Regulations relating to remuneration of expenses for health care performed outpatient at state health institutions and the health institutions that receive operating subsidies from the regional health
Date FOR-2007-12-19-1761
Ministry of Health and Care Services
Published in 2008 Booklet 1
Commencement 01/01/2008
Edited
FOR 2016-06-23-771 from 01/07/2016
Changes
FOR-2000-12-01-1389
For
Norway
Legal
LOV-1994-08-05-55-§6-2, LOV-1997-02-28-19-5-3, LOV-1999-07-02-61-§2-1a, legislation 1999-07-02-61-4-1, LOV-1999-07-02-61-5-5, LOV-1999-07-02-63-§5-1, LAW-2001-06-15 -93-§53
Promulgated
15.01.2008 kl. 15.35
Short Title
Regulations on expenses for outpatient medical care
Chapter Overview:
Chapter 1 (§§ 1-10)
Chapter 2 - Deductibles and patient payment
Chapter 3 - General remarks
Chapter 4 - Reimbursement Bet
Chapter 5
Adopted by the Ministry of Health on 19 December 2007 pursuant to the Act 2 July 1999. 61 of the Specialist Health Services (Specialized Health Services Act) § 2-1a fourth paragraph, § 4-1 second paragraph, § 5-5 no. 1 and no. 2, ref. law 15 June 2001. 93 about health mm (health law) § 53. 12, Act 2 July 1999. 63 on patient and user rights (patient and user rights Act) § 5-1 last paragraph and law 5 august 1994. 55 on protection against infectious diseases § 6-2.
Added basis: Law on 28 February 1997 no. 19 on National Insurance (Insurance Act) § 5-3 fourth paragraph.
Changes: Amended by regulations 26 February 2008 No.. 192, June 26, 2008 no. 7.34, 25 November 2008 no. 1265, 15 Dec 2008 no. 1393, January 7, 2009 No.. 28, 8 January 2009 No.. 44, June 26, 2009 no. 906, 18 Dec 2009 No.. 1728, January 6, 2010 no. 9, 1 February 2010 no. 81, June 23, 2010 no. 961, 15 Dec 2010 No.. 1693, 29 June 2011 No.. 702, 19 Dec 2011 No.. 1430, 18 Dec 2012 No.. 1339, 17 January 2013 No.. 61, June 25, 2013 No. . 766, 12 Dec 2013 No.. 1503, 24 June 2014 No.. 870, 26 August 2014 No.. 1114, 11 Dec 2014 No.. 1670, 22 June 2015 No.. 748, 14 Dec 2015 No.. 1475, 17 Dec 2015 No.. 1728, 18 Dec 2015 No.. 1740, 5 February 2016 No.. 101, June 23, 2016 no. 771.
Chapter 1
§ 1. Remuneration of expenses for outpatient medical care provided if health professionals are sought for illness or suspected illness, legemsfeil, for guidance in family planning, maternity and confinement. Remuneration of expenses for such medical care as mentioned in the first paragraph is also provided in connection with cervical cytological examinations performed convened as part of established screening program.
§ 2. The patient should normally be referred by a physician, chiropractor, manual therapist, dentist or psychologist outside the competent hospital for that allowance is granted, and that the deductible under these regulations shall be required. Patients can also be referred by the optician to an ophthalmologist specialist / ophthalmology department outside the competent hospital. Moreover, patients may be referred to outpatient interdisciplinary specialized treatment for substance addiction from municipal health and care or social services. Exceptions apply to the patient who themselves seek an emergency function that immediate assistance and how this department / function finds it necessary to examine / treat them. The same applies where the survey conducted at the outpatient clinic in a main specialty proves that he has a disease of an entirely different nature which require full examination at the outpatient clinic in another main specialty unrelated to assessment or treatment of the first disease state.
The patient shall after treatment returned to the requester with discharge summaries.
§ 3.
1.
Compensation from the state granted pursuant to rules and tariffs set out in this regulation. Fees from patients provided by tariffs laid down in Regulations Chapter 2. Households and allowances granted by the tariffs applicable on the time.
2.
Compensation from the state paid to the regional health authority that owns or has an operating agreement with the health institution where the outpatient health care provided, and directly to government institutions which are not owned by a regional health authority. Health institution may not require the patient for the portion of the allowance that the state covers.
§ 4. Approved deductibles, ref. Chapter 2, Section 2.1, are covered by the state:
1.
By examinations during pregnancy and confinement and the treatment of illness related to pregnancy and maternity, as well as for an investigation after confinement. The same applies to termination of a pregnancy and a control examination after the procedure.
2.
In the treatment of injury (disease) which falls under Chapter 13, ref. § 5-25 in the National Insurance Act and under the laws of war pension. For military personnel, it is still a requirement that health care can not be provided by military health professionals.
3.
When treating persons who are inmates in correctional institutions if medical assistance is provided by other personnel than those related to health care to inmates.
4.
When treating the patient's condition is an obstacle to levy deductible, for example by severe mental illness, treatment for patient and user Rights Act Chapter 4A, major acute damage, unconsciousness and death.
5.
By psychiatric treatment of children and adolescents under 18 years.
6.
When treating children under 16 years.
7.
Upon examination, treatment and control of communicable diseases. That is when:
A)
a patient has reason to believe themselves infected with a communicable disease and receives outpatient health care in the form of necessary survey by Control Act § 5-1 or
B)
healthcare under consultation are grounds to suspect that the patient has a communicable disease and the consent of the patient initiates necessary survey by Control Act § 3-5, or
C)
healthcare have encouraged or ordered the patient to a consultation for a communicable disease to carry out exploration as part of contact tracing for Diseases Control Act § 3-6, or
D)
it needs treatment or control of communicable disease.
With communicable diseases means these diseases (ref. The Regulations of January 1, 1995 no. 100 on communicable diseases):
Botulism
Chlamydia infection, genital
Diphtheria
typhus
gonorrhea
Yellow fever Hemorrhagic fever
Hepatitis A virus infection
Hepatitis B virus infection
Hepatitis C virus
Hepatitis E virus infection
HIV infection
Pertussis
cholera
Legionnaires
Lepra
Meningococcal Disease
Anthrax
Para Typhoid
Pest
Poliomyelitis
Rabies
shigellosis
Syphilis
Relapse Fever
Tuberculosis | || Typhoid
Disease caused by enteropatogen E. coli (enterohemoragisk E. coli / EHEC, enteroinvasiv E. coli / EIEC, enteropatogen E. coli / EPEC, enterotoxigenic E. coli / ETEC, enteroaggregativ E. coli / EAggEC) | || Disease caused by methicillin-resistant staphylococcus aureus
Disease caused by multidrug-resistant pneumococci
Disease caused by vancomycin-resistant enterococci.
Remuneration is given under this provision when the patient lives in Norway, even if the patient is a member of the National Insurance Scheme.
