Kaelo Tariff Structure
The Kaelo Tariff : The maximum amount we will pay for the cost of services by a non-Prime Cure Network provider. While we cover the cost of Treatment, payment will be limited to a maximum of 300% of the 2006 National Health Reference Price List (NHRPL). The 2006 NHRPL is available on the Council for Medical Schemes website at https://www.medicalschemes.com/files/NHRPLSchedules/MedicalPractitioners2006_v06.pdf.
In calculating the Kaelo Tariff , the following rounding method is used: Values R10 and below rounded to the nearest cent, R10+ rounded to the nearest 10cent. Modifier values are rounded to the nearest cent. When new item prices are calculated, e.g. when applying a modifier, the same rounding scheme should be followed.
ALL Kaelo TARIFFS ARE VAT INCLUSIVE.
This list is subject to continuous review and may be updated or revised periodically to reflect changes in regulations, best practices, organisational needs, or other relevant factors. It is the responsibility of all stakeholders to stay informed of the latest version and comply accordingly.
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| wdt_ID | wdt_created_by | wdt_created_at | wdt_last_edited_by | wdt_last_edited_at | Tariff Code | Description | Amount |
|---|---|---|---|---|---|---|---|
| 1 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0001 | Appointment not kept | - |
| 2 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0002 | Modifier 0002: Orthopaedic, Neurosurgical and Vascular: | - |
| 3 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0003 | 15% of the relevant rate to be deducted where equipment used is not owned by the practitioner | - |
| 4 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0004 | Procedures performed in own procedure rooms: a) Procedures performed in doctors' own procedure rooms instead of in a hospital theatre or unattached theatre unit: as per fee for procedure + 100% (the value of modifier 0004 equals 100% of the value of the p | - |
| 5 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0005 | Multiple therapeutic procedures/operations under the same anaesthetic: a) Unless otherwise identified in the tariff when multiple therapeutic procedures/operations add significant time and/or complexity, and when each procedure/operation is clearly identi | - |
| 6 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0007 | a) Use of own monitoring equipment in the rooms: Remuneration for the use of any type of own monitoring equipment in the rooms for procedures performed under intravenous sedation - 15,00 clinical procedure units irrespective of the number of items of equi | - |
| 7 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0008 | Specialist surgeon assistant: Where a procedure requires a registered specialist surgeon assistant, the fee is 33,33% (1/3) of the fee for the specialist surgeon | - |
| 8 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0009 | Assistant: The fee for an assistant is 20% of the fee for the specialist surgeon, with a minimum of 36,00 clinical procedure units. The minimum fee payable may not be less than 36,00 clinical procedures units | - |
| 9 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 00090 | Consumables used in radiology procedures: cost price PLUS 26% (up to a maximum of R26,00). (Where applicable, VAT should be added to the above). | - |
| 10 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 001 | Unless timely steps (i.e. 24 hours prior to the appointment) are taken to cancel an appointment the relevant fee may be charged, but shall not be payable by medical schemes. Each case shall, however, be considered on merit and, if circumstances warrant, n | - |
| 11 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0010 | Local anaesthesic: (a) A fee for a local anaesthetic administered by the operator may only be charged for (1) an operation or procedure having a value greater than 30,00 clinical procedure units (i.e. 31,00 or more clinical procedure units allocated to a | - |
| 12 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0011 | Emergency procedures: Any bona fide, justifiable emergency procedure (all hours) undertaken in an operating theatre and/or in another setting in lieu of an operating theatre, will attract an additional 12,00 clinical procedure units per half-hour or part | - |
| 13 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0013 | Endoscopic examinations done at operations: Where a related endoscopic examination is done at an operation by the operating surgeon or the attending anaesthesiologist, only 50% of the fee for the endoscopic examination may be charged | - |
| 14 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 00130 | X-ray with mobile unit in other facility | - |
| 15 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0014 | Operations previously performed by other surgeons:b) Where an operation is performed which has been previously performed by another surgeon, e.g. a revision or repeat operation, the units shall be calculated according to the units for the full operation p | - |
