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 - 2024

Renal Care Gazette 2024

Renal care Tariffs of Fees as from 1 April 2024

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CLINICAL TECHNOLOGIST (PRACTICE TYPE 075)

General Information

Dialysis is always performed in accordance to a dialysis prescrition.

Dialysis prescription and supervision can be provided by a nephrologist or a medical practitioner with appropriate training in nephrology.

Haemodialysis provided in a dialysis unit, applies to both outpatient and stablised patients in a general ward.

Services and authorisation for renal dialysis should only be provided or issued for either a clinical technologist.

General Rules for processing of Renal Care invoices in terms of COIDA
1.In terms of Sec 73(1) of COIDA, The Compensation Fund shall pay reasonable medical costs incurred by or on behalf of an employee in respect of medical aid necessitated by such accident/disease.
2.The renal condition must be directly related to the nature of injury sustained or complications thereof.
3.Dialysis is always performed in accordance to a dialysis prescription.
4.Dialysis prescriptions can be provided by a nephrologist or a medical practitioner with appropriate training in nephrology.
5.Haemodialysis provided in a dialysis unit, applies to both outpatients and stabilised in-hospital patients.
6.Services and authorisation for renal dialysis should only be provided or issued for a Renal dialysis practitioner.
7.The Renal dialysis practitioner should have a referral and a dialysis prescription from the nephrologist or medical practitioner, indicating the number of sessions or treatments.
8.After a series of treatments prescribed by the nephrologist or a medical practitioner, the Renal dialysis practitioner should refer the employee back to the treating medical practitioner.
9.If further treatment is still indicated the treating medical practitioner should submit a medical report with clinical indications for further treatment.
10.A monthly medical report should be submitted and should the condition become chronic, a medical report explaining such condition must be submitted to The Compensation Fund.

General Rules

Rule

Rule Description

 

001

Travel Fee

Please note that the Compensation Fund does not accept the responsibility for transport expenses, as they are deemed to be included in the fee.

 

Tariff Codes

Code

Code Description

Rand

Note

In the case of tariff codes 75146 and 75148, routine outpatient dialysis includes dialyser, bloodlines, acetate dialysate, priming set, sodium heparin anticoagulant, saline infusion, dressing pack, fistula needles/catheter dressing, syringes and needles, cleaning materials, equipment set-up, up to 5 hours treatment time, equipment rental.

When a dialyisate is changed from acetate to bicarbonate haemodialysis solution, only one of the codes can be used.

 

75146

Chronic haemodialysis (acetate dialysate).

Use tariff code once per treatment day only.

2274.75

75147

Peritoneal dialysis, once per treatment day only.

308.57

75148

Chronic Haemodialysis (Bicarbonate Dialysate) for inpatient and outpatient in dialysis unit.

Use tariff code once per treatment day.

3294.33

 

The global fees for Continuous Ambulatory Peritoneal Dialysis (CAPD) (tariff code 75176) and Automated Peritoneal Dialysis (APD) (tariff code 75177) include: consumables; cost of machine and machine disposables; professional fee; initial training; in-centre follow-up visits; and home visits.

However, they exclude Tenchkhoff catheter and insertion thereof; and disposables required for a transfer set change (usually 6 monthly).

 

These fees are chargeable for each 30 day cycle in which CAPD or APD is provided.

If CAPD or APD is provided for less than a 30 days in any one cycle (for example due to complications or death of the patient):

 

a. if the period of treatment is 26 days or more that cycle, the full fee applies;

 

b. if the period of treatment is 26 days in that cycle, the full should be prorated according to number of actual treatment days. Modifier 0001 should be quoted, and number of treatment days specified.

 

75150

Acute Haemodialysis inpatient. Use tariff code once per treatment day only. This tariff code applies to all acute dialysis including haemodiafiltration, intermittent and continuous modalities.

6547.65

 

Emergency dialysis treatment in hospital; includes dialyser, bloodlines, acetate/bicarbonate dialysate, primary set, equipment set-up, up to 5 hours treatment time, equipment rental.

Applicable tariff codes 75150, 75151, 75152, 75154, and 75156.

 

75151

Treatment procedures for CRRT (Continous Renal Replacement Therapy) for up to 6 hours or part thereof. Tariff code to be charged in ICU general ward or high care only.

473.90

75152

Treatment procedure for CRRT up to 12 hours or part thereof provided that such part comprises more than 6 hours of the time.

Tariff code to be charged in ICU or high care only

949.85

75153

Patient training in centre for dialysis, CPAP training and problem-solving, home ventilators and nebulisers, per 30 minutes (to maximum of 24 hours)

290.59

75154

Treatment procedure for CRRT up to 18 hours or part thereof provided that such part comprises more than 12 hours of the time.

Tariff code to be charged in ICU or high care only.

1423.97

75155

Patient training or follow-up at patient's home for dialysis, home ventilators and neubilisers, per 30 minutes (to maximum of 24 hours).

509.06

75156

Treatment procedure for CRRT up to 24 hours or part thereof provided that such part comprises more than 18 hours of the time.

Tariff code to be charged in ICU or high care only.

1897.89

75176

Global Fee for Continuous Ambulatory Peritoneal (CAPD) charged per for 30 day period.

1169.71

75177

Global Fee for Automated Peritoneal Dialysis (APD) charged per for 30 day period.

1623.85