The state does not cover the patient's deductible unless the patient has reason to believe themselves infected or healthcare professional gets justified suspicion that there is a communicable disease. Health personnel should be in the patient record to justify that any of the conditions for coverage of the deductible is met.
8.
By outreach treatment for substance dependent.
§ 5. If claiming compensation of expenses for outpatient medical care should health institution submit itemized bill Medical Officer or the agency Directorate of Health decides. The bill must besides diagnosis, tariff number and datum performed health care contain all information necessary to determine the refund claim. The deadline to make a claim for compensation is four months from the end of the month the treatment took place. Health institution is obliged to transfer the bill, as mentioned in the first paragraph, electronically to the Directorate of Health or the agency Directorate of Health decides in accordance with the requirements laid down by that authority. Health institution shall follow the Data Inspectorate's rules on protection of personal data.
Health Directorate or the agency Directorate of Health decides to enter into an agreement with a regional health authority for a special settlement scheme for outpatient treatment or examination conducted by a medical institution as the regional health authority owns. Health Directorate may stipulate further conditions for the conclusion of such an agreement.
§ 6. Health Directorate or the agency Directorate of Health decides to revise and check the bill for completed examination / treatment and disburse the allowance no later than one month after the bill is received.
§ 7. When a patient is declared unfit for work duty health institution to send the form "Medical assessment of work opportunity by illness" Part A signed by the attending physician directly to NAV on the same day as the consultation has taken place. Part B, C and D of the form delivered to the member. The physician should the "Medical assessment of work opportunity by illness" document that the member is unable to work because of a disability caused by illness or injury. If the member is not in work-related activity, and this is due to medical reasons which are clearly an obstacle to such activity, the physician at the latest when the disability has lasted for 8 weeks issuing Part II of "Medical assessment of work opportunity by disease."
"Medical assessment of work opportunity by illness" is issued on a form prescribed by the Labour and Welfare and will be fully completed. Your doctor will build issuing the form of a personal examination of the patient. Documentation of disability should not generally granted for a longer period than 14 days at a time. The provisions of this section apply correspondingly to other health professionals are given the opportunity to demonstrate incapacity.
§ 8. Disputes concerning the calculation of the amount of compensation may be submitted to the Directorate of Health or the agency Directorate of Health decides to decision-making, if the case does not fall under the law on appeal to the Insurance Court.
§ 9. Disputes regarding the interpretation of the individual items in the agreement on compensation for expenses for outpatient medical assistance may, if provisions regarding the handling of disputes are not included in the agreement, be submitted to the Directorate of Health or the agency Directorate of Health determines the decision-making if both parties agree that.
§ 10. Health Directorate may in special cases for a single body or several bodies governed by the Directorate of Health, grant exemptions from the regulations.
Chapter 2 - Deductibles and patient payment
The following deductibles and regulations about patient payments are granted pursuant to the Act of 2 July 1999 no. 61 relating to specialist health etc. § 5-5, no. 1 and no. 2 ref. Law 15 June 2001. 93 on health, etc. § 53. 12 and Act of 2 July 1999 no. 63 on patient and user rights § 5-1, last paragraph.
2.1 Approved deductibles
The following deductibles are approved and included in the ceiling 1, cf. Regulation 18 April 1997 no. 334 on ceiling 1 issued pursuant to the Act on 28 February 1997 no. 19 on Insurance § 5-3:
Tariff Number
Deductible
201b Examination, treatment or control by the relevant specialist physician, psychologist specialist or dental specialist, or performed by physicians, psychologists and dentists without or during specialization, general practitioner, nurses, midwives, physiotherapists, occupational therapists, dieticians and audiologists and personnel approved dedicated post in adult psychiatric outpatient clinics and ruspoliklinikk.
£ 345
202
Radiological examination and ultrasound examination at a specialized imaging and nuclear medicine imaging studies.
£ 245
Note 2A Once approved user fees may be required
Approved dedicated post be understood that in the remarks P11. The deductible can be required even when the investigation, treatment or control has been outpatient contact when other conditions are met. Cf.. Nevertheless Regulations § 4.
Note 2B Help function from other outpatient
If a patient receives medical care related to the same illness / injury of OTPs on the same day, the patient may not be required more than one deductible. Deductible for radiology, ultrasound and nuclear medicine image examination by respective specialist departments can still required.
Note 2C Delayed consultation
If treatment / examination or control at public outpatient clinics are delayed by more than one hour after the agreed time, and the patient has not received notice of the delay before the show, there is no opportunity to demand a premium for service. Patients should be informed of the reason for delay. If possible, the patient should be notified of the delay before the show.
Note 2D Deductible for children and youth psychiatric clinics
It should not be stipulated for treatment for children and youth psychiatric clinics or youth psychiatric team, cf. Regulations § 4 no. 5
Note 2E Deductibles for group-oriented patient education, outpatient rehabilitation and treatment centers in the group
It only required one deductible per patient per program within group directed patient education, for outpatient rehabilitation and treatment measures in the group. The program is defined as one health care episode, although the program over several days.
2.2 Patient Payment
Patient Payment may, as a rule, required of all patients, including patients who are exempt from paying the deductible. Patient payment is not approved deductible and are not included in the ceiling 1, ref. Note 2A. Such payments can not be recognized on deductible card and is not included in the calculation of free card.
Note 2F
For an appointment that is not used, it means that the patient absent without notice or cancel later than 24 hours before the agreed time, the patient may be required to submit payment in the amount equal to twice the deductible 201b. Patients should be informed about the obligation to pay by omission. Such payment may be required by all patients, including patients who are exempt from payment of the deductible.
Tariff Number
Pasientbet.
201C Patient fee for no show / cancellation
£ 690
Note 2G Print Journal
Tariff Number
Pasientbet.
203
Printing of patient / Copy of radiographs
£ 70
Polyclinic may require payment by the patient for printing journal or for copies of X-rays. May be required by all patients.
Note 2H costs of dressings and anesthetics
Tariff Number
Pasientbet.
204a Max. Patient payment for the cost of dressings and anesthetics
£ 25
204b
Max. Patient payment for the cost of dressings and anesthetics
£ 75
In addition to the deductible may somatic clinics require payment for patient expenses for bandages and anesthetics material, if used by the exploration / processing. Although it performed several procedures, each of which gives the right to demand payment of the patient, it only required payment by the patient once per survey / processing. Inspectors 204a and 204b may be required only when the deductible triggered ref. Note 2A.
Payment for bandages and anesthetics may generally required of all patients, including patients who are exempt from user fees. These expenses are not covered by deductible scheme and can not therefore be recognized on receipt card. National Insurance covers such expenses in the approved occupational, ref. Insurance Act Chap. 13 and by authorized war damage, cf. Act of 13 December 1946 No.. 21 about war pension for military persons and the Act of 13 December 1946 No.. 22 War Pension home strengthen personnel and civilians with addition 22 December 1968 no. 2.
