2018 Private Hospital Fees Schedule
Private hospitals fee order from 1 July 2018 under section 62(1) of the Workers Compensation Act 1987.
| Code | Type of service | Maximum fees for service |
|---|---|---|
| Overnight facility fees (daily) | ||
| PTH001 | Advanced surgical 1 to 14 days | $838.30 |
| > 14 days | $568.00 | |
| PTH002 | Surgical 1 to 14 days | $789.10 |
| > 14 days | $568.00 | |
| PTH003 | Psychiatric 1 to 21 days | $749.90 |
| 22 to 65 days | $579.80 | |
| Over 65 days | $532.30 | |
| PTH004 | Rehabilitation 1 to 49 days | $814.60 |
| >49 days | $598.60 | |
| PTH005 | Other (medical) 1 to 14 days | $700.60 |
| > 14 days | $568.00 | |
| PTH007 | Intensive care <5 days, level 2 | $3,259.90 |
| <5 days, level 1 | $2,256.70 | |
| PTH006 | Day facility fees (including accident and emergency attendance) (daily) | |
| Psychiatric | ||
| Full-day program - treatments with a minimum of 4.5 hours' duration | $360.50 | |
| Half-day program - treatments with a minimum of 2.5 hours' duration | $281.70 | |
| Rehabilitation | ||
| Full-day program - treatments with a minimum of 3 hours' duration | $360.50 | |
| Half-day program - treatments between 1.5 and 2.5 hours' duration | $281.70 | |
| Band 1 - absence of anaesthetic or theatre times | $360.50 | |
| Band 2 - local anaesthetic, no sedation | $423.40 | |
| Band 3 - general or regional anaesthetic or intravenous sedation, less than 1 hour theatre time | $477.80 | |
| Band 4 - general or regional anaesthetic or intravenous sedation, 1 hour or more theatre time | $534.00 | |
| PTH008 | Theatre fees - as per national procedure banding schedule.
| |
| Band 1A | $202.40 | |
| Band 1 | $360.50 | |
| Band 2 | $617.30 | |
| Band 3 | $755.10 | |
| Band 4 | $1,022.00 | |
| Band 5 | $1,501.50 | |
| Band 6 | $1,722.60 | |
| Band 7 | $2,302.40 | |
| Band 8 | $3,205.50 | |
| Band 9A | $3,314.40 | |
| Band 9 | $4,235.20 | |
| Band 10 | $5,009.70 | |
| Band 11 | $5,931.40 | |
| Band 12 | $6,409.30 | |
| Band 13 | $7,773.10 | |
| Surgical prostheses fees: | ||
| As per Department of Health listed minimum rate | |
| 5% of prosthesis fee capped at $169.00 | |
| WCO005 | Fee for the electronic provision of health records | Flat fee of $38 |
Fee for electroconvulsive (ECT): this service is to be billed using the facility fee Band 3 (PTH006) and theatre Band 1 (PTH008).
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