Chapter 1 / Consultations, Practitioner Fees, Simple Investigations and Procedures and General Procedures

1.1 - Investigations

Code Description Complexity Procedure fees Fee for general anaesthesia
Unacceptable Combinations
Additional Information

20110 ECG (Including reporting) £25.00 £0.00 Show arrow
20150 Patch testing (Inclusive of application, reading & reporting) £25.00 £0.00 Show arrow
20210 Pure tone audiogram (air conduction) - including masking £25.00 £0.00 Show arrow
20141 Continuous ambulatory ECG for up to 72 hours (including reporting) £75.00 £0.00
20220 Pure tone audiogram (air and bone conduction) - including masking £25.00 £0.00 Show arrow
20230 Impedance audiogram £25.00 £0.00 Show arrow
20240 Impedance audiogram as part of other procedure £25.00 £0.00 Show arrow
64301 Echocardiography including bubble contrast (including reporting) as sole procedure £150.00 £0.00 Show arrow

1.2 - Simple procedures

Code Description Complexity Procedure fees Fee for general anaesthesia
Unacceptable Combinations
Additional Information

20144 Continuous ambulatory ECG for over 72 hours and up to 7 days (including reporting) £125.00 £0.00
25000 Incision and drainage (not elsewhere covered) £75.00 £0.00 Show arrow
25022 Stellate ganglion block (local anaesthetic) +/- Image Guidance £150.00 £110.00 Show arrow
C6180 Bleb needling +/- antimetabolites (including topical or local anaesthetic) £100.00 £0.00 Show arrow
C6181 Laser suture lysis (including topical or local anaesthetic) £100.00 £0.00
E2880 Epley manoeuvre (code for specialist use only) £25.00 £0.00 Show arrow
F2621 Frenotomy /frenectomy of tongue under local anaesthetic £150.00 £0.00
H2510 Rigid sigmoidoscopy including proctoscopy and biopsy £75.00 £0.00 Show arrow
H5230 Injection of sclerosing substance into haemorrhoids £75.00 £100.00 Show arrow
H5240 Banding of haemorrhoids £75.00 £55.00 Show arrow
H5260 Low voltage treatment of internal haemorrhoids £75.00 £0.00
L8600 Unilateral varicose vein injection sclerotherapy £75.00 £0.00 Show arrow
S1110 Curettage/cryotherapy of lesion of skin including cauterisation - up to three £75.00 £0.00 Show arrow
S1500 Biopsy of skin or subcutaneous tissue £75.00 £0.00 Show arrow
S1510 Needle/tru-cut biopsy of muscle (as sole procedure) £75.00 £0.00 Show arrow
S4780 Aspiration of subcutaneous haematoma £75.00 £0.00 Show arrow
S5322 Injection of therapeutic substance into keloid scar £75.00 £0.00
X3520 IV sedation administered by anaesthetist (as sole procedure) £100.00 £0.00 Show arrow
X3530 Sedation or general anaesthesia for MRI or CT scan £0.00 £100.00
W9040 Injection(s) +/- aspiration, into joint, cyst, bursa or soft tissue Minor £50.00 £100.00 Show arrow
S5211 Injection of Botulinum Toxin for Hyperhidrosis £100.00 £0.00 Show arrow
W9282 Joint fluid examination (eg polarising microscopy) performed by consultant including aspiration of fluid £75.00 £100.00 Show arrow
X4810 Change of cast without general anaesthetic (as sole procedure) £75.00 £0.00 Show arrow

1.3 - General procedures

Code Description Complexity Procedure fees Fee for general anaesthesia
Unacceptable Combinations
Additional Information

20130 Exercise ECG (including base line 12 lead ECG and reporting) £75.00 £0.00 Show arrow
20132 Exercise or dobutamine stress echocardiography (including ECG and reporting) £100.00 £0.00 Show arrow
20140 24 hour ECG Holter (including reporting) £75.00 £0.00 Show arrow
20142 Insertion of implantable ECG loop recorder (including reporting) £200.00 £0.00 Show arrow
20143 Removal of implantable ECG loop recorder (including reporting) £200.00 £0.00 Show arrow
22000 Routine electroencephalography (EEG) in adult or child aged over 5 (including reporting) £75.00 £0.00 Show arrow
25010 Paravertebral block up to two levels (without X-ray control) £120.00 £0.00 Show arrow
64300 Echocardiography (including reporting) as sole procedure £100.00 £0.00 Show arrow
G2180 Ambulatory 24h pH and impedance monitoring £100.00 £0.00 Show arrow
D0702 Aural toilet (including microsuction and/or suction of exteriorised mastoid cavity) including bilateral £50.00 £0.00 Show arrow
P2730 Colposcopy (+/- biopsy, polypectomy or vulvoscopy) £100.00 £100.00 Show arrow
Q1280 Introduction of a Mirena coil £50.00 £100.00 Show arrow
Q2020 Endometrial biopsy or aspiration £100.00 £0.00 Show arrow
S4760 Fine needle aspiration cytology £100.00 £0.00 Show arrow

1.4 - Consultations and Physicians’ fees

In-patient care fees are only claimable by the person in primary charge of the case.... Other specialists may claim for specific consultations for specific purposes. ITU fees are expected to include insertion of central lines, arterial lines, dialysis lines, pulmonary artery catheters and similar.

20300Initial out-patient consultation - face to face£130£175£250
20310Follow-up out-patient consultation - face to face£100£120£170
20370Remote Consultation 30 minutes or more (Initial consultation) £130£175£250
20360Remote Consultation 16-29 minutes (Follow up consultation) £100£120£170
20320In & day-patient care£50£60£50
ITU (see policy) £200
Family therapy£290
Psychological therapy£100

1.5 - Practitioner and Therapist fees

We will pay fees up to the contracted or agreed rate which we have in-place with the individual recognised practitioner who provides the treatment. The member will not be responsible for any shortfall (subject to any policy or benefit limitations).

The following fees are reimbursable per session of treatment. No more than one session can be claimed on the same day.

Nurse practitioner£60Dietician£60
Psychologist£100Speech therapist£75

Neuropsychological and Neuropsychiatric Assessment

We will pay a fee of up to £600 for an eligible assessment. To qualify, the assessment must be pre authorised by our customer service department. If not pre authorised, the reimbursement limit of £100 for psychologists and £250 for psychiatrists will apply, and we will shortfall the claim. The payment we make is to include all preparation, report writing, travel and any other administrative costs.

Back to chapter list