Note 2I patient payment by special treatment
sterilization of women without medical indication, ref. tariff code B23d, section 4
for sterilization of women may require a patient payment at $ 6079 . This is not covered by deductible scheme and can not be recorded on the receipt card. If sterilization made after medical indication (tariff code B23i) can such a patient payment not required. For sterilization by medical indication can ordinary deductible charged, cf. Note 2A. Inspectors Code B23d be reported to the Directorate of Health or the agency Directorate of Health decides.
Sterilization of men, ref. Tariff code B10b, Section 4
For sterilization of men it may require a patient payment of $ 1 268. This is not covered by deductible scheme and can not be recorded on the receipt card. You can not claim regular deductible as well. Inspectors Code B10b be reported to the Directorate of Health or the agency Directorate of Health decides.
Assisted Reproduction, ref. Tariff code B50, B51 and B52, Section 4
state provides reimbursement for up to three attempts with assisted reproduction. Polyclinics can claim £ 1500 in patient payment per attempt. The amount can not be recorded on deductible card. Fare codes shall be reported to the Directorate of Health or the agency Directorate of Health decides.
Rehabilitation of dentition in the treatment of marginal periodontitis, ref. Tariff code E07 and E08, Section 4
By rehabilitation of dentition with prosthetic treatment as a result of tooth loss after systematic treatment of marginal periodontitis may require a maximum patient payment £ 6500 by inserting the first implant, and $ 2500 per. implant as well. The amount can not be recorded on deductible card. Fare codes shall be reported to the Directorate of Health or the agency Directorate of Health decides.
- Maximum patient payment on sterilization of women without medical indication
£ 6079
Maximum patient payment for sterilization of men
£ 1268
- Patient Payment per attempt with assisted reproductive
£ 1500
- Patient Payment by surgical insertion of the implant where marginal periodontitis is major cause of tooth loss - the first insertion of implant
£ 6500
- Patient Payment by surgical insertion of the implant where marginal periodontitis is major cause of tooth loss - pr. implant in addition
£ 2550
Chapter 3 - General remarks
Out-patients versus inpatients
For regular outpatient consultations and brief observation, the patient should be recorded in the patient administration system as outpatient care and polyclinic level will be used. Patients should not be registered as admitted in the patient administration system.
If the patient is admitted to the hospital the same day as the outpatient consultation has taken place, the patient should be recorded in the patient administration system for admitted. Hospital stay will not cover the subsidy provided for in these regulations and outpatient reimbursement under these regulations shall not be required. It should not be stipulated from the patient. This applies regardless of whether there is a correlation between the outpatient consultation and reason for admission. Directorate of Health may issue further guidance on the distinction between outpatient and hospitalized patients.
As long as a patient is admitted to a hospital, it is not entitled to claim reimbursement, patient payments or deductibles from the patient under these regulations. This applies whether the patient is treated by one of the hospital's own clinics or at an outpatient clinic outside the hospital.
Star Tariffs
Simpler laboratory examinations marked with * are included in the ISF Polyclinic. This applies to simple quantitative research in clinical chemistry. Tariffs for more demanding laboratory services, which are not marked with an * may be required as well.
Convention Patients
According to the Specialist Health Service Act § 5-3 shall National Insurance cover expenses for convention patients and members not domiciled in Norway.
Chapter 4 - Reimbursement Bet
(Fom July 1, 2016.)
tariff codes linked to special treatment with patient payment
Urology Reimbursement
Pas. bet.
Notice
B10b Sterilization of men
0
1268
B10
Gynecology / Obstetrics
B23d sterilization by laparotomy / -skopi without medical indication
0
6079
B23d
B23i Sterilization laporotomo / -skopi after medical indication
0
75
B23i
B50
AIH / AID
0
1500
B50
B51
IVF
0
1500
B50
B52
IVF with eset and cryopreservation of embryos
0
1500
B50
E07 Surgical insertion of implant where marginal periodontal disease is major cause of tooth loss - the first insertion of implant
0
6500
E7
E08 Surgical insertion of implant where marginal periodontal disease is major cause of tooth loss - pr. implant in addition
0
2550
E7
Note B10:
may be required patient payment by sterilization of men, see Note 2I, Chapter 2. It can not be stipulated as well. Inspectors B10b be reported to the Directorate of Health or the agency Directorate of Health decides.
Note B23d:
may be required patient payment on sterilization of women without medical indication, ref. Note 2I, Chapter 2. It can not be claimed usual deductible as well. Inspectors B23d be reported to the Directorate of Health or the agency Directorate of Health decides.
Note B23i:
If sterilization performed by medical indication can not be required additional deductible, see Note 2I Chapter 2. However, it may be stipulated (cf.. Fares 201a, 201b and 202). It may also be required patient payment for the cost of dressings and anesthetics, ref. Fare 204b.
Note B50:
state provides reimbursement for up to three attempts with assisted reproduction per patient. At each attempt may be required for a patient payment of NOK 1 500. This amount can not be recorded on the receipt card. Maximum patient payment regardless of the method, with three attempts NOK 4 500 per couple.
Notice E7:
Rehabilitation of dentition with implants anchored prosthetic treatment as a result of tooth loss of marginal periodontitis.
Inspectors E07 may be required upon insertion of the first implant. Inspectors E08 may be required per. inmates implant beyond the first.
It required a patient payment for a maximum of 6 500 by inserting the first implant. Upon insertion of multiple implants than one, it may require a patient payment of maximum 2550 crowns per implant. These patient payments can not be recorded on receipt card, ref. Chapter 2, note 2G. It can not be demanded other forms of payment by the patient in connection with the treatment regimen. Inspectors E07 and E08 must be reported to the Directorate of Health or the agency Directorate of Health decides.
P adult clinics, ruspoliklinikk
Tariff No..
Text
Ref.
P.bet.
Merkn.
Main Tariffs
P10 Intake and first consultation (patient and / or their families / guardians present)
384
P9, P10
P11 per hour worked of employees in approved dedicated post has performed outpatient work
49.5
P9, P11
P12
Assessment or treatment (patient and caregivers / family members present)
102
P9, P12
P12a Investigation or Treatment (only patient present)
102
P9, P12
P12b Investigation or Treatment (only guardians / family members present)
102
P9, P12
P13
Follow-up meeting with front-line (meet / supervision / consultation with front-line if one or more named patients)
104
P9, P13
P14a Monitoring Call by phone with the front-line of named patient.
