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2016 Public hospital fees order

Public hospital fees, codes, items and services descriptors for services to injured workers on or after 1 July 2016.

For all patients admitted prior to 1 July 2016, please refer to the  Workers Compensation (Public Hospital Rates) Order 2015 for the appropriate fee.

Acute admitted, emergency department admitted and emergency department non-admitted patient services except in small rural hospitals - patients admitted on or after 1 July 2016.

Payment
classification
code
Item Fee
PUH 001 Acute admitted (NWAU (16) - 11%) x NEP ($4,883)
ED admitted (NWAU (16) - 11%) x NEP ($4,883)
ED non admitted NWAU (16) x NEP ($4,883)
Non-acute/sub-acute admitted patient services and outpatient services and ED patient services small rural hospitals
Payment classification code Item Fee
PUH 002 Public hospital (sub-acute and non-acute) - in patient Max $1,135/day
Incorporating:
  • public hospital
$1,135/day
  • public psychiatric hospital
$476/day
  • other (eg residential aged care facility)
$267/day
Dialysis $640 (per session)
PUH 003 Public hospital - outpatient occasion of services (excluding physiotherapy, psychology and exercise physiology services - use relevant WC gazetted fees for these services with code PUH 003) and ED of small rural hospitals not collecting patient level data Max $121/occasion
Public hospital $121/occasion
Public psychiatric hospital $84/occasion
Other (eg residential aged care facility) $84/occasion
Brain injury rehabilitation program services
Code Item Fee
PBI 001 Admitted patient brain injury rehabilitation service Max $1696/day
Incorporating:
  • category A patient
$1,193/day
  • category B patient
$763/day
  • category X patient
$1696/day
PBI 002 Metropolitan (non-referral) services Max $852/day
Incorporating:
  • category A patient
$852/day
  • category B patient
$422/day
PBI 003 Non-admitted patient services $81 per half hour
PBI 004 Out-patient medical clinic appointments Max $282
Incorporating:
  • initial assessment
$282
  • follow up assessment
$141
PBI 005 Group activities:
  • directly supervised by qualified allied health clinician
$52 per half hour
  • not directly supervised by qualified allied health clinician
$37 per half hour
Spinal injury rehabilitation services at Royal Rehabilitation Centre Sydney
Code Item Fee
PSI 001 Admitted patients $1,135/day
PSI 002 Out-patient services $81 half hour per therapist
Fees for medical/clinical reports*
Code Item Fee
PHR 001 Public hospital medical reports Max $790
PHR 002 Public hospital records Max $106

*Reports charging in accordance with the rates set out in NSW Health IB2014_054 subject to the categorisations set out in NSW Health PD2006_050, both at those rates or categorisations are amended or revised from time to time.

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©SIRA
Catalogue No. WC01023