2019 Private Hospital Fee Schedule
Private hospital fees order from 1 January 2019 under section 62(1) of the Workers Compensation Act 1987.
Code | Type of Service | Maximum fess 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 | |
Daily facility fees (including accident and emergency attendance) (daily) | ||
PTH006 | 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:
| |
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 | |
PTH009 | Surgical prostheses fees | |
Prostheses | As per Department of Health listed minimum rate | |
Handling fee | 5% of prosthesis fee capped at $169.00 | |
WCO005 | Fee for the electronic provision of health records | Flat fee of $60.00 |
For the electroconvulsive (ECT): this service is to be billed using the facility fee Band 3 (PTH006) and theatre Band 1 (PTH008).
©SIRA