43
P9, P14
P14b Phone Consultation with patient
43
P9, P14
P30 treatment and follow-through ACT teams or similar outpatient outreach treatment team
500
P30
P31 Online handler
400
P31
Additional Tariffs
P15
tester (use of one or more specified tests)
352
P9, P15
P16 group / family therapy
425
P9, P16
P17 Ambulatory consultation
100
P17
Note P9:
Mental health and ruspoliklinikker
To collect aforementioned tariffs shall psychiatric outpatient be professionally approved by the County, ref. Specialist Health Service Act § 4-1 second paragraph. County Governor's decision may be appealed to the national appeal body for health. To become academically approved must psychiatric clinic have appropriate facilities and adequate staffing. Initial staffing in the psychiatric clinic to be at least 4 technical positions with ia doctor who specializes in psychiatry, psychologist and nurse. The above rates may also be triggered by ruspoliklinikker. Such ruspoliklinikker can either enter into organizational health in the structure or be driven by an agreement with a regional health authority. Polyclinics offering interdisciplinary specialized treatment for substance abuse could trigger fares on par with adult clinics and adult clinics that also offer interdisciplinary specialized treatment for substance abusers. Outpatient activity carried out in departments of hospitals or clinics unless this is formally and firmly organized in approved outpatient, are not eligible for reimbursement for hours, fare P11, and for assessment and treatment 1. initial consultation, valuation P12. Reimbursement per referred patient, fare P10, payed yet to psychiatric outpatient operations department in a hospital or clinic.
Necessary laboratory and X-ray examinations are included in the rates.
Note P10:
Inspectors P10 includes 1-time consultation. The tariff can only be used once per year for the same patient. This also applies to emergency care. The tariff can be used again after one year, but requires new referral from a physician in primary care or doctor in somatic hospital ward or municipality in NAV, ev. immediate help. The tariff may also be applied if the consultation has taken place outside the polyclinic premises.
Note P11:
valuation may be required per person-hour employee in approved position has performed psychiatric outpatient work. A FTEs considered 1725 hours. Sickness beyond the period for which the employer is responsible for payroll and leave with or without pay deducted. With outpatient work means therefore all forms of patient care, general counseling and guidance, skills development and internal collaboration. Academic leadership provides the basis for reimbursement, while commercial positions do not give refunds. Number of hours per employee is calculated in terms of seniority share.
Relevant technical positions include doctors, psychologists, nurses, social workers, educators and social educators and other relevant college and university education.
Jobs requiring reimbursement for must be associated with an approved adult clinics. To the extent that employees at other departments perform outpatient work that will provide the basis for reimbursement must be part of a position to be linked to the clinic.
Note P12:
Inspectors P12 includes examination, diagnosis and treatment until the patient can be attributed primary care or municipality in NAV if it is requester. The charges may also be required if the assessment / treatment has taken place outside the polyclinic premises. 1 Initial consultation applies tariff P10.
Note P13:
Inspectors P13 may be required when employed by an approved dedicated post (ref. Note P11) has actively participated in the follow-up meeting with the first line of named patient or given guidance to the front line. First-line defined in this context as a primary / municipal, school, NAV office or municipality. The charges may also be required if the meeting / tutorial is held outside the polyclinic premises.
Note P14:
Inspectors P14 may be required when employed by an approved dedicated post (ref. Note P11) had follow-up conversation by phone with front-line (ref. Note P13) about a named person. The charges may also be requested by telephone consultation with a patient. It is a condition for requiring a valuation P14 that phone call should have the character of consultation. Inspectors P14 may not be required for brief conversations where case information obtained, Meeting Appointments determined etc.
Note P15:
may be required as well fare of comprehensive personality testing, which intelligence assessment / capability assessment, special function surveys, environmental assessments, personality assessments and neuropsychological examinations. Additional Charge for tests does not include general diagnostic tools. The tariff may only be required in connection with the use of tariff P12.
Note P16:
By group / family therapy may fare P16 required in addition to tariff P12. It uses only a main fare and an additional fare per group / family session, so that the number of people present in the group does not affect the number of fees. It can be charged a deductible per patient.
Note P17
valuation may be required in addition to the P10, P12, P12a and P12b when processes (e) seek patient ambulatory and this is justified by the needs of the patient.
With ambulatory services meant outpatient contacts undertaken by specialist health services beyond the scope of ordinary physical premises in hospital, and using the organization's own personnel.
The outpatient service form must be justified in at least one of the following considerations:
-
Access to necessary health services.
-
Prudent and caring treatment.
-
Adequate assessment and mapping of therapeutic possibilities.
-
Cooperation with municipal health and care services.
Note P30
valuation may be required when the patient is monitored and processed by an established ACT team or ACT function in a FACT team.
The tariff may also be required in cases where the patient is monitored and treated through other ambulatory and outreach teams that have similarities with the ACT team with respect to the target population and methodology.
Tariff may be claimed once per calendar month.
The patient must have received ACT or ACT-like follow-up at least half of the calendar month that the fee may be claimed. For FACT team, this means that the patient must have been followed up through the team's ACT function for at least half of the calendar month.
Requirements for team organization that fare reimbursement may be claimed:
-
Team will offer diagnosis and integrated treatment of concurrent substance abuse problems and mental illness.
-
Teams shall be established through mutually binding cooperation agreements between municipalities and health.
-
Treatment and monitoring responsibility should lie with the team.
-
Psychologist and physician / psychiatrist must be part of the team. Interdisciplinary composition of social and health professionals and others with relevant expertise. The team should have at least 5 processors to achieve genuine interdisciplinarity.
-
Get patients per processor. (Approximately 10 patients per processor is currently recommended in the ACT model).
-
Main working methods should be ambulatory, usually such that at least 80 per cent of patient contact should take place outside the office.
-
Team will attend to the patient's need for continuity in treatment. This involves providing non-time-limited treatment / rehabilitation.
-
Team should be available when the patient needs it (also every day in periods) or secure other availability.
It is assumed that the ACT team and ACT function of FACT team to follow professional standards, ref. ACT Handbook 2nd edition. The manual will form the basis for the establishment of ACT and FACT team.
In cases where the valuation is required related to the team who are not ACT or FACT team, the responsible health authorities submit the following information to the Directorate of Health first time valuation required:
-
A copy of the agreement with the municipality that forms the basis for the team.
-
Other documentation that describes how the above requirements to team organization is safeguarded, including the personnel composition and patient audience.
Note P31
tariff may be requested when a patient has completed a comprehensive web-based management application. It can be claimed one fare for each completed treatment.
It is assumed that the treatment for the same illness or problem is part of the same treatment, although this extends over a longer period.
Assumptions related to the online treatment program for fare reimbursement may be claimed:
-
The online treatment program is an integral part of an outpatient consultative and treatment course.
-
The online treatment program to replace some of the outpatient consultations that would otherwise occurred in the treatment of the patient.
-
There is at least one clinician interview at the clinic before the patient started with the online processing and it is ending conversation after completion of the program.
-
The treatment takes place through a secure system that meets the requirements for information security.
It can not be stipulated for online treatment program.
Child and adolescent psychiatry outpatient
Psychiatric youth team
Tariff No..
Text
Ref.
P.bet.
Merkn.
