Counselling & testing for R238,20 for both IPA and non-IPA Affiliated. GPs. BARLOWORLD MEDICAL .... EMERALD & RU
ASAIPA / IPAF Medical Aid Tariff Guide 2014 - Ver 6
NHRPL 2014 not in place. Guide is a compilation of available tariffs. Each practices to set own tariffs.
ASAIPA does not negotiate tariffs with medical aids. Scheme Name
Administrator
Tariffs
Comments
RED CELLS UPDATED FROM PREVIOUS VERSION GREEN CELLS PREVIOUSLY UPDATED AECI MEDICAL AID SOCIETY
Medscheme Limited
2 2 REPI category I participating doctor at R 372,50. REPI category II participating doctor at R315,20. REPI2 category III participating doctor at scheme rate = R286,50.
AECI MEDICAL AID SOCIETY - BASIC OPTION AFRISAM SA MEDICAL SCHEME AFROX MEDICAL AID SOCIETY ALLIANCE MIDMED MEDICAL SCHEME ALTRON MEDICAL AID SCHEME ANGLO MEDICAL SCHEME ANGLOVAAL GROUP MEDICAL SCHEME
Universal Healthcare Administrators
Tariff for consultation rate of 0190 is R294,00
Metropolitan Health Risk Management Private Health Administrators
Tariff for consultation rate of 0190 is R289,20. Tariff for consultation rate of 0190 is R365,30
Scheme closed
Amalgamated with Discovery Health Amalgamated with Discovery Health No balance billing for network doctors. Using the HealthID app (access patient's EHR at least 20% of the time, and submit 75% of CIBs) will ensure an extra R15 for Discovery Health member consults.
Discovery Health Administrators
Consultation rate for GPs participating in the Discovery Health GP Network = R345, non-GP Network = R310.
BANKMED
Metropolitan Health Risk Management
PMB and Basic Plans - CareCross Network. All other plans, Bankmed IPA Affiliated GPs paid at R342,50. Bankmed Network Non-IPA Affiliated Doctors paid at R315,00. Noncontracted doctors paid at R289,20. Consultation tariff for 0190 reimbursed at R286,00.
BARLOWORLD MEDICAL SCHEME
Medscheme Limited
BESTMED MEDICAL SCHEME
Sanlam Healthcare Management
BESTMED MEDICAL SCHEME PULSE 2 OPTION
ONECARE Health
BMW EMPLOYEES MEDICAL AID SOCIETY
Discovery Health Administrators
BONITAS MEDICAL AID
Medscheme Limited
REPI category I participating doctor at R 321,60. REPI category II participating doctor at R303,10. REPI2 category III participating doctor at scheme rate = R284,60.
BONITAS MEDICAL AID - BONCAP OPTION
Medscheme Limited
Non-dispensing doctors reimbursed at R272,10. Dispensing doctors reimbursed at R322,70.
BP MEDICAL AID SOCIETY
Metropolitan Health Risk Management
BUILDING AND CONSTRUCTION INDUSTRY MEDICAL AID FUND (BCIMA) BUILT ENVIRONMENT PROFESSIONAL ASSOCIATIONS MEDICAL SCHEME (BEPMED) CHARTERED ACCOUNTANTS (SA) MEDICAL AID FUND (CAMAF) CLICKS GROUP MEDICAL SCHEME COMMUNITY MEDICAL AID SCHEME (COMMED) COMPCARE WELLNESS MEDICAL SCHEME
Universal Healthcare Administrators
Consultation rate for IPA GPs participating in the Metropolitan GP Network = R327, non-IPA GPs participating in the GP network = R312,00, and payment for non-GP network doctors is R238,00. Tariff for consultation rate of 0190 is R289,20.
Contracted GPs will be paid R380,00 for 0190 on Cat 1, R354,00 on Cat 2, and R327,90 on Cat 3. Non-contracted GPs will be paid at R295,70. Non-IPA GPs will be paid at R354.00, R340.00 and R327,90 on Cat 1, 2 and 3 respectively. Non-dispensing doctors reimbursed at R280,00. Dispensing doctors reimbursed at R380,00. Consultation rate for GPs participating in the Discovery Health GP Network = R345, non-GP Network = R232,50. 2
For Bankmed contracted doctors, completion of PHA for R202,95, HIV Counselling & testing for R238,20 for both IPA and non-IPA Affiliated GPs.
