de

ntis

t's d

iagn

osis

and

is u

sed

by th

e de

ntis

ts fo

r th

e re

stor

atio

n an

d/or

mai

nten

ance

of o

ptim

al o

ral h

ealth

009

Sur

gery

gui

delin

es:

1.F

ollo

w-u

p ca

re fo

r th

erap

eutic

sur

gica

l pro

cedu

res:

The

fee/

bene

fit fo

r an

ope

ratio

n sh

all,

unle

ss o

ther

wis

e st

ated

, inc

lude

nor

mal

pos

t-op

erat

ive

care

for

a pe

riod

not e

xcee

ding

four

mon

ths.

If a

pra

ctiti

oner

doe

s no

t him

/her

self

com

plet

e th

e po

st-o

pera

tive

care

, he/

she

shal

lar

rang

e fo

r po

st-o

pera

tive

care

with

out a

dditi

onal

cha

rges

. A fe

e/be

nefit

for

post

-ope

rativ

etr

eatm

ent o

f a p

rolo

nged

or

spec

ialis

ed n

atur

e m

ay b

e ch

arge

d as

agr

eed

upon

bet

wee

n th

epr

actit

ione

r an

d th

e sc

hem

e.

2005

.02

2005

.02

Pag

e 3

of 2

6

Val

ueM

P L

ab T

C

96 No. 35684 GOVERNMENT GAZETTE, 14 SEPTEMBER 2012

GU

IDE

LIN

E T

AR

IFF

S F

OR

SE

RV

ICE

S B

Y D

EN

TA

L P

RA

CT

ITIO

NE

RS

2540

026

200

2640

029

200

2940

029

800

Pub

lishe

d in

term

s of

Sec

tion

53 (

3) (

d) o

f the

HE

ALT

H P

RO

FE

SS

ION

S A

CT

(56

OF

197

4)

Not

e th

at th

is s

ched

ule

is b

ased

on

the

2006

NH

RP

L w

hich

was

infla

ted

by 4

6.66

%.

The

200

6 N

HR

PL

is a

vaila

ble

in d

atab

ase

form

at a

t http

://w

ww

.hpc

sa.c

o.za

2.M

ultip

le P

roce

dure

s (M

axill

o -f

acia

l and

ora

l sur

gery

): T

he fe

e/be

nefit

for

mor

e th

an o

neop

erat

ion

or p

roce

dure

per

form

ed th

roug

h th

e sa

me

inci

sion

sha

ll be

det

erm

ined

as

the

fee

for

the

maj

or o

pera

tion

plus

fee/

bene

fit fo

r th

e su

bsid

iary

ope

ratio

n to

the

indi

cate

d m

axim

um fo

r ea

chsu

ch s

ubsi

diar

y op

erat

ion

or p

roce

dure

(M

odifi

er 8

005)

. The

fee/

bene

fit fo

r m

ore

than

one

oper

atio

n or

pro

cedu

re p

erfo

rmed

und

er th

e sa

me

anae

sthe

tic b

ut th

roug

h an

othe

r in

cisi

on s

hall

be d

eter

min

ed o

n th

e fe

e/be

nefit

for

the

maj

or o

pera

tion

plus

: 75%

for

the

seco

ndpr

oced

ure/

oper

atio

n (M

odifi

er 8

009)

. 50%

for

the

third

and

sub

sequ

ent p

roce

dure

s/op

erat

ions

(Mod

ifier

800

6). T

his

rule

sha

ll no

t app

ly w

here

two

or m

ore

unre

late

d op

erat

ions

are

per

form

ed b

ypr

actit

ione

rs in

diff

eren

t spe

cial

ities

, in

whi

ch c

ase

each

pra

ctiti

oner

sha

ll be

ent

itled

to th

e fu

llfe

e/be

nefit

of t

he o

pera

tion.

If, w

ithin

four

mon

ths,

a s

econ

d op

erat

ion

for

the

sam

e co

nditi

on o

rin

jury

is p

erfo

rmed

, the

fee/

bene

fit fo

r th

e se

cond

ope

ratio

n sh

all b

e 50

% o

f tha

t of t

he fi

rst

oper

atio

n (M

odifi

er 8

006)

.3.

