HEALTHMAN UROLOGY COSTING GUIDE 2013

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1 HEALTHMAN UROLOGY COSTING GUIDE COMPARATIVE TARIFFS: Scheme Rates Base Rates Practice Cost Tariff (VAT Incl.) Discovery (VAT incl.) Consultations: Units R R R R R R R R R R See the Notes below for All 0109 Hospital follow-up visit Prolonged first/follow-up consultation : 15 min Telephone consultation (all hours) Repeat Script Writing of special motivations Consultation : Away from doctor's room Unscheduled consultation: Emergency (cons.room) Unscheduled consultation:emergency(not cons.room) Hospital Consultation Hospital Consultation Hospital Consultation 45 1, Consultation Consultation Consultation 45 1, Chronic Medicine Forms Procedures 1819 Inguinal or femoral hernia: Adult 125 4, , , , , Radical with regional lymph adenectomy for tumour 280 9, , , , , Nephrolithotomy 227 7, , , , , Nephrolithotomy: Multiple calculi: Repeat open operation + 25% 284 9, , , , , Pyeloplasty 252 8, , , , , Ureterolithotomy , , , , , Cystoscopy: Hospital equipment 44 1, And retrograde pyelography or retrograde ureteral catheterisation: Unilateral or bilateral J J Stent catheter 44 1, Uretroscopy 35 1, And bilateral ureteric catheterisation with differential function studies requiring additional attention time 35 1, With dilatation of the ureter or ureters With manipulation of ureteral calculus With removal of foreign body or calculus from urethra or bladder And cold biopsy Optic urethrotomy 80 2, Internal urethrotomy: Female 50 1, Internal urethrotomy: Male , Transurethral resection of bladder tumour 100 3, , , Transurethral resection of bladder tumours: Large multiple tumours 115 3, , , , ,

2 HEALTHMAN UROLOGY COSTING GUIDE COMPARATIVE TARIFFS: Scheme Rates Base Rates Practice Cost Tariff (VAT Incl.) Discovery (VAT incl.) Units R R R R R R R R R R 1986 Transurethral resection of bladder neck: Male 125 4, , , , , Cystometrogram Without videocystograph Vesico-urethropexy with rectus sling , , , , , Evacuation of clots from bladder: Other than post-operative , , , , , Bladder neck plasty: Male 137 4, , , , , Dilatation of urethra stricture: By passage sound: Initial (male) Circumcision: Surgical excision other than by clamp or dorsal slit, any age 60 1, Hypospadias: Urethraplasty: Complete, one stage for hypospadias 300 9, , , , , Operation for maldescended testicle: Including herniotomy 135 4, , , , , Operation for hydrocele or spermatocele , , , Vasectomy: Unilateral or bilateral (no extra fee to be charged if done in combination 2207 with prostatectomy) , Seminal Vesiculectomy 220 7, , , , , Biopsy prostate: Needle or punch, single or multiple, any approach Biopsy prostate: Incisional, any approach 105 3, , , , , Trans-urethral resection of prostate 252 8, , , , , Prostatectomy: Perineal: Radical , , , , , Pelvic lymph adenectomy 175 5, , , , , Retropubic: Sub-total 252 8, , , , , Retropubic: Radical , , , , , Prostate brachytherapy 230 7, , , , , Repair of recurrent enterocele or vault prolapse (except at the time of hysterectomy) 232 7, , , , , Other operations for prolapse: Anterior repair - with or without posterior repair 161 5, , , , , Operation for stress incontinence: Use of tape , , , , , Operations for stress incontinence: Urethro-vesicopexy: Combined abdominal and vaginal approach 196 6, , , , , Electromyography: First 75 2, Procedures for pain relief: Peripheral nerve block Transrectal ultrasonographic prostate volume study for prostate brachytherapy (using own equipment) 110 3, , , , , * Renal tract High definition (small parts) scan: Thyroid, breast lump, scrotum, etc. 50 1, Ultrasound examination includes whole abdomen and pelvic organs, where pelvic organs are clinically indicated (including liver, gall bladder, spleen, pancreas, abdominal vascular anatomy, para-aortic area, renal tract, pelvic organs) 50 1,

3 HEALTHMAN UROLOGY COSTING GUIDE COMPARATIVE TARIFFS: Scheme Rates Base Rates Practice Cost Tariff (VAT Incl.) Discovery (VAT incl.) Note: Units R R R R R R R R R R 1.s, Descriptors and Unit Values have been extracted from the SAMA Doctors Billing Manual 2. The Healthman tariff for codes that relate to equipment have been retained at rate* 3. may differ due to rounding 4. Above codes are the most frequently used codes and is not all inclusive of all the codes 5. Increases from 2012 are as follow: a. = 2012 Scheme Tariff +5.5% b. Tariff = 2012 Tariff +7% c. Discovery Health = 2012 Tariff +5.5% for procedures & 6% for consultations (Note that this increase is for the Rate only) d. = 2012 Tariff +6% e. Fedhealth = 2012 Tariff +6% 6. Discovery Premier A Procedure Rates have NOT been split between In-Hospital & Out-Hospital. Use as appropriate. 7. Please take note that the Practice Cost Tariff is based on our 2008 Cost Studies adjusted with inflation indexes 8. All are inlcusive of VAT Disclaimer: The above schedule is based on information avaiable to and will NOT be held responsible for any losses incurred by practitioners resulting from the use of this schedule. Legend: = Discovery Health = Direct Payment Arrangement Prem = Premier R = Rand = Rand Conversion Factor (Rand Value per Unit) VAT = Value Added Tax