Main Tariffs
P20 Intake and first consultation (patient and / or their families / guardians present)
1165
P18, P19, P20
P21 per hour worked of employees in approved dedicated post has performed outpatient work
79.5
P18, P19, P21
P22 Study or treatment (patient and family / guardian present)
293
P18, P19, P22
P22a Investigation or Treatment (only patient present)
293
P18, P19, P22
P22b Investigation or Treatment (only kin / guardian present)
293
P18, P19, P22
P23
Follow-up meeting with front line. (Meeting / supervision / consultation with front-line if one or more named patients)
192
P18, P19, P23
P24a Monitoring Call by phone with the front-line of named patient.
64
P18, P19, P24
P24b Phone Consultation with patient
64
P18, P19, P24
Additional Tariffs
P25
tester (use of one or more specified tests)
482
P18, P19, P25
P26 group / family therapy
482
P18, P19, P26
P27 Ambulatory consultation
100
P27
Note P18:
Educational Psychological Counselling Service can refer patients to child and adolescent psychiatric clinics providing both parties with the pilot project for referral rights for PPT to BUP and HABU. The pilot project includes Bodo BUP, Meloy PPT, PPT Indre Salten, BUP Levanger, Stjørdal PPT, Inner Namdal PPT, Steinkjer PPT, BUP Haugesund, Karmøy PPT, Haugesund PPT, Sauda PPT, BUP Lower Romerike, Skedsmo PPT, Sørum PPT, Aurskog- Holand PPT, BUP Porsgrunn and Skien BUP, Skien PPT, Porsgrunn PPT and Nome PPT.
Note P19:
To collect tariffs should children and youth psychiatric clinics be professionally approved by the County, ref. Specialist Health Service Act § 4-1 second paragraph. To become academically approved must Polyclinic have suitable premises and adequate staffing. Because workforce polyclinic to be at least 4 technical positions with a physician specialized in child and adolescent psychiatry, specialist in clinical psychology with a specialization area of clinical child and adolescent psychology, social worker with clinical training in child and adolescent psychiatry and clinical educator with training in child and adolescent psychiatry .
Approval of the clinic presupposes that a substantial portion of these specialist jobs have been filled. Other refunds triggering positions may be positions for college educated personnel with training in environmental therapy or other clinical education geared toward outpatient work with children, youth and their families, as well as training positions for doctors, psychologists, social worker, educator and environmental therapist.
Also psychiatric youth teams must be approved by the County to collect fares. To become academically approved must youth team have suitable premises. It requires a minimum crew of four professionals that a youth team to be approved as an independent team, including a doctor who specializes in psychiatry or child and adolescent psychiatry, psychologist and social worker.
Jobs by teams that do not have sufficient manpower to be approved as an independent team may be under adult psychiatric and pediatric psychiatric outpatient clinic and counts its reimbursement basis. In such cases used charges under "Child and adolescent psychiatry outpatient clinic and psychiatric youth teams" for the adolescents positions even if they are linked to adult psychiatric outpatient clinic. By reference to psychiatric youth teams for interdisciplinary specialized treatment for substance triggered fare only if the regional health authorities have designated these to receive such referrals.
County governor pursuant to the first and third paragraphs may be appealed to the national appeal body for health.
It should not be stipulated for treatment for children and youth psychiatric clinics or by psychiatric youth teams, ref. The regulations, § 4 section. 5. The deductible is included in the reimbursement tariff.
Necessary laboratory and X-ray examinations are included the respective fares.
Note P20:
Inspectors P20 includes 1-time consultation. The tariff can only be used once per year for the same patient. This also applies to emergency care. The tariff can be used again after one year, but requires new referral from a physician in primary care or somatic hospital ward or child welfare or municipality in NAV, ev. immediate help. The tariff may also be applied if the consultation has taken place outside the polyclinic premises.
Note P21:
valuation may be required per person-hour employee in approved position has performed outpatient work. A FTEs considered 1725 hours. Sickness beyond the period for which the employer is responsible for payroll and leave with or without pay deducted. With outpatient work means therefore all forms of patient care, general counseling and guidance, skills development and internal collaboration. Academic leadership provides the basis for reimbursement, while commercial positions do not give refunds. Number of hours per employee is calculated in terms of seniority share.
Relevant technical positions include doctors, psychologists, nurses, social workers, educators and social educators and other relevant college and university education.
Jobs requiring reimbursement for must be related to approved clinics. To the extent that employees at other departments perform outpatient work that will provide the basis for reimbursement must be part of a position to be linked to the clinic.
Note P22:
Inspectors P22 includes examination, diagnosis and treatment until the patient can be attributed primary care, childcare or municipality in NAV if it is requester. The charges may also be required if the assessment / treatment has taken place outside the polyclinic premises. 1 Initial consultation applies tariff P20.
Note P23:
Inspectors P23 may be required when employed by an approved dedicated post (ref. Note P21) has actively participated in the follow-up meeting with the first line of named patient or given guidance to the front line. First-line defined in this context as a primary / municipal, school, NAV office, municipality, kindergarten, childcare or PPT.
The tariff may also be required if the meeting / tutorial is held outside the polyclinic premises.
Note P24:
Inspectors P24 may be required when employed by an approved dedicated post (ref. Note P21) had follow-up conversation by phone with front-line (ref. Note P23) about a named person. The charges may also be requested by telephone consultation with a patient. It is a condition for requiring a valuation P24 that phone call should have the character of consultation. Inspectors P24 may not be required for brief conversations where case information obtained, Meeting Appointments determined etc.
Note P27
valuation may be required in addition to the P20, P22, P22a and P22b when processes (e) seek patient ambulatory and this is justified in patient needs.
With ambulatory services meant outpatient contacts undertaken by specialist health services beyond the scope of ordinary physical premises in hospital, and using the organization's own personnel.
The outpatient service form must be justified in at least one of the following considerations:
-
Access to necessary health services.
-
Prudent and caring treatment.
-
Adequate assessment and mapping of therapeutic possibilities.
-
Cooperation with municipal health and care services.
Note P25:
may be required additional fare for comprehensive personality testing, which intelligence assessment / capability assessment, special function surveys, environmental assessments, personality assessments and neuropsychological examinations. Additional Charge for tests does not include general diagnostic tools. The tariff may only be required in connection with the use of tariff P22.
Note P26:
In group therapy may fare P26 required in addition to tariff P22. The same applies to family treatment. It uses only a main fare and an additional fare per group / family session, so that the number of people present in the group does not affect the number of fees.
R Laboratory testing and trying
order for medical laboratories should be able to collect fares, the business must be approved according to regulations on 1 December 2000 no. 1276 concerning medical laboratory and radiology operations issued pursuant to the Specialized Health Services Act § 2-1 fourth paragraph, § 4-1 and § 5-2, fourth paragraph. For that hospitals should be able to collect the fares must laboratory activities be part of the approved establishment of the hospital in accordance with regulations issued pursuant to the Specialized Health Services Act § 4-1.
1 General tariffs
Ref.
Merkn.