Ass

ista

nt S

urge

on (

Max

illo-

faci

al a

nd p

erio

dont

al s

urge

ry):

The

fee

paya

ble

to a

spe

cial

ist

assi

stan

t is

dete

rmin

ed a

s 1/

3 (o

f the

fee

of th

e pr

actit

ione

r pe

rfor

min

g th

e pr

oced

ure

(Mod

ifier

8001

). T

he fe

e pa

yabl

e to

a g

ener

al d

enta

l pra

ctiti

oner

ass

ista

nt is

det

erm

ined

as

15%

(of

the

fee

of th

e pr

actit

ione

r pe

rfor

min

g th

e pr

oced

ure

(Mod

ifier

800

7). T

he p

atie

nt m

ust b

e in

form

edbe

fore

hand

that

ano

ther

den

tist/s

peci

alis

t will

be

assi

stin

g at

the

oper

atio

n an

d th

at a

fee

will

be

paya

ble

to th

e as

sist

ant.

The

ass

ista

nt's

nam

e m

ust a

ppea

r on

the

invo

ice

rend

ered

to th

e pa

tient

.

Ver

sion

Add

Val

ueV

alue

Val

ueV

alue

Val

ue

2005

.02

2005

,02

4.S

urgi

cal t

eam

(M

axi l

lo-f

acia

l and

ora

l sur

gery

): T

he a

dditi

onal

fee

to a

ll m

embe

rs o

f the

sur

gica

l20

05.0

2te

am fo

r af

ter

hour

s em

erge

ncy

surg

ery

shal

l be

calc

ulat

ed b

y ad

ding

25%

to th

e fe

e fo

r th

epr

oced

ure

or p

roce

dure

s pe

rfor

med

(M

odifi

er 8

008)

.01

0O

rtho

dont

ic g

uide

lines

:20

05.0

2T

he d

ocum

enta

tion

and

first

invo

ice

to th

e pa

tient

/med

ical

sch

eme

rega

rdin

g or

thod

ontic

ser

vice

s20

06.0

3w

ill in

clud

e th

e fo

llow

ing

info

rmat

ion:

a. T

he tr

eatm

ent p

lan

and

type

of t

reat

men

t (tr

eatm

ent c

ode

num

ber)

;b.

A d

iagn

ostic

cod

e (I

CD

-10)

and

c. A

n or

thod

ontic

pay

men

t pla

n in

dica

ting

the

follo

win

g:i.

The

tota

l fee

that

will

be

levi

ed fo

r th

e tr

eatm

ent;

ii. T

he to

tal m

onth

s of

ort

hodo

ntic

trea

tmen

t (re

tent

ion

perio

d ex

clud

ed);

iii. T

he in

itial

fee

paya

ble

by th

e pa

tient

(ap

prox

imat

ely

20%

of t

he to

tal f

ee);

and

iv. T

he m

onth

ly p

aym

ents

of t

he b

alan

ce o

f the

fee.

2,T

he fe

e fo

r or

thod

ontic

trea

tmen

t doe

s no

t inc

lude

a c

linic

al o

ral e

valu

atio

n an

d ne

cess

ary

2005

.02

diag

nost

ic s

ervi

ces.

The

fee

for

corr

ectiv

e th

erap

y (i.

e. c

odes

886

1 to

888

8) is

an

incl

usiv

e fe

ean

d no

add

ition

al fe

es m

ay b

e le

vied

for

intr

a-op

erat

ive

oral

eva

luat

ions

and

pre

vent

ive

serv

ices

.A

pre

-ort

hodo

ntic

trea

tmen

t vis

it, a

n or

thod

ontic

ret

entio

n, a

nd a

n or

al e

valu

atio

n on

com

plet

ion

ofth

e tr

eatm

ent p

lan

(ret

entio

n ph

ase

incl

uded

) ar

e ex

clud

ed a

nd s

houl

d be

rep

orte

d in

add

ition

toco

rrec

tive

orth

odon

tic tr

eatm

ent a

s se

para

te p

roce

dure

s (C

ode

8803

x3)

. Inf

ra/p

ost o

rtho

dont

ictr

eatm

ent r

ecor

ds c

onsi

stin

g of

rad

iogr

aphs

/dia

gnos

tic im

ages

(lim

ited

to a

cep

halo

met

ric fi

lm a

nd5

oral

/faci

al im

ages

) an

d di

agno

stic

cas

ts m

ay b

e le

vied

whe

n a

corr

ectiv

e or

thod

ontic

trea

tmen

tpl

an is

com

plet

ed (

rete

ntio

n ph

ase

incl

uded

).3.

