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2018 Private Hospital Fees Schedule

Private hospitals fee order from 1 July 2018 under section 62(1) of the Workers Compensation Act 1987.

CodeType of serviceMaximum fees for service
Overnight facility fees (daily)
PTH001Advanced surgical 1 to 14 days$838.30
> 14 days$568.00
PTH002Surgical 1 to 14 days$789.10
> 14 days$568.00
PTH003Psychiatric 1 to 21 days$749.90
22 to 65 days$579.80
Over 65 days$532.30
PTH004Rehabilitation 1 to 49 days$814.60
>49 days$598.60
PTH005Other (medical) 1 to 14 days$700.60
> 14 days$568.00
PTH007Intensive care <5 days, level 2$3,259.90
<5 days, level 1$2,256.70
PTH006Day 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.
Multiple procedure rule:

  • 100% of fee for first procedure
  • 50% for second procedure undertaken at the same time as the first
  • 20% for the third and subsequent procedures undertaken at the same time as the first
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:
  • Prostheses
As per Department of Health listed minimum rate
 
  • Handling fee
5% of prosthesis fee capped at $169.00
WCO005Fee for the electronic provision of health recordsFlat 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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