Additional Procedures per fee structure for 2014 in Carecross Health GP Guide 2014. No balance billing for network doctors.
2
Authorisation is required after the 12th visit. After the 12th visit, benefits for PMBs only. No BonCap overall annual limit. No pre-auth for procedures. HIV rapid tests to be charged as well as consult. Auth number needed for specialist referral.
BEPMED to be merged into Topmed. Sanlam Healthcare Management
Tariff for consultation rate of 0190 is R292,20
Allcare Administrators Universal Healthcare Administrators
Tariff for consultation rate of 0190 is R290,60 Tariff for consultation rate of 0190 is R289,20.
Scheme closed
"IPAF has taken great care preparing this tariff list but cannot accept any liabilities for any loss incurred in the use thereof. It is still the responsibility of each individual practice to confirm these tariffs."
ASAIPA / IPAF Medical Aid Tariff Guide 2014 - Ver 6 ASAIPA does not negotiate tariffs with medical aids.
NHRPL 2014 not in place. Guide is a compilation of available tariffs. Each practices to set own tariffs.
DE BEERS BENEFIT SOCIETY DISCOVERY HEALTH MEDICAL SCHEME
De Beers Benefit Society Discovery Health Administrators
Tariff for consultation rate of 0190 is R294,00 Consultation rate for GPs participating in the Discovery Health GP Network = R345, non-GP Network = R310. Executive option is paid at R413 for Discovery Health Network and non-network doctors. All other rates in and out of GP network will increase at 6%.
DISCOVERY HEALTH KEYCARE (INCLUDING LA KEYPLUS, QUANTUM KEYPLUS & KEYCARE ACCESS)
Discovery Health Administrators
Fee for service (dispensing) = R287,50, FFS (nondispensing) = R218,50, Capitation dispensing = R143,80, Capitation non-dispensing = R109,30.
EDCON MEDICAL AID SCHEME ENGEN MEDICAL BENEFIT FUND EYETHUMED MEDICAL SCHEME
Metropolitan Health Risk Management
Consultation tariff for 0190 reimbursed at R294,70
FEDHEALTH MEDICAL SCHEME
Medscheme Limited
2 2 No balance billing allowed. REPI category I participating doctor at R 313,20. REPI category II participating doctor at R299,10. REPI2 category III participating doctor at scheme rate = R284,90.
FEDHEALTH BLUE DOOR
Medscheme Limited
FISHING INDUSTRY MEDICAL SCHEME (FISH-MED) GEN-HEALTH MEDICAL SCHEME GENESIS MEDICAL SCHEME GLENCORE MEDICAL AID
Metropolitan Health Risk Management
Consultation tariff for 0190 reimbursed at R335,20
Self Administered Medscheme Limited
Consultation tariff for 0190 reimbursed at R296,00 REPI2 category I participating doctor at R312,20. REPI2 category II participating doctor at R298,00. REPI2 category III participating doctor at scheme rate = R283,80.
GOLDEN ARROWS EMPLOYEES MEDICAL BENEFIT FUND GOLD FIELDS MEDICAL SCHEME GOOD HOPE MEDICAL AID SOCIETY GOVERNMENT EMPLOYEES MEDICAL SCHEME (GEMS) - BERYL & SAPPHIRE OPTIONS
Metropolitan Health Risk Management Providence Healthcare Risk Managers
Consultation tariff for 0190 reimbursed at R334,50 Consultation tariff for 0190 reimbursed at R289,80
Medscheme Limited
Dispensing doctors will be paid R297,40, R285,40 and R260,00 for REPI Cat 1, 2 and 3 respectively. Nondispensing, doctors will be paid R224,00, R224,00, and R208,30 respectively for REPI Cat 1, 2 and 3 respectively.