| 16 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 00145 | X-ray fluoroscopy guidance for biopsy, any region | - |
| 17 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0017 | Injections oradministered by the medical doctor: When desensitisation, intravenous, intramuscular or subcutaneous injectionsare administered by the medical doctor him-/herself to patients who attend the consulting rooms, a first injection forms part of th | - |
| 18 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0018 | Surgical modifier for persons with a BMI of 35> (calculated according to kg/m2): Fee for procedure +50% for surgeons and a 50% increase in anaesthetic time units for anaesthesiologists | - |
| 19 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0019 | a) Surgery on neonates OR low birth weight infants (less than 2 500g) under general anaesthesia (excluding circumcision): Units for procedure + 50% of units for procedure performed for surgeons and a 50% increase in anaesthetic time units for anaesthes | - |
| 20 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 00190 | X-ray examination contrast material | - |
| 21 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0020 | Conscious sedation: Any case that is conducted outside of a hospital theatre shall be coded with the relevant procedure code. To identify these cases, the above modifier should be used to indicate to the medical scheme that there will be no hospital/theat | - |
| 22 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0021 | Determination of anaesthetic fees: (a) Anaesthetic fees are determined by obtaining the sum of the basic anaesthetic units (allocated to each procedure that might be performed under anaesthetic as indicated in the Anaesthetic Performed column) plus the | - |
| 23 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0023 | The basic anaesthetic units are laid down in the tariff and are reflected in the anaesthetic column. These basic anaesthetic units reflect the additional anaesthetic risk, the technical skill required of the anaesthesiologist/anaesthetist and the scope of | - |
| 24 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 00230 | Ultrasound guidance | - |
| 25 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0026 | One lung ventilation: Utilisation of one lung ventilation: Add 3.00 anaesthetic units | - |
| 26 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0029 | Assistant anaesthesiologists: When rendered necessary by the scope of the anaesthetic, an assistant anaesthesiologist may be employed. The remuneration of the assistant anaesthesiologist shall be calculated on the same basis as in the case where a general | - |
| 27 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0031 | Intravenous drips and transfusions: Treatment with intravenous drips and transfusions is considered part of the normal treatment in administering an anaesthetic. No additional fees may be charged for such services when rendered either prior to, or during | - |
| 28 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0032 | Any procedure performed in any position other than lithotomy or supine has a basic minimum value of 5.00 anaesthetic units. When the basic anaesthetic units for the procedure is 3.00 units, two extra anaesthetic units should be added. If the basic anaesth | - |
| 29 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 00320 | CT guidance (separate procedure) | - |
| 30 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0034 | Head, neck and shoulder girdle procedures: All anaesthetic administered for diagnostic, surgical or x-ray procedures on the head, neck and shoulder girdle shall have a minimum of 5.00 anaesthetic units. When the basic anaesthetic units for the procedure i | - |
| 31 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0035 | Anaesthetic administered by an anaesthesiologist/anaesthetist: No anaesthetic administered shall have a total value of less than 7,00 anaesthetic units (basic units, time units plus appropriate modifiers). | - |
| 32 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0036 | Anaesthetic administered by general practitioners:The units (basic units plus time plus the appropriate modifiers) used to calculate thefor an anaesthesia administered by a general practitioner lasting one hour or less, shall be the same as that for aanae | - |
| 33 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0037 | Body hypothermia: Utilisation of total body hypothermia: Add 3,00 anaesthetic units | - |
| 34 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0038 | Peri-operative blood salvage: Add 4,00 anaesthetic units for intra-operative blood salvage and 4,00 anaesthetic units for post-operative blood salvage | - |
| 35 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0039 | Control of blood pressure: Deliberate control of the blood pressure: All cases up to one hour: Add 3,00 anaesthetic units, thereafter add 1,00 (one) additional anaesthetic unit per quarter hour or part thereof | - |
| 36 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 00390 | CT examination contrast material | - |