4 Payment Arrangments Consultations: Units Prem A In Hosp. Prem A Out Hosp. Classic Rate Prem B Exec Rate 137% 162% 147% 217% 300% 165% 210% R R R R R R R See the Notes below for All 0109 Hospital follow-up visit Prolonged first/follow-up consultation : 15 min Telephone consultation (all hours) Repeat Script Writing of special motivations Consultation : Away from doctor's room Unscheduled consultation: Emergency (cons.room) Unscheduled consultation:emergency(not cons.room) Hospital Consultation Hospital Consultation Hospital Consultation Consultation Consultation Consultation Chronic Medicine Forms , Procedures 1819 Inguinal or femoral hernia: Adult Radical with regional lymph adenectomy for tumour Nephrolithotomy Nephrolithotomy: Multiple calculi: Repeat open operation + 25% Pyeloplasty Ureterolithotomy Cystoscopy: Hospital equipment And retrograde pyelography or retrograde ureteral catheterisation: Unilateral or bilateral J J Stent catheter Uretroscopy And bilateral ureteric catheterisation with differential function studies requiring additional attention time With dilatation of the ureter or ureters With manipulation of ureteral calculus With removal of foreign body or calculus from urethra or bladder And cold biopsy Optic urethrotomy Internal urethrotomy: Female Internal urethrotomy: Male Transurethral resection of bladder tumour Transurethral resection of bladder tumours: Large multiple tumours 115 1, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,403.20

5 Payment Arrangments Units 1986 Transurethral resection of bladder neck: Male Cystometrogram Without videocystograph Vesico-urethropexy with rectus sling Evacuation of clots from bladder: Other than post-operative Bladder neck plasty: Male Dilatation of urethra stricture: By passage sound: Initial (male) Circumcision: Surgical excision other than by clamp or dorsal slit, any age Hypospadias: Urethraplasty: Complete, one stage for hypospadias Operation for maldescended testicle: Including herniotomy Operation for hydrocele or spermatocele Vasectomy: Unilateral or bilateral (no extra fee to be charged if done in combination with prostatectomy) Seminal Vesiculectomy Biopsy prostate: Needle or punch, single or multiple, any approach Biopsy prostate: Incisional, any approach Trans-urethral resection of prostate Prostatectomy: Perineal: Radical Pelvic lymph adenectomy Retropubic: Sub-total Retropubic: Radical Prostate brachytherapy Repair of recurrent enterocele or vault prolapse (except at the time of hysterectomy) Other operations for prolapse: Anterior repair - with or without posterior repair Operation for stress incontinence: Use of tape Operations for stress incontinence: Urethro-vesicopexy: Combined abdominal and vaginal approach Electromyography: First Procedures for pain relief: Peripheral nerve block Transrectal ultrasonographic prostate volume study for prostate brachytherapy (using own equipment) * Renal tract High definition (small parts) scan: Thyroid, breast lump, scrotum, etc. 50 Prem A Prem A Out Classic In Hosp. Hosp. Prem B Rate Exec Rate 137% 162% 147% 217% 300% 165% 210% R R R R R R R 1, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , Ultrasound examination includes whole abdomen and pelvic organs, where pelvic organs are clinically indicated (including liver, gall bladder, spleen, pancreas, abdominal vascular anatomy, para-aortic area, renal tract, pelvic organs) , ,

6 Payment Arrangments Note: Units Prem A In Hosp. Prem A Out Hosp. Classic Rate Prem B Exec Rate 137% 162% 147% 217% 300% 165% 210% R R R R R R R 1.s, Descriptors and Unit Values have been extracted from the SAMA Doctors Billing Manual 2. The Healthman tariff for codes that relate to equipment have been retained at rate* 3. may differ due to rounding 4. Above codes are the most frequently used codes and is not all inclusive of all the codes 5. Increases from 2012 are as follow: a. = 2012 Scheme Tariff +5.5% b. Tariff = 2012 Tariff +7% c. Discovery Health = 2012 Tariff +5.5% for procedures & 6% for consultations (Note that this increase is for the Ra d. = 2012 Tariff +6% e. Fedhealth = 2012 Tariff +6% 6. Discovery Premier A Procedure Rates have NOT been split between In-Hospital & Out-Hospital. Use as appropriate. 7. Please take note that the Practice Cost Tariff is based on our 2008 Cost Studies adjusted with inflation ind 8. All are inlcusive of VAT Disclaimer: The above schedule is based on information avaiable to and will NOT be held responsible for any Legend: = Discovery Health = Direct Payment Arrangement Prem = Premier R = Rand = Rand Conversion Factor (Rand Value per Unit) VAT = Value Added Tax

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