GOVERNMENT EMPLOYEES MEDICAL SCHEME (GEMS) - ONYX, EMERALD & RUBY OPTIONS
Medscheme Limited
SAAB GRINTEK ELECTRONICS MEDICAL AID SCHEME HARMONY HEALTH SERVICES HORIZON MEDICAL SCHEME HOSMED DSP GP NETWORK - STEP OPTION
Universal Healthcare Administrators Providence Healthcare Risk Managers Medscheme Limited Thebe-ya-bophelo Healthcare
IBM (SA) MEDICAL AID SOCIETY IMPALA MEDICAL PLAN
Providence Healthcare Risk Managers
GEMS REO Network rate is R292,20 and non-network rate is No balance billing allowed. R266,30. GEMS REO Cat 1 GP enhanced fee is R41,70 above rate for network doctors only. Consultation tariff for 0190 reimbursed at R289,20 Consultation tariff for 0190 reimbursed at R289,80 Consultation tariff for 0190 reimbursed at R286,50. Consultations reimbursed at R240,00 and acute medication reimbursed at R105.00. Amalgamated with Discovery Health Consultation tariff for 0190 reimbursed at R289,80
IMPERIAL GROUP MEDICAL SCHEME - BUDGET OPTION
Metropolitan Health Risk Management
INGWE HEALTH PLAN
No balance billing for network doctors. For patients using a Discovery GP network doctor, there are unlimited GP visits paid for on Executive, Comprehensive, Priority options, and a defined number of visits on Saver series. Using the HealthID app (access patient's EHR at least 20% of the time, and submit 75% of CIBs) will ensure an extra R50 for Discovery Health member consults. Each dependant on a membership is entitled to three emergency visits at their chosen GP during the year. There is a 7.8% increase applied to the capitation model if applicable. There is a 6% increase in rates for procedures. Scheme closed Discontinued from Dec 2012
Scheme closed
Amalgamated with Makhoti. No balance billing allowed.
Consultation rate for IPA GPs participating in the All members are to make a standardised co-payment of R43.20. Metropolitan GP Network = R43,20 + R273,50 = R316,70. Non-IPA GPs participating in the GP network = R43,20 + R259,10 = R302,30 and payment for non-GP network doctors is R43,20 + R244,70 = R287,90. Ingwe has merged with Momentum Health.
"IPAF has taken great care preparing this tariff list but cannot accept any liabilities for any loss incurred in the use thereof. It is still the responsibility of each individual practice to confirm these tariffs."
ASAIPA / IPAF Medical Aid Tariff Guide 2014 - Ver 6 ASAIPA des not negotiate tariffs with medical aids.
NHRPL 2014 not in place. Guide is a compilation of available tariffs. Each practices to set own tariffs.
KEYHEALTH
PMSA
Consultation tariff for 0190-0192 reimbursed at R299,50.
Reimbursement for code 0132 is R86,50 and for code 0133 is R155,50.
LA-HEALTH
Discovery Health Administrators
Consultation rate for GPs participating in the Discovery Health GP Network = R345, non-GP Network = R310.
No balance billing for network doctors. Using the HealthID app (access patient's EHR at least 20% of the time, and submit 75% of CIBs) will ensure an extra R15 for Discovery Health member consults.
LIBCARE MEDICAL SCHEME
V Medical Aid Administrators
Consultation tariff for 0190 reimbursed at R440,00
LIBERTY MEDICAL SCHEME
V Medical Aid Administrators
Consultation tariff for 0190 for network doctors reimbursed at Reimbursement for code 0133 is R156,20. R335,70, and non-network doctors at R291,90.
LONMIN MEDICAL SCHEME
Discovery Health Administrators
MALCOR MEDICAL SCHEME MASSMART HEALTH PLAN
Sanlam Healthcare Management Universal Healthcare Administrators
Consultation rate for GPs participating in the Discovery Health GP Network = R310, non-GP Network = R310. Consultation tariff for 0190 reimbursed at R290,50 Consultation tariff for 0190 reimbursed at R289,20
MBMED MEDICAL AID FUND
Medscheme Limited
2 2 REPI category I participating doctor at R 308,90. REPI category II participating doctor at R297,00. REPI2 category III participating doctor at scheme rate = R285,10.
MEDIHELP MEDIHELP NICESSE OPTION
Self Administered Self Administered
Consultation tariff for 0190 reimbursed at R298,00 Non-contracted GPs - not benefit. Non-dispensing IPA GPs will be paid at R250.00, R225.00 and R200.00 for Cat 1, 2 and 3 respectively. Dispensing IPA GPs will be paid at R325.00, R300.00 and R295.00 for Cat 1, 2 and 3 respectively. Non-dispensing non- IPA GPs will be paid at R220.00, R215.00 and R195.00 for Cat 1, 2 and 3 respectively. Dispensing non-IPA GPs will be paid at R295.00, R285.00 and R280.00 for Cat 1, 2 and 3 respectively.