The

fee

for

'Fix

ed a

pplia

nce

ther

apy'

(co

des

8861

and

886

5 to

888

8), a

s de

term

ined

by

the

2005

.02

indi

vidu

al p

ract

ition

er, w

ill b

e le

vied

on

a m

onth

ly m

anne

r ov

er th

e tr

eatm

ent p

erio

d (r

eten

tion

phas

e ex

clud

ed).

4.W

hen

part

ial f

ixed

app

lianc

e or

pre

limin

ary

orth

odon

tic tr

eatm

ent (

code

s 88

58, 8

861,

886

5 or

2005

.02

8866

) is

follo

wed

by

full

fixed

app

lianc

e or

thod

ontic

trea

tmen

t (co

des

8873

to 8

888)

pro

vide

d by

the

sam

e or

thod

ontis

t, th

e fe

es le

vied

for

the

part

ial f

ixed

app

lianc

e th

erap

y or

pre

limin

ary

trea

tmen

tw

ill b

e de

duct

ed fr

om th

e fe

e qu

oted

for

the

full

fixed

app

lianc

e or

thod

ontic

trea

tmen

t.

Pag

e 4

of 2

6

Val

ueM

P L

ab T

C

STAATSKOERANT, 14 SEPTEMBER 2012 No. 35684 97

GU

IDE

LIN

E T

AR

IFF

S F

OR

SE

RV

ICE

S B

Y D

EN

TA

L P

RA

CT

ITIO

NE

RS

2540

026

200

2640

029

200

2940

029

800

Pub

lishe

d in

term

s of

Sec

tion

53 (

3) (

d) o

f the

HE

ALT

H P

RO

FE

SS

ION

S A

CT

(56

OF

197

4)

Not

e th

at th

is s

ched

ule

is b

ased

on

the

2006

NH

RP

L w

hich

was

infla

ted

by 4

6.66

%.

Ver

sion

Add

Val

ueV

alue

Val

ueV

alue

Val

ueT

he 2

006

NH

RP

L is

ava

ilabl

e in

dat

abas

e fo

rmat

at h

ttp://

ww

w.h

pcsa

.co.

za5.

The

tota

l fee

for

mul

tiple

pha

ses

of fu

ll fix

ed a

pplia

nce

orth

odon

tic tr

eatm

ent p

rovi

ded

by th

e20

05.0

2sa

me

orth

odon

tist m

ay n

ot e

xcee

d th

e m

ost r

ecen

t fee

(de

term

ined

on

com

men

cem

ent d

ate

of th

efin

al s

tage

of f

ull f

ixed

app

lianc

e tr

eatm

ent)

for

the

appr

opria

te fu

ll fix

ed o

rtho

dont

ic p

roce

dure

.

6.W

hen

the

patie

nt tr

ansf

ers

to a

noth

er p

ract

ition

er d

urin

g tr

eatm

ent,

or tr

eatm

ent i

s te

rmin

ated

2005

.02

for

any

reas

on, t

he o

rigin

al tr

eatin

g pr

actit

ione

r m

ust r

epor

t the

num

ber

of tr

eatm

ent m

onth

sre

mai

ning

and

det

erm

ine

the

bala

nce

of th

e fe

e by

app

lyin

g th

e fo

llow

ing

form

ula:

Tot

al p

aym

ent

(for

trea

tmen

t onl

y) m

inus

20%

of t

he to

tal f

ee (

for

band

ing

- w

hen

appl

icab

le)

mul

tiplie

d by

the

perc

enta

ge o

f tre

atm

ent r

emai

ning

. For

exa

mpl

e, if

the

prac

titio

ner

was

pai

d R

10,

000.

