2016 Private Hospital Fees Schedule

Private hospitals fee schedule from 1 July 2016 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$786.40
> 14 days$532.80
PTH002Surgical 1 to 14 days$740.20
> 14 days$532.80
PTH003Psychiatric 1 to 21 days$703.50
22 to 65 days$543.90
Over 65 days$499.30
PTH004Rehabilitation 1 to 49 days$764.10
>49 days$561.50
PTH005Other (medical) 1 to 14 days$657.20
> 14 days$532.80
PTH006Day facility fees (including accident and emergency attendance) (daily)
Psychiatric
Full-day program - treatments with a minimum of 4.5 hours' duration$338.20
Half-day program - treatments with a minimum of 2.5 hours' duration$264.20
Rehabilitation
Full-day program - treatments with a minimum of 3 hours' duration$338.20
Half-day program - treatments between 1.5 and 2.5 hours' duration$264.20
Band 1 - absence of anaesthetic or theatre times$338.20
Band 2 - local anaesthetic, no sedation$397.20
Band 3 - general or regional anaesthetic or intravenous sedation, less than 1 hour theatre time$448.20
Band 4 - general or regional anaesthetic or intravenous sedation, 1 hour or more theatre time$500.90
PTH007Intensive care <5 days, level 2$3,057.90
<5 days, level 1$2,116.80
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$189.80
Band 1$338.20
Band 2$579.00
Band 3$708.30
Band 4$958.70
Band 5$1,408.50
Band 6$1,615.90
Band 7$2,159.80
Band 8$3,006.90
Band 9A$3,109.00
Band 9$3,972.80
Band 10$4,699.30
Band 11$5,563.90
Band 12$6,012.20
Band 13$7,291.50
Surgical prostheses fees:
  • Prostheses
As per Department of Health listed minimum rate
 
  • Handling fee
5% of prosthesis fee capped at $158.50

Fee for electroconvulsive (ECT): this service is to be billed using the facility fee Band 3 (PTH006) and theatre Band 1 (PTH008.

______________________________________

©WorkCover NSW
Catalogue No. WC01012

Related Content

Contact Us

Email
contact@workcover.nsw.gov.au
Telephone
13 10 50