Molecular biological techniques
701A Simple DNA / RNA isolation or foul
27
R2
701b Organic extraction of DNA / RNA
51
R2
701c PCR (polymerase chain reaction) 1-2 primer
84
R2
701d Supplement per extra primer
22
R2
701e Reverse transcription
27
R2
701f Sequencing per DNA strand
239
R2
701g
In situ hybridization (1-3 probes)
221
R2
701h Additional per probe beyond 3
27
R2
Other
701j Measurement of bone mineral content - measurement with DXA
50
R3b
701K Testing for human papilloma virus (HPV)
304
R3bb
Note R1:
tariffs in internal medicine, immunohaematology, microbiology, serology, virology, pathology and clinical chemistry is intended for specialists in these subjects, but can be used by other doctors when special circumstances. The tariffs in pathology can also be used by dentists specialized in the oral pathology. It is not calculated well for taking the sample simultaneously with the fees for study.
Note R2:
tariffs can only be used by specialists in immunology and transfusion medicine, clinical chemistry, medical genetics, medical microbiology and pathology at regional hospitals, central hospitals, the Norwegian Radium Hospital and the National Institute for Public Health. The tariffs can only be used for patient-oriented and professional medical reasoned analysis. Rates are valid not chlamydia or commercial kits for the detection of infectious agents, with the exception of Mycobacteria. Molecular biological fares that are not general, is mentioned under the individual specialty. The tariffs under Comment R2 may not be required for HPV testing, ref. Fare 701K.
Notice R3:
Taking ECG triggering refund.
Note 3b:
Inspectors 701j can not be used in screening assays. The tariff can only be required by specialists in endocrinology, nuclear medicine, radiology, rheumatology or other with proven specialist knowledge in the field of metabolic bone diseases. The valuation may be required only once per year per patient. The patient may also demanded deductible, tariff 202.
Note R3bb:
Inspectors 701K may be required when the criteria for HPV testing in studies of cervical cancer followed. The charges may also be requested when the HPV test used in accordance with supervisors or guidelines for management of patients with screening findings or after treatment for cervical cancer or precancerous such cancer.
2 Clinical Neurophysiology
Ref.
Merkn.
Polygrafisk polysomnography
702A Stationary polygrafisk long registration and videometri
1355
R4
702b Ambulatory polygrafisk polysomnography, ambulatory long-term EEG band plays
814
R5
EEG
702c
Taking of standard EEG
109
R6
702d Interpreting standard EEG
82
R6
702e
Taking and interpreting particular work or time-consuming EEG
298
R7
702F needle tests, electromyography, etc.
191
R8
702g
evoked responses
114
R9
Note R4:
Includes examination of at least 8 physiological parameters during sleep. The tariff also includes long-term stationary EEG recording with a duration of 4 hours and long-term EEG with synchronized video recording (videometri).
Note R5:
Polygrafisk polysomnography must include at least registration and interpretation of sleep stages that the tariff should be applied.
Note R6:
In addition to specialists in Clinical Neurophysiology, can also neurologists with special approval from the Norwegian Medical Association avail fares 702c and 702d.
Note R7:
Inspectors 702e includes premature, neonatal and perinatal registration, and langtidsreg. with duration up to 4 hours.
Note R8:
Inspectors number 702F includes special-EMG, senresponser, dekrementreaksjoner, neurophysiological sensibility, dynamometri ol tariff multiplied in proportion to the number of the current investigations carried out in accordance with the elaborate guidelines: "Use of specialist fees in clinical neurophysiology with public hospital laboratories, "Norwegian Society for clinical neurophysiology 1998.
Note R9:
Fare 702g include SEP, VEP, AER, ERG and motor cortical stimulation.
3 Immunology and Transfusion Medicine
R1
Ref.
Merkn.
Blood typing
703a ABO typing, Rh (D) -typing
20
703b
Other special Typing
86
Investigation of blood group antibodies
703c Easy settlement
22
703d Full antibody screening. Extended settlement
38
703e Comprehensive immunhematologisk survey (titration and immunological studies)
71
703f Antibody Identification
117
703g
Direct antiglobulin reaction
37
703h Therapeutic bottling and bottling of autologous blood
150
Detection of antibody / antigen
703i
Immunological quantitation of single protein. Quantitation of hemolytic complement activity. Nephelometric quantitation of rheumatoid factor
21
703j
Identification and titration of rheumatoid factor with indirect hemagglutinasjonsteknikk
22
703k
Other antibody with indirect hemagglutinasjonsteknikk
44
703l immunoelectrophoresis. Immune Fixation, one antiserum
26
R10
703ll immunoelectrophoresis. Immune Fixation, per antiserum than one
22
R10
703m Detection of antibodies by indirect immunofluorescence, ELISA or RIA technique. Qualitative latex agglutination of antigen or antibody detection
22
703n
Additional Titration / quantitation of autoantibodies with indirect immunofluorescence, ELISA or RIA technique
22
703o detection of antibody or antigen by immunodiffusion
27
703P identification plate specific antibodies (Maipa)
296
703q Detection of spermieagglutinier
22
Immunological studies of cells
703r
With 1-10 antisera
253
703S With 11 or more antisera
387
Comprehensive examination of peripheral blood lymphocytes
703t Stimulation of lymphocytes in culture
222
Lymfocyttransformasjonstest with one antigen or mitogen
703u
Additional stimulation for each additional antigen or mitogen
32
703v
Quantitation of subpopulations of lymphocytes by membrane markers and flow cytometry per antigen
38
Serological allergy research
703w
Quantitation of immunoglobulin E with RIA or EIA
22
703X Quantitation of allergen-specific antibody with RIA or EIA
33
703y
In vitro allergy test for the detection of specific IgE antibodies
52
Testing of minimum 5 allergen antibody
Samples of phagocytosis and chemotaxis
703z Nitro Blue tetrazoliumprøve (NTB) without stimulation
32
703æ Nitro Blue tetrazoliumprøve (NTB) with endotoxinstimulering
37
703ø Quantitative fagocytoseprøve
99
703å Quantitative kjemotakseprøve
101
Serologic HLA typing
703aa Serological HLA Class I typing
172
703bb Serological HLA Class II typing
247
703cc Serologic HLA typing, one antigen
118
703dd Cross Match or screening of HLA antibodies
80
Other analyzes
703ee
Simple surveys, kuldeagglutinasjon, rapid test or titration
18
703ff mixed lymphocyte culture (MLC)
241
703gg Plasma Replacement
563
R11
703hh Replacement Bag w / plasma exchange (by invoice)
R11
Note R10:
For immunoelectrophoresis and immune fixation, fare 703l, the valuation for setup with one antiserum, for each further antiserum fare 703ll.
Note R11:
Reimbursement for plasma exchange is granted only after the approval of the Ministry of Health. In addition to the survey spent working the varying and costly substitution liquid which is financed by invoice.
4 Medical Microbiology
Ref.
