Compensation for Occupational Injuries and Diseases Act, 1993 (Act No. 130 of 1993)

Scale of Fees

Annual Increase in Medical Tariffs for Medical Service Providers - 2018

Renal Care, Social Worker Services, Psychologists and Wound Care 2018

Rules for payments of Social Worker services and Psychologists
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Rules for payments of Social Worker services and Psychologists in terms of COIDA

 

From 1 April 2018

 

1.In terms of SEC 73(1) of COIDA, the Compensation Fund shall pay reasonable medical costs incurred by on behalf of an employee in respect of medical aid necessitated by such accident or disease.

 

2.The need for the services must be directly related to the nature of injury sustained or complications thereof.

 

3.The services of a social worker shall be available only on a written referral by a medical practitioner. Medical invoice must be accompanied by a progress report and a referral letter. Without both these reports, payment will not be considered.

 

4.Code 89205 and 89206 can be claimed with code 89200, 89201 and 89202.

 

5.Only 10 sessions are payable (individual and group session together) per claim.

 

6.Unless timely steps are taken to cancel an appointment, the relevant fee may be charged to the employee.

 

7.If there is no active therapy for a period of three (3) calendar months, the treatment will be deemed to have terminated. Subsequently services will require a new referral letter and a treatment plan.

 

 

Psychologists

 

1.Only twelve(12) consultations payable, should further treatment be required, the treating medical practitioner must submit progress report to the Compensation Commissioner indicating a need for further treatment and only a maximum of 6 additional consultations can be approved. Without such a report payment cannot be considered.