00 fo

r a

24-

mon

th tr

eatm

ent p

lan

and

18 m

onth

s of

trea

tmen

t wer

e co

mpl

eted

. The

bal

ance

wou

ld b

e R

2,00

0.00

(or

R 1

0,00

0.00

- R

2,0

00.0

0 x

6/24

). T

he le

ngth

of t

he tr

eatm

ent p

lan

from

the

orig

inal

requ

est f

or a

utho

risat

ion

will

be

used

to d

eter

min

e th

e nu

mbe

r of

trea

tmen

t mon

ths

rem

aini

ng. T

hepr

actit

ione

r co

ntin

uing

trea

tmen

t will

pro

vide

the

info

rmat

ion

stip

ulat

ed in

par

agra

ph 1

abo

ve.

Rep

ort c

ode

8891

(O

rtho

dont

ic tr

ansf

er)

with

the

fee

that

will

be

levi

ed fo

r co

ntin

uatio

n of

the

trea

tmen

t in

addi

tion

to th

e ap

prop

riate

ort

hodo

ntic

trea

tmen

t cod

e. T

he fe

e fo

r co

ntin

uous

trea

tmen

t is

subj

ect t

o pr

ior

auth

oris

atio

n by

the

patie

nt's

med

ical

sch

eme.

7.W

hen

an e

stab

lishe

d or

thod

ontic

pat

ient

req

uire

s re

-tre

atm

ent,

the

info

rmat

ion

stip

ulat

ed in

2005

.02

para

grap

h 1

abov

e an

d th

e ca

use(

s) fo

r re

-tre

atm

ent w

ill b

e pr

ovid

ed. R

epor

t cod

e 88

92(O

rtho

dont

ic r

e-tr

eatm

ent)

with

the

fee

that

will

be

levi

ed fo

r re

-tre

atm

ent i

n ad

ditio

n to

the

appr

opria

te o

rtho

dont

ic tr

eatm

ent c

ode.

Ort

hodo

ntic

re-

trea

tmen

t is

subj

ect t

o pr

ior

auth

oris

atio

nby

the

patie

nt's

med

ical

sch

eme.

011

Den

to-le

gal f

ees:

2005

.02

Pra

ctiti

oner

s ar

e en

title

d to

rem

uner

atio

n if

they

are

pre

sent

at C

ourt

at t

he r

eque

st o

f an

advo

cate

or a

ttorn

ey. U

se c

ode

8111

(D

enta

l tes

timon

y) to

rep

ort d

ento

-lega

l wor

k. T

he c

ode

is li

sted

in th

ead

junc

tive

gene

ral s

ervi

ces

sect

ions

in th

e co

de li

sts.

D.

Mod

ifier

s01

2M

odifi

ers:

2006

.03

Mod

ifier

s sh

ould

be

used

with

pro

cedu

res

iden

tifie

d th

roug

hout

the

NH

RP

L.M

odifi

ers

prov

ide

the

mea

ns b

y w

hich

the

repo

rtin

g pr

actit

ione

r ca

n in

dica

te th

at a

ser

vice

or

proc

edur

e th

at h

as b

een

perf

orm

ed h

as b

een

alte

red

by s

ome

spec

ific

circ

umst

ance

but

not

chan

ged

it its

def

initi

on o

r co

de. T

he s

ensi

ble

appl

icat

ion

of m

odifi

ers

obvi

ates

the

nece

ssity

for

sepa

rate

pro

cedu

re li

stin

gs th

at m

ay d

escr

ibe

the

mod

ifyin

g ci

rcum

stan

ce. M

odifi

ers

may

be

used

to in

dica

te to

the

reci

pien

t of t

he r

epor

t tha

t:a.

A s

ervi

ce o

r pr

oced

ure

was

per

form

ed b

y m

ore

than

one

pra

ctiti

oner

.b.

A s

ervi

ce o

r pr

oced

ure

has

been

incr

ease

d or

red

uced

.c.

Onl

y pa

rt o

f a s

ervi

ce w

as p

erfo

rmed

.cl

.An

adju

nctiv

e se

rvic

e w

as p

erfo

rmed

.e.

