Fee eligibility

All pre and post-operative care
Daily ward care, including intensive care for procedures for which it is expected
Pre-operative anaesthetic assessment
Management of post-operative analgesia
Management of commonly occurring minor complications in the peri-operative period

Fees that do not exceed our maxima for procedures that have been authorised by us in advance
For continuous regional anaesthesia e.g. brachial plexus block, epidural block where performed by the operator, in the absence of general anaesthesia. The multiple procedure billing rules should be followed
For topical or infiltration anaesthesia, or moderate conscious sedation, where performed by the operator, in the absence of general anaesthesia. In such cases the code AC100 should be used
For continuous epidural blockade, or major nerve blockade after localisation, performed by an anaesthetist in addition to general anaesthesia. The multiple procedure rules should be followed
Fees of a standby consultant where there is written motivation for the clinical need received in advance of the procedure and this is agreed by us

Fees that exceed our maxima for procedures that have been unusually complex and have been agreed by us in advance of invoicing
Fees of a second consultant where the procedure is unusually complex and this has been agreed by us in advance of the procedure
For procedures that are experimental, provided there is evidence of their safety and efficacy, they are performed as part of a properly conducted clinical trial and they are discussed with and agreed by us in advance

Surgeons' fees for local anaesthesia where an anaesthetist has provided anaesthesia
For additional procedures that are integral to the procedure(s) being performed (unbundling). For examples, please see the section on unbundling
Fees of surgical assistants
For routine postoperative care, including daily visiting
Fees for consultations by radiologists or anaesthetists
Consultant fees for histopathology or diagnostic imaging in a private hospital
Fees for consultations on the same day as an inpatient procedure

For more information, click the links below.