Public – I3 – A2
                            OFFICIAL
     Public hospital 
     fee schedule and 
     guidelines
     Effective date: 01 July 2022
                 Contents
               How to use this booklet---------------------------------------------------------------------------------------------------------------------4
               Interpretations--------------------------------------------------------------------------------------------------------------------------------5
                  Determination of fees-----------------------------------------------------------------------------------------------------------------------------6
                  Discount or remission of fees-------------------------------------------------------------------------------------------------------------------6
               Schedule 1 – Incorporated hospitals and public hospital sites: fees for admitted patients who are work injury 
               patients-----------------------------------------------------------------------------------------------------------------------------------------7
                  1      Interpretation--------------------------------------------------------------------------------------------------------------------------------7
                  2      Determination of applicable AR-DRG--------------------------------------------------------------------------------------------------7
                  3      Standard fee for admitted patients----------------------------------------------------------------------------------------------------7
                  4      Fee for rehabilitation or maintenance care------------------------------------------------------------------------------------------8
                  5      Medical or diagnostic services not included in fees for private patients------------------------------------------------------8
                  6      Retrieval fee (admitted patients)-------------------------------------------------------------------------------------------------------8
                  7      Transportation fee--------------------------------------------------------------------------------------------------------------------------8
                  8      Other fees-------------------------------------------------------------------------------------------------------------------------------------8
                  9      Tables------------------------------------------------------------------------------------------------------------------------------------------9
                           Table 1: Hospital prices-----------------------------------------------------------------------------------------------------------------9
                           Table 2: Rehabilitation and maintenance care fees-----------------------------------------------------------------------------9
                           Table 3: Diagnostic related groups (DRG) Version 8.0-------------------------------------------------------------------------10
               Schedule 2 – Incorporated hospitals and public hospital sites: fees for non-admitted patients who are work injury 
               patients----------------------------------------------------------------------------------------------------------------------------------------34
                  1      Interpretation------------------------------------------------------------------------------------------------------------------------------34
                  2      Fee for emergency department or emergency occasion of service----------------------------------------------------------35
                  3      Fee for outpatient occasion of service-----------------------------------------------------------------------------------------------36
                  4      Fee for outpatient group occasion of service--------------------------------------------------------------------------------------36
                  5      Fee for outreach occasion of service-------------------------------------------------------------------------------------------------36
                  6      Additional fees-----------------------------------------------------------------------------------------------------------------------------36
                  7      Retrieval fee (non-admitted patients)-----------------------------------------------------------------------------------------------37
                  8      Transportation fee------------------------------------------------------------------------------------------------------------------------37
                  9      Tables----------------------------------------------------------------------------------------------------------------------------------------37
                           Table 1: Non-admitted patient prices---------------------------------------------------------------------------------------------37
                           Table 2: Emergency department (ED) cost weights----------------------------------------------------------------------------38
                           Table 3: Outpatient (OP) cost weights---------------------------------------------------------------------------------------------38
                           Table 4: Outpatient (OP) Group cost weights------------------------------------------------------------------------------------40
                           Table 5: Outreach cost weights-----------------------------------------------------------------------------------------------------42
               Schedule 3 – Incorporated hospitals and public hospital sites: accommodation, rehabilitation, domiciliary care, 
               transportation and related fees for work injury patients-------------------------------------------------------------------------43
                  1.     Glenside Hospital facility----------------------------------------------------------------------------------------------------------------43
                  2.     Hampstead Rehabilitation Hospital Facility – Head injury service-----------------------------------------------------------43
                  3.     Country domiciliary care----------------------------------------------------------------------------------------------------------------43
                  4.     All incorporated hospitals and public hospital sites-----------------------------------------------------------------------------43
               Schedule 4 – Classification of public hospital sites---------------------------------------------------------------------------------44
               General information------------------------------------------------------------------------------------------------------------------------47
                  Account and invoicing standards-------------------------------------------------------------------------------------------------------------47
                  GST 47
               ReturnToWorkSA – Public hospital fee schedule                                                                                           2
       Changes to provider details--------------------------------------------------------------------------------------------------------------------47
       Where payment is outstanding----------------------------------------------------------------------------------------------------------------47
      Useful contacts------------------------------------------------------------------------------------------------------------------------------48
       Claims agents--------------------------------------------------------------------------------------------------------------------------------------48
       ReturnToWorkSA EnABLE Unit----------------------------------------------------------------------------------------------------------------48
       Self-insured employers-------------------------------------------------------------------------------------------------------------------------48
       
      ReturnToWorkSA – Public hospital fee schedule         3
              How to use this booklet
              This booklet contains information on services and fees that apply to public hospitals that provide services to South 
              Australian workers who are managed under the Return to Work scheme.
              This publication is based on the schedule published by the Minister for Industrial Relations in the South Australian 
              Government Gazette. Gazetted fees are the maximum fees chargeable, excluding GST. Where applicable, GST can be 
              applied over and above the gazetted fee. 
              All services and fees in this schedule are effective 01 July 2022.
              Invoicing and service provision is actively monitored to ensure services are billed in accordance with this fee schedule 
              and that services are reasonable for the work injury and payable under the Return to Work Act 2014, (the Act).
              This schedule contains the following:
              1.   Interpretations
              2.   Schedule 1 – fees for admitted patients
              3.   Schedule 2 – fees for non-admitted patients
              4.   Schedule 3 – accommodation, rehabilitation, domiciliary care and related fees
              5.   Schedule 4 – classification of public hospital sites
              6.   General information (including invoicing standards and useful contacts).
              For copies of this document visit our website at www.rtwsa.com.
              The gazetted version can be downloaded from the South Australian Government Gazette website at 
              www.governmentgazette.sa.gov.au.
              If you have any questions, please contact ReturnToWorkSA on 13 18 55.
              ReturnToWorkSA – Public hospital fee schedule                                                                                   4