Merkn.
Bacteriology (incl. Mycology and parasitology)
R1
704a
Simple survey
21
Gram or KOH preparation own investigation
Serotyping of S. pneumoniae, S.pyogenes, N.meningitidis
Cultivation of bacteria (incl. Easy identification)
Cultivation of Trichomonas
Cultivation of yeasts (incl. Easy identification)
Spirochetes, darkfield
Sterility Control of dialysis or infusion
704b Complicated examination
22
R12
Ziehl-Nielsen composition own investigation
Malariaplasmodiser (microscopy)
ELISA / RIA / IF for the detection of antigen / antibody
Sterility Control of transfusion blood
Resistance Investigations lapp- / tablet method (simple survey, 5 or fewer funds - as well as cultivation)
Arts Identification of additional biochemical testing (except basic identification) of bacteria from blood, cerebrospinal fluid, etc. (incl. Easy identification)
Water Surveys (filter method)
Cultivation of Borrelia
Cultivation tarmpatogene bacteria (per agent)
Chlamydia antigen test ELISA / IF
704c
Special Investigations In
28
R12
Cultivation of blood cultures, anaerobic bacteria, mycobacteria, molds dermatofyter
Resistance Investigations of mycobacteria (per agent)
Resistance Investigations lapp- / tablet method (extended examination -> 5 funds - as well as cultivation)
Antibiotic Concentration Regulations (microbiological method)
Anti Concentration Regulations, EMIT / TDX ol
C. difficile toxin research
Fagtyping
Water Surveys (tube)
Investigation on protozoa and helminths in faeces with concentration
704d Special Investigations II
66
Species / type identification of mycobacteria
Resistance Determinations of bacteria by E-test (per 4 funds) or by automatically MIC reading (per 4 agents) or with agar / buljongfortynningsmetoden per agent
Mycoplasma / ureaplasma (with identification)
Studies on protozoa and helminths with concentration and 2 dyeing
Virology
R1
704e
Simple survey
23
Latex agglutination for antigen detection, rapid test
ELISA / RIA / IR for detecting antigen / antibody
Chlamydia antigen test ELISA / IF
704f Complicated examination
28
Chlamydia Cultivation
704g
Special Investigations In
53
Cultivation of virus in cell culture
Identification / typing of virus in cell culture with neutralizing type sera
Grafting of eggs or animals per agents
PCR / LCR chlamydia
704h
Special Investigations II
120
Easy electron microscopy
Infeksjonsserologi
R1
704i Surveys In
12
VDRL / RPR
704j Investigations II
13
Kuldeagglutinasjon, rapid test or titration
Indirect hemagglutination (IHA), screening
Reverse hemagglutination (HA), screening
704k Simple survey
20
Agglutination with bakterieantigen per antigen
Antistreptolysintitrering
Antistafylolysintitrering
KBR with bakterieantigen and cardiolipin
ELISA / RIA HBsAg screening
IHA, single surveys
Reverse HA, single surveys
704l Complicated examination
22
Paul-Bunnell reaction with absorptions
Hemolysis in gel, quantitation
IHA quantitation of antibody
KBR and HI with viral antigen per antigen
ELISA RIA / IR for detecting the antigen / antibody, single survey
704m Very complicated investigation
26
FTA ABS
Neutralization virus antibody per antigen
ELISA / RIA specific IgM / IgA
704n
Special Investigations In
27
R13
HIV test
704o
Special Investigation II
43
R14
TPI
Detection of specific IgM by sucrose gradient
Toxoplasmosis Dye Test
704p
Reference Studies In
297
R15
HIV confirmation test. Reference Sample
704q
Reference Studies II
120
HCV confirmation test. Reference Sample
704r HIV RNA quantitation (technical execution and interpretation)
767
R16
Note R12:
Use of tariff 704c excludes the use of tariff 704b in the same isolate.
Note R13:
Inspectors 704n may not be used for screening examinations, including blood donation, but only in case of illness or suspected illness. The tariff paid in full by the National Insurance Scheme.
Note R14:
National Insurance does not provide compensation for tests carried out free for health advice at public laboratory for Diseases Control Act.
Note R15:
Inspectors 704p can not be used for screening examinations, including blood donation, but only in case of illness or suspected HIV infection. The tariff paid in full by the National Insurance Scheme.
Note R16:
Inspectors 704r can only be used by Regional Hospital and the National Institute for Public Health. The tariff paid in full by the National Insurance Scheme.
704s HIV resistance analysis
1036
5 Pathology
R1
Ref.
Merkn.
Preparation and examination of histological samples
705a 1-2 blocks
62
R17, R19
705b 3-7 blocks
122
R17, R19
705c 8-19 blocks
236
R17, R19
705D
20 blocks or more
362
R17, R19
Preparation and investigation of cytological smears
705e Cervico-vaginal smears
26
705f
Other smears, incl. Liquid-based cytology and punksjonscytologi
77
705g
Punksjonscytologi, sampling and rapid staining
170
Autopsies
705H
Routine autopsy
1203
R18
705i
Separate neuropathological examination
543
R18
The immune and enzymhistokjemiske research on preserved material
705j 1-3 surveys
156
R19
705k 4 or more surveys
233
R19
The immune and enzymhistokjemiske studies on unfixed material
705l Frozen sections surveys, rapid diagnostics
84
R19
705m
The immune and enzymhistokjemi, 1-10 surveys
302
R19
705n
The immune and enzymhistokjemi, 11 or more surveys
451
R19
705o Electron Microscopic examinations
906
Specific quantitative surveys
705p image analyzes
451
705q flow cytometry (flow cytometry)
451
Refine physician work per started half hour
705r Additional work
53
Note R17:
With histological samples means all tissues accompanied by a remittance. In valuation included deeper cuts and spesialfarginger (not immune and enzymhistokjemi).
Note R18:
Tariffs 705H and 705i remunerated by insurance in the case where the death occurred outside hospitals and where the autopsy is ordered by a physician.
Note R19:
Inspectors number 705r may be used for additional work beyond 1/2 hour at fares 705a, 705b, 705l, beyond 1 hour at fare 705c, 705D, beyond 2 hours at tariff 705j, 705k, 705m and 705n .
6 Medical Genetics
Ref.
Merkn.
Cytogenetic studies
706A Chromosome Studies
452
706b Supplement for prometafaseundersøkelse
267
706c Supplement for fluorescence in situ hybridization
753
706d Additional establishment of fibroblast
767
706e Supplement for bone marrow cells and solid tumors
1004
Molecular Genetic studies
706f Mutation Analysis by PCR-based method
119
R21
706g
Mutation Analysis by Southern blot method
157
R21
706h Mutation Study with PCR-based method
169
R21
Biochemical investigations
706i
Analysis of gene products and metabolites
1158
706j
Additional establishment of fibroblast
767
Note R20:
Tariffs in medical genetics can be used only by authorized specialists in the art. The fares also apply only studies of born individuals. If there is need for genetic counseling, used tariffs M01, M02, M03a, M04a, M05a and M05b.
