Compensation for Occupational Injuries and Diseases Act, 1993 (Act No. 130 of 1993)Scale of FeesAnnual Increase in Medical Tariffs for Medical Service Providers - 2019Physiotherapist, Occupational Therapy and Chiropractor 2019Occupational TherapyGeneral Rules governing the tariff |
| 001 | Unless timely steps are taken (at least two hours) to cancel an appointment for a consultation the relevant consultation fee shall be payable by the employee. |
| 002 | In exceptional cases where the tariff fee is disproportionately low in relation to the actual services rendered by the practitioner, a higher fee may be negotiated. Conversely, if the fee is disproportionately high in relation to the actual services rendered, a lower fee than that in the tariff should be charged. |
| 003 | The service of an occupational therapist shall be available only on written referral by the treating doctor medical doctor. The referral must be signed,dated and stamped by the treating doctor. |
| 004 | In cases of out-patients, all treatment sessions will need pre-authorisation. The Occupational Therapist must submit a referral with motivation from the treating doctor and a treatment plan. The referral letter should be signed,dated and stamped. The first consultation can be done before pre-authorisation to allow the O.T. to provide a treatment plan to the Fund for pre-authorisation. Practitioners will be allowed up to a maximum of ten (10) sessions to continue with treatment after submitting their request while awaiting response from the Fund. |
| 005 | The Occupational Therapist must provide an updated Rehabilitation Report, including outcome based measures. |
| 006 | "After hours treatment" shall mean those emergency treatment sessions performed at night between 18:00 and 07:00 on the following day or during weekends between 13:00 Saturday and 07:00 Monday. Public holidays are regarded as Sundays. The fee for all treatment under this rule shall be the total fee for the treatment plus 50 per cent. This rule shall apply for all treatment administered in the practitioner's rooms, or at a nursing home or private residence (only by arrangement when the patient's condition necessitates it). Modifier 0006 must then be quoted after the appropriate tariff code to indicate that this rule is applicable. |
| 008 | The provision of aids or assistive devices shall be charged at cost. Modifier 0008 must be quoted after the appropriate codes to show this rule is applicable. |
| 009 | Materials used in the construction of orthoses will be charged as per Annexure "A" for the applicable device and pressure garments will be charged as per Annexure "B" for the applicable garment. Modifier 0009 must be quoted after the appropriate codes to show that this rule is applicable. |
| 010 | Materials used in treatment shall be charged at cost. Modifier 0010 must be quoted after the appropriate tariff codes to show that this rule is applicable. |
| 011 | When the occupational therapist administers treatment away from his/her premises, travelling costs shall be charged as follows: R3.30 per km for each kilometre travelled in own car e.g. 19 km total = 19 X R3.30 = R62.70. |
| 012 | The occupational therapist shall submit the account for treatment to the employer of the employee concerned. |
| 013 | Physiotherapist, Occupational Therapists and Chiropractors cannot give the treatment concurrently and the treatment must not overlap. |