MEDIMED MEDICAL SCHEME MEDIPOS MEDICAL SCHEME MEDSHIELD
Providence Healthcare Risk Managers Metropolitan Health Risk Management Full Circle Health
Consultation tariff for 0190 reimbursed at R289,80 Consultation tariff for 0190 reimbursed at R291,00 Tariff for 2014 is 2013 + 6% = R285,14.
Metropolitan Health Risk Management
Consultation rate for IPA GPs participating in the Metropolitan GP Network = R322,63. Non-IPA GPs participating in the GP network = R307,97 and payment for non-GP network doctors is R293,30.
METROCARE METROPOLITAN MEDICAL SCHEME - PREMIER OPTION
No balance billing for network doctors.
Scheme closed
MINEMED MEDICAL SCHEME
Amalgamated with Bestmed.
MOMENTUM HEALTH MEDICAL SCHEME - CUSTOM, INCENTIVE, EXTENDER AND SUMMIT OPTIONS.
Momentum Medical Scheme Administrators Tariff for 0190, 0191, 0192 for Momentum Health Cat 1 No balance billing for network doctors. R344, Cat 2 - R317, Cat 3, 4 and 5 - R290. All other services rendered will be subjected to an increase of 5.5%.
MOMENTUM HEALTH MEDICAL SCHEME - INGWE AND ACCESS OPTIONS. MOREMED MEDICAL SCHEME MOTO HEALTH MUTUAL & FEDERAL MEDICAL AID FUND NAMPAK (SA) MEDICAL SCHEME NASPERS MEDICAL FUND MMED OPTIONS
Momentum Medical Scheme Administrators Tariff for 0190 Category 1 - R280,00, Category 2 - R265,00, Category 3 is R250.00. Scheme closed Metropolitan Health Risk Management
Discovery Health Administrators
Consultation tariff for 0190 reimbursed at R289,30
Consultation rate for GPs participating in the Discovery Health GP Network = R345, non-GP Network = R310.
Scheme closed Amalgamated with Discovery Health No balance billing for network doctors. Using the HealthID app (access patient's EHR at least 20% of the time, and submit 75% of CIBs) will ensure an extra R15 for Discovery Health member consults.
"IPAF has taken great care preparing this tariff list but cannot accept any liabilities for any loss incurred in the use thereof. It is still the responsibility of each individual practice to confirm these tariffs."
ASAIPA / IPAF Medical Aid Tariff Guide 2014 - Ver 6
NHRPL 2014 not in place. Guide is a compilation of available tariffs. Each practices to set own tariffs.
ASAIPA does not negotiate tariffs with medical aids. NASPERS MEDICAL FUND N OPTIONS
Discovery Health Administrators
Consultation rate for GPs participating in the Discovery Health GP Network = R345, non-GP Network = R310.
No balance billing for network doctors.
NATIONAL INDEPENDENT MEDICAL AID SOCIETY (NIMAS) NEDGROUP MEDICAL AID SCHEME
Medscheme Limited
Consultation tariff for 0190 reimbursed at R286,50.
NEDGROUP MEDICAL AID SCHEME TRADITIONAL PLUS PLAN
ONECARE Health
NETCARE MEDICAL SCHEME OLD MUTUAL STAFF MEDICAL AID SCHEME OXYGEN MEDICAL SCHEME PARMED MEDICAL AID SCHEME
Metropolitan Health Risk Management Medscheme Limited
Non-dispensing doctors reimbursed at R280,00. Dispensing doctors reimbursed at R380,00. Consultation tariff for 0190 reimbursed at R287,80 Consultation rate for 0190 is R285,90.
Medscheme Limited
Consultation rate for 0190 is R284,90.
PATHFINDER MEDICAL SCHEME PG BISON MEDICAL AID SOCIETY PG GROUP MEDICAL SCHEME PHAROS MEDICAL PLAN PICK & PAY MEDICAL SCHEME PLATINUM HEALTH
Allcare Administrators Metropolitan Health Risk Management Private Health Administrators Metropolitan Health Risk Management Self Administered
Consultation tariff for 0190 reimbursed at R290,60 Consultation tariff for 0190 reimbursed at R290,60
PRO SANO MEDICAL SCHEME PROFMED
PMSA
Consultation rate for GPs is R350 for Prosecure and Prosecure Plus. Consultation rate for ProPinnacle is R1050. Consultation rate for PMB conditions is R350. ProActive and ProActive Plus. Procedures will be Profmed Tariff plus 20% for GPs.