Note R21:
When needed for reanalysis, the fees used several times.
7 Clinical Chemistry
Ref.
Merkn.
* 707a
Simple quantitative surveys. The charges may be claimed in addition to tariff groups 1-6
4
R1
Albumin / ALT / ALP / amylase / AST
Bicarbonate / Bilirubin, total or fractionated
CK
Phosphate
Glucose / GT
Hematogram, single (Hb, Hct, EPK, LPK)
Iron
Potassium / Calcium (total) / Chloride / cholesterol (total) / Urea
(Urea) / Creatinine
LD / Lipase
Magnesium
Sodium / NT
PT
TIBC / Total Protein / Triglycerides / Platelets / TT
Uric acid (urate)
707B More complicated or complex analyzes
12
CK-MB
Manual differential leukocyte counts
Ferritin
Hormones, vitamins, drugs and specific metabolites determined by photometric methods (incl. Flame-photometry)
Immunological quantitation of single protein
Calcium (ionized). Cholesterol (fractional) Creatinine clearance and corresponding
HbA1c
Lactate
Osmolality
Reticulocytes
The acid-base status of blood gases (complete)
Thyreoideafunksjonsanalyser (T3, T4, free T4, TSH)
Extended hematogram (machining diff.telling, thrombocytes)
707c More complicated or complex analyzes
27
Atomabsorbsjonsspektrofotometri
Direct determination of alcohols, hormones (excl. Thyroid), drugs, vitamins and other organic compounds (excl. Ferritin) with immunometric (or equivalent) methodology
Tynnskikt- or paper-chromatographic investigation of amino acids or drugs
Electrophoretic separation of proteins, incl. Any accumulation of material
Konk Reme Tana Light
Sperm Studies (sample preparation, counting, morfologi- and motolitetsvurdering)
Immunoelectrophoresis or immune fixation, one antiserum
707cc immunoelectrophoresis or immune fixation, per antiserum than one
20
707d Extremely expensive and complex analysis
80
Particularly time-consuming function studies In
Load studies with glucose, insulin, lactose, xylose, etc. (incl. The necessary procedures). Determination of alcohols, hormones, drugs, metabolites and other organic compounds by chromatographic or immunometric methodology after prior extraction or enzyme treatment
High resolution serumproteinelektroforese direct quantitation of single proteins
707e Extremely expensive and complex analysis
159
Particularly time-consuming function investigations II
Determination of alcohols, hormones, drugs, metabolites and other organic compounds by chromatographic, immunometric or massespektrometriskmetodikk after prior chromatographic separation. Determination of aminosyremønster with amino acid analyzer
8 Nuclear medicine (repealed)
9 Clinical Pharmacology
Ref.
Merkn.
709a
Direct determination of drugs and intoxicants
28
Direct determination of drugs and drugs with immunometric or similar methodology, chromatographic methods (GC, HPLC or equivalent) or atomabsorbsjons- / flame photometric methodology
709b Quantitative determination of drugs and intoxicants
80
Quantitative determination of drugs and drugs with chromatographic (GC, HPLC or equivalent) methodology, or immunometric or similar methodology for extraction or enzyme treatment
709c Confirmatory analyzes of drugs and intoxicants
157
Confirmatory analyzes of drugs and drugs with mass spectrometric (or equivalent) methodology or frifraksjonsbestemmelse of drugs
S Radiology
For the total number of investigations requisition includes, it may require one deductible by the patient, cf. Fare 202.
1
Radiology main rule is that any given outpatient radiological procedure is associated with one and only one unique reimbursement rate (currency units). In the "Regulations for the financing of outpatient radiology at state health institutions in 2016" stated that the reimbursement category the individual procedure is placed in.
The refund may be claimed for the radiological procedures that are part of the coding is "Norwegian classification of radiological procedures" (NCRP) .
See code guidance and regulations for financing of outpatient radiology at state health institutions for details, see. Note S1.
A valid refund claim must at least contain a code for either a diagnostic examination or an image-guided intervention, and the refund amount required, cf. Note S1.
Table S1: Reimbursement Categories wagering radiology
Modality Reimbursement Category
Kroner
Notice
Ray RG1
16.5
S1
Ray RG2
41
S1
Ray RG3
145
S1
Ray RG4
297
S1
Ray RG5
504
S1
Computer Tomography
CT1
166
S1
Computer Tomography
CT2
278
S1
Computer Tomography
CT3
491
S1
MR MR1
408
S1
MR MR2
465
S1
MR MR3
1026
S1
Ultrasonic
UL1
18
S1
Ultrasonic
UL2
44
S1
Ultrasonic
UL3
89
S1
Ultrasonic
UL4
331
S1
Intervention INT1
99
S1
Intervention INT2
139
S1
Intervention INT3
759
S1
Intervention INT4
2020
S1
2 Nuclear Medicine
The main rule is that any given outpatient nuclear medicine procedure is associated with one and only one unique reimbursement rate (currency units). The procedures the refund may be claimed is contained in "Regulations for the financing of outpatient radiology at state health institutions in 2016". A valid refund claim must as well as a procedure code always contain an additional code for the radiopharmaceutical used. See code guidance and rules for the financing of outpatient radiology at state health institutions for details, see. Note S1. In sets of rules for the financing of outpatient radiology also shows the reimbursement category the individual procedure is placed in.
Table S2: Reimbursement Categories and tariffs for nuclear medicine including PET
Reimbursement Category
Reimbursement
Notice
NM 1
887
S1
NM 2
1122
S1
NM 3
1894
S1
NM 4
3567
S1
NM 5
6461
S1
NM 6
10,054
S1
NM 7
18,494
S1
PET 1
4244
S1
PET2
5150
S!
PET3
5724
S1
PET 4
8972
S1
Note S1:
See the following documents at the Directorate of Health website
-
Code Administration "Norwegian classification of radiological procedures (NCRP)» is coordinated with other procedure codes and is now part of the coding of medical, surgical and radiological procedures (NCMP, NCSP and NCRP), ref. Https: // Health Directorate .com / health professional code works
-
"Norwegian classification of radiological procedures (NCRP), code guidance for 2016" is now included in the Code guidelines for ICD 10, NCMP, NCSP and NCRP, ref. Https://helsedirektoratet.no/retningslinjer/regelverk-og Tutorial-for-clinical code works-in-specialist health
See the following document on HELFO sites (www.helfo.no)
-
"Regulations for the financing of outpatient radiology at state health institutions in 2016".
An overall statement of codes in NCRP 2016 and the related reimbursement categories listed in Appendix A of the Code.
Chapter 5
Regulation enters into force on 1 January 2008. From the same date, the Regulations on 1 December 2000 no. 1389 for the remuneration of expenses for medical care performed outpatient at health institutions at county health plan and at state health institutions.