A s

ervi

ce o

r pr

oced

ure

was

pro

vide

d m

ore

than

onc

e.f.T

he fe

e/be

nefit

was

alte

red

due

to a

fina

ncia

l agr

eem

ent.

8001

Ass

ista

nt s

urge

on -

spe

cial

ist (

1/3

of th

e ap

prop

riate

ben

efit)

8003

Min

imum

ass

ista

nt s

urge

on80

05 M

axim

um m

ultip

le p

roce

dure

s (s

ame

inci

sion

) -

MF

O s

urge

on80

06 M

ultip

le s

urgi

cal p

roce

dure

s -

third

and

sub

sequ

ent p

roce

dure

s (5

0% o

f the

app

ropr

iate

ben

efit)

8007

Ass

ista

nt s

urge

on -

gen

eral

den

tal p

ract

ition

er (

15%

of t

he a

ppro

pria

te b

enef

it)80

08 E

mer

genc

y su

rger

y -

afte

r ho

urs

(PLU

S 2

5% o

f the

app

ropr

iate

ben

efit)

8009

Mul

tiple

sur

gica

l pro

cedu

res

- se

cond

pro

cedu

re (

75%

of t

he a

ppro

pria

te b

enef

it)80

10 O

pen

redu

ctio

n (P

LUS

75%

of t

he a

ppro

pria

te b

enef

it)80

11 P

roce

dure

acc

ompa

nied

by

unus

ual c

ircum

stan

ces

(Ben

efit

PLU

S X

% a

s de

term

ined

by

the

prac

titio

ner

and

agre

ed u

pon

by p

atie

nt/m

edic

al s

chem

e)

2006

.03

2006

.03

R17

2.95

R17

2.95

-R

172.

9520

06.0

3R

268.

51R

268.

51-

R26

8.51

2006

.03

2006

.03

2006

.03

2006

.03

2006

.03

2006

.03

Pag

e 5

of 2

6

Val

ueM

P L

ab T

C

98 No. 35684 GOVERNMENT GAZETTE, 14 SEPTEMBER 2012

GU

IDE

LIN

E T

AR

IFF

S F

OR

SE

RV

ICE

S B

Y D

EN

TA

L P

RA

CT

ITIO

NE

RS

2540

026

200

2640

029

200

2940

029

800

Pub

lishe

d in

term

s of

Sec

tion

53 (

3) (

d) o

f the

HE

ALT

H P

RO

FE

SS

ION

S A

CT

(56

OF

197

4)

Not

e th

at th

is s

ched

ule

is b

ased

on

the

2006

NH

RP

L w

hich

was

infla

ted

by 4

6.66

%.

Ver

sion

Add

Val

ueV

alue

Val

ueV

alue

Val

ueT

he 2

006

NH

RP

L is

ava

ilabl

e in

dat

abas

e fo

rmat

at h

ttp://

ww

w.h

pcsa

.co.

za80

12 R

educ

ed s

ervi

ces

(ben

efit

MIN

US

X %

as

dete

rmin

ed b

y th

e pr

actit

ione

r)20

06.0

380

13 M

ultip

le m

odifi

ers

2006

.03

8023

Fab

ricat

ion

of in

lay/

onla

y (P

LUS

25%

of t

he a

ppro

pria

te b

enef

it)20

06.0

380

25 H

andl

ing

fee

- di

rect

mat

eria

ls (

26%

of m

ater

ial c

ost t

o a

max

imum

of R

26.0

0)20

06.0

3E

.E

xpla

natio

nsT

ooth

iden

tific

atio

n an

d de

sign

atio

n of

are

as o

f the

ora

l cav

ity:

Too

th id

entif

icat

ion

and

desi

gnat

ion

of a

reas

of t

he o

ral c

avity

is c

ompu

lsor

y fo

r al

l inv

oice

s20

04.0

0

rend

ered

. Too

th id

entif

icat

ion

is a

pplic

able

to p

roce

dure

s id

entif

ied

with

the

lette

r (

T )

, and

oth

erde

sign

atio

n of

are

as o

f the

ora

l cav

ity w

ith th

e le

tter

( Q

) fo

r a

quad

rant

and

the

lette

r (

M )

for

the

max

illar

y or

man

dibu

lar

area

in th

e m

outh

par

t ( M

P )

col

umn

of th

e D

enta

l Cod

ing.

