1. The following Rules apply to all practitioners
001 Item 8101 refers to a Full Mouth Examination, charting and treatment planning and no further examination fees shall be chargeable until the treatment plan resulting from this consultation is completed with the exception of Item 8102. This includes the issuing of a prescription where only medication is prescribed.
Item 8104 refers to a consultation for a specific problem and not to a full mouth examination, charting and treatment planning. This includes the issuing of a prescription where only medication is prescribed.
002 Except in those cases where the fee is determined "by arrangement", the fee for the rendering of a service which is not listed in this schedule shall be based on the fee in respect of a comparable service that is listed therein and Rule 002 must be indicated together with the tariff item.
003 In the case of a prolonged or costly dental service or procedure, the dental practitioner shall ascertain beforehand from the Commissioner whether he will accept financial responsibility in respect of such treatment.
004 In exceptional cases where the tariff fee is disproportionately low in relation to the actual services rendered by a practitioner, such higher fee as may be mutually agreed upon between the dental practitioner and the Commissioner may be charged and Rule 004 must be indicated together with the tariff item.
005 Save in exceptional cases the service of a specialist shall be available only on the recommendation of the attending dental or medical practitioner. Referring practitioners shall indicate to the specialist that the patient is being treated under the Compensation for Occupational Injuries and Diseases Act.
007 "Normal consulting hours" are between 08:00 and 17:00 on weekdays, and between 08:00 and 13:00 on Saturdays.
008 A dental Practitioner shall submit his account for treatment under the Act to the employer of the employee concerned.
009 Dentists in general practice shall be entitled to charge two-thirds of the fees of specialists only for treatment that is not listed in the schedule for dentists in general practice and Modifier 8004 must be shown against any such item.
Benefits in respect of specialists charging treatment procedures not listed in the schedule for that speciality, shall be allocated as follows:
General Dental Practitioners Schedule 100%
Other Dental Specialists Schedule 2/3
010 Fees charged by dental technicians for their services (PLUS L) shall be shown on the dentist's invoice against the code 8099. Such dentist's invoice shall be accompanied by the actual invoice of the dental technician (or a copy thereof) and the invoice of the dental technician shall bear the signature of the dentist (or the person authorised by him) as proof that it has been complied correctly. "L" comprises the fee charged by the dental technician for his services as well as the cost of gold and of teeth. For example, item 8231 is specified as follows:
|
|
Rc |
|
8231 |
X |
|
8009 (8231) |
Y |
|
Total |
R(X+Y) |
011 Modifiers may only be used where (M/W) appears against the item in the schedule.
8001 33 1/3 % of the appropriate scheduled fee (see Note 4 - preamble to Maxillo-facial and oral surgery schedule).
8002 The appropriate scheduled fee + 50% (see Note 1 - preamble to Maxillo-facial and oral surgery schedule).
8003 The appropriate scheduled fee + 10% (see Note 5 - preamble to Perio schedule).
8004 Two-thirds of appropriate scheduled fee (see Rule 009).
8005 The appropriate scheduled fee up to a maximum of R171.20 (see Note 2 - preamble to Maxillo-facial and oral surgery schedule).
8006 50% of the appropriate scheduled fee (see Note 3 - preamble to Maxillo-facial and oral surgery schedule).
8007 15% of the appropriate scheduled fee with a maximum of R86.90 (see preamble(s) under "oral surgery" in the schedule for GP's and the schedule for specialists in Maxillo-facial and oral surgery).
8008 The appropriate scheduled fee + 25% (see Note 5 - preamble to Maxillo-facial and oral surgery schedule, GP's schedule).
8009 75% of the appropriate scheduled fee (see Note 3 under the preamble of the Maxillo-facial and oral surgery schedule).
8010 The appropriate scheduled fee plus 75%.
012 In cases where treatment is not listed in the schedule for dentists in general practice or specialists then the appropriate fee listed in the medical schedules shall be charged and the relevant item in the medical schedules must be indicated.
013 Cost of material (VAT inclusive): This item provides for a charge for material where indicated against the relative item codes by the words (See Rule 013). Material to be charged for at cost plus a handling fee not exceeding 35%, up to R1433.80. A maximum handling fee of 10% shall apply above a cost of R1433.80. A maximum handling fee of R2150.70 will apply.
Note: Item 8220 (suture) is applicable to all registered persons.
Explanations
2. Additions, deletions and revisions
A summary listing of additions, deletions and revisions applicable to this Schedule is found in Appendix A.
New code numbers added to the Schedule are identified with the symbol . placed before the code number.
In instances where a code has been revised, the symbol * is placed before the code number.
3. Tooth identification
Tooth identification is compulsory for all invoices rendered. Tooth identification is only applicable to procedures identified with the letter (T) in the mouth part (MP) column. The International Standards Organisation (ISO) in collaboration with the FDI designated system for teeth and areas of the oral cavity, should be used.
4. Abbreviations used in the Schedule
+D Add fee for denture
+L Add laboratory fee
GP General practitioner
M/W Modifier
MP Mouth part
Na Not applicable
T Tooth
5. VAT
Fees are VAT inclusive.