Independent Practitioners Association Foundation

Medscheme

Dear Healthcare Professional,

The South African Medical Association (SAMA) changed their definition of after- hours (in the SAMA billing guidelines) stating that practices who advertise being open from 07:00 to 19:00 can no longer bill code 0148 for patients seen after 17:00 or before 08:00. Medscheme has decided to keep the original SAMA definition of office hours, i.e. 08:00 to 17:00 from Monday to Friday and 08:00 to 13:00 on Saturday. Therefore, services rendered outside of these hours are defined as being after hours.

This consultation is available to all Bankmed members and is covered from the insured benefit, so there is no financial impact on members’ savings.

Since there are a number of differing views on this change on the description for this code, Medscheme (following discussion with the IPA Forum and our administered Schemes) has decided to apply the following definitions for codes 0146, 0147 and 0148:

Medscheme will process payments according to the information stated above and will implement monitoring processes to ensure adherence.

Kind regards,

Medscheme Healthcare Professional Relations Department