PROTEA MEDICAL AID SOCIETY QUANTUM MEDICAL AID SOCIETY
Discovery Health Administrators
Consultation rate for GPs participating in the Discovery Health GP Network = R345, non-GP Network = R310.
RAND WATER MEDICAL SCHEME REMEDI MEDICAL AID SCHEME
Metropolitan Health Risk Management Discovery Health Administrators
RESOLUTION HEALTH MEDICAL SCHEME
Agility Administrators
RETAIL MEDICAL SCHEME
Discovery Health Administrators
RHODES UNIVERSITY MEDICAL SCHEME SA BREWERIES MEDICAL AID SOCIETY SABC MEDICAL SCHEME
Providence Healthcare Risk Managers Metropolitan Health Risk Management Medscheme Limited
Fees for Progressive Flex, Classic, Millenium and Supreme options: a) Acute consultations + procedures, excl medicines = R311.00; b) Chronic consultations + procedures, excl medicines = R384.00. Consultation rate for GPs participating in the Discovery No balance billing for network doctors. Health GP Network = R345, non-GP Network = R310. Consultation tariff for 0190 reimbursed at R289,80 Consultation tariff for 0190 reimbursed at R293,20 Consultation tariff for 0190 reimbursed at R284,60.
SAMWUMED SAPPI MEDICAL AID SCHEME SASOLMED
Metropolitan Health Risk Management
Consultation tariff for 0190 reimbursed at R286,50.
Medscheme Limited
REPI category I participating doctor at R353,40. REPI category II participating doctor at R332,20. REPI2 category III participating doctor at scheme rate = R284,60.
SEDMED SELFMED MEDICAL SCHEME SIEMENS MEDICAL AID
Self Administered Self Administered
Consultation tariff for 0190 reimbursed at R345,00 Consultation tariff for 0190 reimbursed at R286,40
SISONKE MEDICAL AID
Providence Healthcare Risk Managers
Consultation tariff for 0190 reimbursed at R289,80
SIZWE MEDICAL FUND
Sechaba Medical Solutions
Consultation tariff for 0190 reimbursed at R292,00
Scheme closed. Has become Resolution AGHS
Scheme closed Scheme closed
Consultation tariff for 0190 reimbursed at R289,20
Merged into Bonitas Medical Fund.
Consultation rate for GPs participating in the Discovery Health GP Network = R345, non-GP Network = R310.
Scheme closed No balance billing for network doctors.
No balance billing for network doctors. Using the HealthID app (access patient's EHR at least 20% of the time, and submit 75% of CIBs) will ensure an extra R15 for Discovery Health member consults.
Merged with Bestmed Medical Aid. 2
2
Amalgamating with Fedhealth in 2012.
"IPAF has taken great care preparing this tariff list but cannot accept any liabilities for any loss incurred in the use thereof. It is still the responsibility of each individual practice to confirm these tariffs."
ASAIPA / IPAF Medical Aid Tariff Guide 2014 - Ver 6 ASAIPA does not negotiate tariffs with medical aids.
SOUTH AFRICAN POLICE SERVICE MEDICAL SCHEME (POLMED)
Metropolitan Health Risk Management
SPECTRAMED SUREMED HEALTH THEBE-MED DSP GP NETWORK - UNIVERSAL OPTION
V Medical Aid Administrators Providence Healthcare Risk Managers Thebe-ya-bophelo Healthcare
THEBE-MED DSP GP NETWORK - ENERGY OPTION
Thebe-ya-bophelo Healthcare
TIGER BRANDS MEDICAL SCHEME TOPMED MEDICAL SCHEME
Universal Healthcare Administrators
TRANSMED MEDICAL FUND TRANSMED MEDICAL FUND - STATE OPTION TRUWORTHS FOSCHINI GROUP MEDICAL AID SCHEME
Metropolitan Health Risk Management Universal Healthcare Administrators Discovery Health Administrators
TSOGO SUN GROUP MEDICAL SCHEME
Discovery Health Administrators
NHRPL 2014 not in place. Guide is a compilation of available tariffs. Each practices to set own tariffs. Consultation rate for Network doctors and non-network doctors is R310.00 and R287.00 respectively. Gp procedure codes will increase by 6.5% for network and non-network doctors. Consultation tariff for 0190 reimbursed at R289,00 Consultation tariff for 0190 reimbursed at R289,80 Consultations reimbursed at R240,00 and acute medication reimbursed at R105.00. Consultations reimbursed at R281,00 and acute medication reimbursed at R161.00. Consultation tariff for 0190 reimbursed at R289,20 Amalgamated with Pharos Medical Plan from 1 Jan 2014. Consultation tariff for 0190 reimbursed at R287,90 Consultation tariff for 0190 reimbursed at R294,00 Consultation rate for GPs participating in the Discovery Health GP Network = R345, non-GP Network = R310. Consultation rate for GPs participating in the Discovery Health GP Network = R345, non-GP Network = R310.
