Fees Explained

  1. All our practices charge private fees. The fees will differ between the different practices. The office will provide you with the necessary tariff information for each practice.
  2. Some practices will claim in full or partially from your medical aid, but will not take responsibility for non payment.
  3.  There is no universal “medical aid” fee. All medical aids pay different amounts for the same service.
  4. If your medical aid pays less than the rate charged, you will be liable for the difference.
  5. If for what ever reason your medical aid does not pay, you will be liable for the full amount.
  6. You should check with your medical aid if you are covered and for what amount. It remains your responsibility.
  7. Fees are time based and are calculated as follows: 15min setup time + time from entering the procedure room until awake enough to be moved to the general reception area.
  8. Fee consists of Clinical fee ( doctors time and expertise) Medicine and disposables used during procedure

 

Sedation codes if applying for authorization

ICD 10 codes:   Usually K02.1 / K08.1  for dental procedures
Codes for other procedures will differ and can be obtained from your surgeon

Sedation Procedure codes:

1461                   Dental procedure / Other procedures will have a different code (Obtained from your surgeon)
0020                 Sedation outside a hospital theatre
0151                   Pre-anesthetic assessment
0034                  Head/neck or shoulder modifier
0036/0023      Sedation/ anesthetic time
0007                  The use of own monitoring equipment
0201                  The drugs and consumables used during the sedation.