The

Inte

rnat

iona

l Sta

ndar

ds O

rgan

isat

ion

(IS

O)

in c

olla

bora

tion

with

the

FD

I des

igna

ted

syst

em fo

rte

eth

and

area

s of

the

oral

cav

ity s

houl

d be

use

d. F

or s

uper

num

erar

ies,

the

abbr

evia

tion

SU

Psh

ould

be

used

.T

reat

men

t cat

egor

ies:

Tre

atm

ent c

ateg

orie

s (T

C)

of d

enta

l pro

cedu

res

are

iden

tifie

d in

the

TC

col

umn

of th

e D

enta

l20

04.0

0C

odin

g as

follo

ws:

Bas

ic d

entis

try-

des

igna

ted

as (

B )

in th

e tr

eatm

ent c

ateg

ory

colu

mn

Adv

ance

d de

ntis

try-

des

igna

ted

as (

A)

in th

e tr

eatm

ent c

ateg

ory

colu

mn

Sur

gery

- de

sign

ated

as

( S

) in

the

trea

tmen

t cat

egor

y co

lum

nA

bbre

viat

ions

use

d in

Den

tal C

odin

gD

MD

irect

Mat

eria

l Col

umn

2005

.02

+D

Add

fee/

bene

fit fo

r de

ntur

e+

LAdd

labo

rato

ry fe

e+

MA

dd m

ater

ial f

eeM

PM

outh

Par

t Col

umn

2005

.02

MM

axill

a/M

andi

ble

QQ

uadr

ant

SS

exta

ntT

Too

thT

CT

reat

men

t Cat

egor

y C

olum

n20

05.0

2A

Adv

ance

d de

ntis

try

BB

asic

den

tistr

yS

Sur

gery

Pra

ctic

e ty

pe c

odes

:20

06.0

325

400

Gen

eral

Den

tal P

ract

ition

er26

200

Spe

cial

ist M

axill

o F

acia

l and

Ora

l Sur

geon

2640

0 S

peci

alis

t Ort

hodo

ntis

t29

200

Spe

cial

ist i

n O

ral M

edic

ine

and

Per

iodo

ntic

s29

400

Spe

cial

ist P

rost

hodo

ntis

t29

800

Spe

cial

ist O

ral P

atho

logi

st39

500

Den

tal T

hera

pist

F.

Gui

delin

es to

med

ical

sch

emes

Age

of a

Chi

ld.

2005

.02

The

det

erm

inat

ion

of a

chi

ld o

r ad

ult s

tatu

s of

the

patie

nt s

houl

d be

bas

ed o

n th

e cl

inic

alde

velo

pmen

t of t

he p

atie

nt's

den

titio

n. W

here

adm

inis

trat

ive

cons

trai

nts

prec

lude

the

use

of c

linic

alde

velo

pmen

t so

that

the

chro

nolo

gica

l age

mus

t be

used

to d

eter

min

e th

e ch

ild o

r ad

ult s

tatu

s, th

epa

tient

is d

efin

ed a

s an

adu

lt be

ginn

ing

at a

ge 1

2 w

ith th

e ex

clus

ion

of tr

eatm

ent f

or o

rtho

dont

ics

or s

eala

nts.

Pag

e 6

of 2

6

Val

ueM

PLa

b T

C

STAATSKOERANT, 14 SEPTEMBER 2012 No. 35684 99

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STAATSKOERANT, 14 SEPTEMBER 2012 No. 35684 119

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120 No. 35684 GOVERNMENT GAZETTE, 14 SEPTEMBER 2012

Code

Dental Practitioners 2006

Description25400 General Dental Practice26200 Maxillo- facial and Oral Surgery26400 Orthodontics29200 Oral Medicine and Periodontics29400 Prosthodontics29800 Oral Pathology

20 Feb 2006 Page 1 of 1 Version 2006.06

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35684—1

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