UMED
No balance billing for network doctors. No balance billing for network doctors. Using the HealthID app (access patient's EHR at least 20% of the time, and submit 75% of CIBs) will ensure an extra R15 for Discovery Health member consults. Scheme closed
UMVUZO HEALTH MEDICAL SCHEME - STANDARD AND ULTRA AFFORDABLE OPTIONS UNIVERSITY OF KWA-ZULU NATAL MEDICAL SCHEME
Universal Healthcare Administrators
Consultation tariff for 0190 reimbursed at R294,00
Discovery Health Administrators
Consultation rate for GPs participating in the Discovery Health GP Network = R345, non-GP Network = R310.
UNIVERSITY OF WITWATERSRAND MEDICAL FUND
Medscheme Limited
2 2 REPI category I participating doctor at R316,10. REPI category II participating doctor at R301,80. REPI2 category III participating doctor at scheme rate = R287,40.
WITBANK COALFIELDS MEDICAL AID SCHEME WOOLTRU HEALTHCARE FUND WORLD BANK MEDICAL SCHEME XSTRATA ALLOYS MEDICAL AID
Witbank Coal Medical Aid Society Metropolitan Health Risk Management
No balance billing for network doctors. Using the HealthID app (access patient's EHR at least 20% of the time, and submit 75% of CIBs) will ensure an extra R15 for Discovery Health member consults.
Consultation tariff for 0190 reimbursed at R293,30 Closed Previously Xstrata Alloys Medical Aid.
"IPAF has taken great care preparing this tariff list but cannot accept any liabilities for any loss incurred in the use thereof. It is still the responsibility of each individual practice to confirm these tariffs."
Insurance Tariffs 2014 Medical examinations Note: Fee includes VAT.
General Practitioners Tariff code A1101 A1102 A1103 A1105 A1106
Description Standard Medical Report including copies of specialist reports or special investigations Standard Medical Report without any copies of specialist reports or special investigations Short Medical Report or abbreviated variations thereof Cardiovascular examination and report only Three blood pressure recordings during one visit
Units
Description Standard Medical Report including copies of specialist reports or special investigations Standard Medical Report with resting ECG only - 12 leads Standard Medical Report with Effort ECG (resting, post-effort, 3and 6 minutes post recovery of tracings) Examination and completion questionnaire on cardiovascular system Examination and completion of questionnaire on cardiovascular system, including resting 12-lead ECG Examination and completion of questionnaire on cardiovascular system, including effort ECG Nurses (doctor delegated exams, in fulltime employment of a doctor) Tariff code Description A1103 Short Medical Report or abbreviated variations thereof A1104 Body mass index (BMI) assessment A1106 Three blood pressure recordings during one visit
Units
25 20 10 10 10
Fee (R) 617.70 494.20 247.10 247.10 247.10
30 40 45 18 27 32
Fee (R) 887.80 1159.60 1283.20 532.70 799.10 947.10
10 2 10
Fee (R) 247.10 48.30 247.10
4
Fee (R) 98.80
11 16
Fee (R) 271.90 395.50
10
Fee (R) 247.10
Specialist Physicians Tariff code A2100 A2200 A2300 A2401 A2402 A2403
Units
Sample collection General Practitioners and Specialist Physicians Tariff code A1202
Electrocardiograms
Description Units Collection of blood sample(s) for pathological examination(s), per venesection
General Practitioners and Specialist Physicians Tariff code A1301 A1302
Lung function tests
Description Resting ECG only - 12 leads Effort ECG (including resting, immediately post-effort, 3- and 6 minutes posteffort tracings )
Units
General Practitioners Tariff code A1306
Description Lung function test with vitalometer (no interpretation or report)
Units
Description
Units
Specialist Physicians Tariff code
Fee (R)
A1307
Lung function test with vitalometer (no interpretation or report)
11
247.10
12 8 10 4 12 18
Fee (R) 296.50 197.70 247.10 98.80 296.50 459.70
20
Fee (R) 494.20
18 14
Fee (R) 532.60 414.30
8 12 15 10
Fee (R) 236.70 355.10 443.80 295.90
Extracts from records/special questionnaires General Practitioners Tariff code A1401 A1402 A1403 A1404 A1405 A4104