| 37 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 004 | In the case of prolonged or costly treatment, the practitioner should first ascertain from the scheme concerned whether it will accept financial responsibility in respect of such treatment, since the member may be subject to maximum annual benefits | - |
| 38 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0042 | Extracorporeal circulation: Utilisation of extracorporeal circulation: Add 3,00 anaesthetic units | - |
| 39 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0043 | Anaesthesia for patients under one year of age: For all cases where the patient is under one year of age– 3,00 anaesthetic units to be added | - |
| 40 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0044 | Neonates (i.e. up to and including 28 days after birth): 3,00 anaesthetic units to be added to the basic anaesthetic units for the particular procedure. This modifier is charged in addition to Modifier 0043: Cases under one year of age, if appropriate | - |
| 41 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0045 | Regional or nerve block procedure is performed | - |
| 42 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0049 | Except where otherwise specified, in cases of compound fractures, 77,00 clinical procedure units (specialists) and 77,00 clinical procedure units (general practitioners) are to be added to the units for the fractures including debridement | - |
| 43 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 00490 | MR examination contrast material | - |
| 44 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0051 | Fractures requiring open reduction, internal fixation, external skeletal fixation and/or bone grafting: Specialists add 77,00 clinical procedure units. General practitioners add 77,00 clinical procedure units | - |
| 45 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0053 | Fracture requiring percutaneous internal fixation [insertion and removal of fixatives (wires) in respect of fingers and toes included]: Specialists and general practitioners add 32,00 clinical procedure units | - |
| 46 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 00540 | Digital monoplane screening table | - |
| 47 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0055 | Dislocation requiring open reduction: Units for the specific joint plus 77,00 clinical procedure units for specialists. General practitioners add 77,00 clinical procedure units | - |
| 48 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 00550 | Dedicated angiography suite: Digital monoplane unit. Once off charge per patient by owner of equipment. | - |
| 49 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0058 | Revision operation for total joint replacement and immediate re-substitution (infected or non-infected): Units as for the procedure(s) + 100% of the units as for the total revision procedure (the units for modifier 0058 equals 100% of the procedure(s) per | - |
| 50 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0060 | Musculo-Skeletal poly trauma: Signficant injury to more than one musculo-skeletal system. Examples: two long bone fractures, or a long bone fracture or a pelvic fracture, or a long bone fracture and a spinal fracture, or any fracture plus a signifcant inj | - |
| 51 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0062 | - | - |
| 52 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0063 | Where two specialists work together on a replantation procedure, each shall be entitled to two-thirds of the fee for the procedure | - |
| 53 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0067 | Microsurgery of the larynx: Add 25% to the fee of the operation performed (òFor other operations requiring the use of an operation microscope, the fee include the use of the microscope, except where otherwise specified elsewhare in the Tariff) | - |
| 54 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0069 | When endoscopic instruments are used during intranasal surgery: Add 10% of the fee of the procedure performed. Only applicable to items 1025, 1027, 1030, 1033, 1035, 1036, 1039, 1047, 1054 and 1083 | - |
| 55 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 007 | Practitioners are reminded that a lower fee than that appearing in the scale of benefits shall be charged if the customary fee in the area is less than that charged. Reduced fees shall also be charged where the practitioner would have reduced his/her fee | - |
| 56 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0070 | Add 45,00 clinical procedure units to procedure(s) performed through a thorascope | - |
| 57 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0074 | Endoscopic procedures performed with own equipment: The basic procedure fee plus 33.33% (1/3) of that fee (+ codes excluded) will apply where endoscopic procedures are performed with own equipment. | - |
| 58 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0075 | Endoscopic procedures performed in own procedure room: (a) The value of modifier 0075 = 21,00 clinical procedure units, where endoscopic procedures are performed in rooms. (b) This fee is chargeable by medical practitioners who own or rent the facility.(d | - |
