These are patients whose hospital fees are funded through or being paid by:
- The Compensation for Occupational Injuries and Diseases Fund (formerly Workmen's Compensation Fund).
- The Road Accidents Fund.
- Medical aid schemes.
- Another state department.
- A local authority.
- A foreign government.
- An employer.
Their treatment incurs the full UPFS fee.
A private patient is a patient treated in a government institution by a private practitioner. These patients pay the full UPFS facility fee.
Patients are treated as South African if they are:
- Permanently resident in South Africa.
- Visitors or foreigners with study permits or temporary work permits.
- Persons from neighbouring states.
- Asylum seekers and refugees
Patients who do not fall into these categories, including foreign tourists, must pay the full-paying UPFS fee.
The Uniform Patient Fee Schedule (UPFS) is the tariff which sets out the fees which full-paying patients are charged at government hospitals in the Western Cape.
The UPFS Fee Schedule for full-paying paying patients has two components for the fee for each service:
- The facility fee.
- The professional fee.
A patient, for example, who has an outpatient hospital consultation is charged, per visit, a professional fee plus a facility fee. The amount of the professional fee and the facility fee depends on the type of professional and the level of hospital providing the service.
The amount of the facility fee depends on the level of hospital ie, the UPFS facility fee at a level 3 hospital is higher than that of a level 1 and level 2 hospital.
Note: For further enquiries, please contact the relevant hospital (head of fees/case manager)
You can download the UPFS Tariff Schedule for full-paying patients.
The UPFS Billing Procedure Schedules refer to categories of medical procedure in some instances, for example, for theatre procedures. Every medical procedure is assigned a cost code A, B, C, D or E, from A (least expensive) to E (most expensive).
So to find the fee for a particular procedure, you have to first know what the cost code is for that procedure. The lists of all the procedures with their cost codes are in the Procedures Code Book, Oral Health Code Book, Radiology Code Book, Cosmetic Surgery Code Book and Nuclear Medicine Code Book.
There are also fees charged for assistive & prostetic devices, othotic aids and consumables, etc. where applicable.