Description Personal Medical Attendant Report Copies of previous reports Completion of specific reports (e.g. Diabetes, psychological/nervous disorders questionnaire etc) Loan of one or more ECG,s Report for deceased estate
Units
Personal Medical Attendant Report for sportspeople by
Counselling General Practitioners and Specialist Physicians Tariff code A1501
Description HIV Post-Test Counselling
Units
Description X-Ray chest PA and lateral X-Ray chest PA only
Units
Description Copies of previous reports PMA by a Specialist PMA by a Specialist with copies of previous reports and test results Completion of specific reports (Psychological/Nervous disorders questionnaire/blood pressure treatment)
Units
Radiology Specialist Radiologists Tariff code A3101 A3103
Reports Specialist Physicians Tariff code A4101 A4102 A4103 A1450
CARECROSS GP FEE STRUCTURE 2014 PROCEDURE CODE 190 191 192
DESCRIPTION New and established patient: Consultation/visit of new or established patient of an average duration and/or complexity. New and established patient: Consultation/visit of new or established patient of a moderately above average duration and/or complexity. New and established patient: Consultation/visit of new or established patient of long duration and/or high complexity.
ADDITIONAL PROCEDURES PROCEDURE CODE 300 301 307 308 255 259 2133 887
DESCRIPTION Stitching of wound Stitching of additional wound Excision and repair Each additional small procedure done at the same time Drainage of subcutaneous abscess & Avulsion of nail Removal of foreign body superficial to Deep fascia Circumcision - clamp Limb cast - Inclusive of cost of P.O.P. and other material
TARIFF 2014 R 315.00 R 70.35 R 420.00 R 138.60 R 256.20 R 350.70 R 525.00 R 350.70
The fees are inclusive of 14% VAT. The tariff for the procedure is in addition to the normal consultation fee. IF THE PROCEDURE IS BOOKED FOR A DAY OTHER THAN THE DAY OF THE DIAGNOSIS AND DECISION ON TREATMENT PLAN, NO ADDITIONAL CONSULTATION FEE SHOULD BE CHARGED. The fee includes tariff codes 0202 & 0201 (setting of sterile tray & material). The fee includes follow up VISIT. The fee includes the completion of a chronic application form. PROCEDURES NECESSITATING HOSPITAL ADMISSION Should any of the above or similar procedures be performed in a hospital, the following process comes into effect: Authorization to perform the procedure should be obtained from the relevant medical scheme. Accounts pertaining to procedures for which authorization were obtained from the medical scheme, should be rendered to
CARECROSS SMALL PROCEDURES PERFORMED IN ROOMS - INCLUDED IN CONSULTATION FEE PROCEDURE CODE DESCRIPTION 201 Cost of material 202 Setting of Sterile Tray 206 Intravenous infusion (push-in) patients over 2 years: Insertion of cannula : chargeable once per 24 207 Intravenous infusion (cutdown) patients over 2 years: Cutdown and Insertion of cannula : chargeable Intralesional Injection into areas of pathology 222 Single 223 Multiple 225 Epilation : per session 227 Special treatment of severe acne cases Treatment of benign skin lesion chemo-cryotherapy 241 First Lesion 242 Subsequent Lesion, each 243 Maximum for multiple additional lesions Removal of benign lesion by curetting under local or general anaesthesia followed by diathermy and curetting or electrocautery
245 First Lesion 246 Subsequent Lesion, each 316 Fine needle aspiration 317 Aspiration of cyst or tumour 1037 Diathermy nose under local 1136 Nebulisation Pulmonary function tests 1192 Peak expiratory flow only Taking of an ECG only 1228 Without effort 1229 With and without effort
Electrocardiogram 1232 Without effort 1233 With and without effort 1234 Effort electrocardiogram Medical Psychotherapy 2957 Individual psychotherapy – short session Eyes 3171 Excision Meibomian cyst eyelid Physical Treatment 3287 Spinal joint and ligament injection 3304 Other physical treatments Any diagnostic pathology tests done in surgery