| 59 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0083 | A reduction of 33,33% (1/3) in the fee will apply to radiological examinations as indicated in section 19: Radiology where hospital equipment is used | - |
| 60 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0084 | Charging for films and thermal paper by non-radiologist: in the case of radiological services rendered by non-radiologists where films, thermal paper or magnetic media are used, these media is charged for according to the film price of 2007, as compiled b | - |
| 61 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0089 | - | - |
| 62 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 009 | When more than one condition requires treatment and each of these conditions necessitates an individual treatment, they shall be charged as individual treatments. Full details of the nature of the treatments and the diagnosis or diagnostic codes shall be | - |
| 63 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0090 | Doctor's remuneration for participation in a team: 30,00 radiology units per ½ hour or part thereof for all interventional radiological procedures, excluding any pre- or post-operative angiography, catheterisation, CT-scanning, ultrasound-scanning or x-ra | - |
| 64 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 00903 | Nuclear Medicine study - Bone, whole body, appendicular and axial skeleton and SPECT | - |
| 65 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0091 | Diagnostic services rendered to hospital inpatients: Quote Modifier 0091 on all accounts for diagnostic services (e.g. MRI, X-rays, pathology tests) performed on patients officially admitted to hospital or day clinic (refer to Rule XX) | - |
| 66 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0092 | Diagnostic services rendered to outpatients: Quote Modifier 0092 on all accounts for diagnostic services (e.g. MRI, X-rays, pathology tests) performed on patients NOT officially admitted to hospital or day clinic (could be within the confines of a hospita | - |
| 67 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0093 | - | - |
| 68 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0095 | Radiation materials: Exclusively for use where radiation materials supplied by the practice are used by clinical and radiation oncologists, modifier 0095 should be used to identify these materials. A material code list with descriptions and guideline cost | - |
| 69 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 00956 | PET/CT scan whole body without contrast | - |
| 70 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 00957 | PET/CT scan whole body with contrast | - |
| 71 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 00990 | Nuclear Medicine Isotope | - |
| 72 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 00991 | Nuclear Medicine Substrate | - |
| 73 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 01010 | Emergency call out fee, first case | - |
| 74 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 01020 | Emergency call out fee, subsequent cases same trip | - |
| 75 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0107 | New born attendance: Exclusive attendance to baby at Caesarean section, normal delivery or visit in the ward (once per patient) (items 0109, 0111, 0113, 0145, 0146 and/or 0147 may not be added to item 0107) | - |
| 76 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0109 | Hospital follow-up visit to patient in ward or nursing facility - Refer to general rule G(a) for post-operative care) (may only be charged once per day) (not to be used with items 0111, 0145, 0146, 0147 or ICU items 1204-1214) | - |
| 77 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 01100 | X-ray procedure after hours, per procedure | - |
| 78 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0111 | Paediatric hospital follow-up visits (excluding neonates) by paediatricians or paediatric cardiologists (may only be charged once per day) (not to be used with items 0109 or ICU items 1204-1214). For a healthy neonate please use item 0109 for a hospital f | - |
| 79 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0113 | New born attendance: Emergency attendance to newborn at all hours (once per patient) (items 0107, 0109, 0111, 0145, 0146 and/or 0147 may not be added to item 0113) | - |
| 80 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0121 | - | - |
| 81 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0122 | - | - |
| 82 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0123 | - | - |
| 83 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0126 | For an UNSCHEDULED consultation/visit at the doctor's home or rooms: ADD only to the consultation/visit items 0190-0192, items 01610164 or items 0151-0153, as appropriate. Note: Only one of items 0145, 0146, 0126 or 0147 may be charged and not combination | - |
