Maintenance Act, 1998
R 385
Compensation for Occupational Injuries and Diseases Act, 1993 (Act No. 130 of 1993)Scale of FeesAnnual Increase in Medical Tariffs for Medical Service Providers - 2022Occupational Therapy Gazette 2022Occupational Therapy Tariff of Fees as from 1 April 2022General Rules |
| 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 fees 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 | Authorisation may only be granted if the medical practitioners written referral letter clearly indicates the reason for the referral, relationship to the original injury. The referral may be on the Occupational therapists or medical practitioners letterhead, provided it is signed by the referring doctor. |
| 004 | Newly hospitalised patients will be allowed up 20 sessions without pre-authorisation. If further treatment is necessary after a series of 20 treatment sessions for the same condition, the treating medical practitioner must submit a motivation with treatment plan to the Compensation Fund for considering further authorisation. |
| 005 | Out Patient : In cases of out-patients, all treatment sessions will need pre-authorisation.All request for pre-authorisation must be based on clinical need, best practice and be in the best interest of the patient. The physiotherapist must submit a referral with motivation from the treating doctor and a treatment plan. The first consultation can be done before pre-authorisation to allow the physiotherapist to provide a treatment plan to the fund for pre-authorisation. Practitioners will be allowed up to ten (10) treatment sessions to continue with treatment after submitting their request while awaiting response from the Fund. The rehabilitation professional must submit monthly progress report. |
| 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. |
| 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. |
| 010 | Materials used in treatment shall be charged at cost. |
| 011 | When the occupational therapist administers treatment away from his / her premises, travelling costs shall be charged as follows: R4.12 per km for each kilometre travelled in own car e.g. 19 km total = 19 X R4.12 = R78.28,e.g. for domiciliary treatments or treatments in nursing homes. |
Modifier 0011 must be quoted after the appropriate tariff code to show that this rule is applicable.
Please note the Compensation Fund will allow payment of transport expenses for exceptional cases only
| 016 | Physiotherapists, Occupational Therapist and Chiropractors may not provide simultaneous treatment at the same time on a day, but may treat the same patient. (Multidisciplinary treatment goals must be considered and the best placed service provider to achieve the rehabilitation goal must address that specific goal). |