| 84 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0129 | Prolonged face-to-face attendance to a patient: ADD to either item 0192, item 0175, item 0164 or item 0169 as appropriate, for each 15-minute period only if service extends 10 minutes or more into the next 15-minute period following on the first 60 minute | - |
| 85 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0130 | Telephone consultation for GPs and Specialists (all hours) via virtual platforms ( SMS, what apps , video and voice calls etc). Applicable during the Covid 19 Pandemic | - |
| 86 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 01300 | CT procedure after hours, per procedure | - |
| 87 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0131 | Subsequent injectionsas part of a planned series of injections for the same condition administered by medical doctors (refer to modifier 0017) (not to be coded together with any consultation item) | - |
| 88 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0132 | Consulting service e.g. writing of repeat scripts or requesting routine preauthorization without the physical presence of the patient (needs not be face-to-face contact), via virtual platforms ( SMS, what apps , video and voice calls etc). Applicable duri | - |
| 89 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0133 | Writing of special motivations for procedures and treatment without the physical presence of a patient (includes report on the clinical condition of a patient) requested by or on behalf of a third party funder or its agent | - |
| 90 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0138 | Patient and/or family education and/or guidance for a specific condition for 40 minutes, supported by the appropriate ICD-10 code(s). ICD-10 codes to be added for this service. This item may be added to a consultation if done in addition to the consultati | - |
| 91 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0145 | For consultation/visit away from the doctor's home or rooms (non-emergency): ADD only to the consultation/visit items 0190-0192, items 0173-0175, items 0161-0164 or items 0166-0169, as appropriate. Note: Only one of items 0145, 0146 or 0147 may be charged | - |
| 92 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0146 | For an unscheduled emergency consultation/visit at the doctors' home or rooms, all hours: ADD only to the consultation/visit items 0190-0192, items 0161-0164 or items 0151-0153, as appropriate (refer to general rule B). Note: Only one of items 0145, 0146 | - |
| 93 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0147 | For an emergency consultation/visit away from the doctor's home or rooms, all hours: ADD only to the consultation/visit items 0190-0192, items 0173-0175, items 0161-0164, items 0166-0169 or items 0151-0153, as appropriate. Note: Only one of items 0145, 01 | - |
| 94 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0148 | For elective after-hours services on request of the patient or family (non emergency) (refer to general rule B(a)): ADD 50% of the fee for the appropriate consultation/visit item (only to be used with items 0190-0193, items 0173-0175, items 0161-0164, ite | - |
| 95 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0149 | After-hours bona fide emergency consultation/visit (21:00-06:00 daily): ADD 25% of the fee for the appropriate consultation/visit item (only to be used with items 0190-0193, items 0173-0175, items 0161-0164, items 0166-0169, items 0151-0153 or item 0113) | - |
| 96 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0151 | Pre-anaesthetic assessment: Pre-anaesthetic assessment of patient (all hours). Problem focused history and clinical examination and straightforward decision making for minor problem. Typically occupies the doctor face-to-face with the patient for between | - |
| 97 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0152 | Pre-anaesthetic assessment: Pre-anaesthetic assessment of patient (all hours). Detailed history and clinical examination and straightforward decision making and counselling. Typically occupies the doctor face-to-face with the patient for between 20 and 35 | - |
| 98 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0153 | Pre-anaesthetic assessment: Pre-anaesthetic assessment of patient or other consultative service. Consultation with detailed history, complete examination and moderate complex decision making and counselling. Typically occupies the doctor face-to-face for | - |
| 99 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0162 | Psychiatry ('22'): New and established patients: Consultation/visit of new or established patient with detailed history, clinical examination and straightforward decision making and counselling. Typically occupies the doctor personally with the patient be | - |
| 100 | KirstyKF | 22/08/2025 09:27 AM | KirstyKF | 22/08/2025 09:27 AM | 0173 | First hospital consultation/visit of an average duration and/or complexity. Includes counselling with the patient and/or family and co-ordination with other health care providers or liaison with third parties on behalf of the patient (not appropriate for | - |