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Tonga Subsidiary Legislation |
LAWS OF TONGA
HEALTH SERVICES (FEES AND CHARGES) REGULATIONS 2000
GS 8D of 2000
HEALTH SERVICES ACT
IN EXERCISE of the powers conferred by section 11 of the Health Services Act 1991 on the Minister of Health with the consent of Cabinet, makes the following Regulations:
1.
(a). These Regulations may be cited as the Health Services (Fees and Charges) Regulations 2000.
(b). The Medical Services (Fees and Charges) Regulations 1977, are repealed.
2. The medical fees and charges set out in the Schedule hereto shall be the authorised fees and charges for services rendered by or on behalf of medical and dental officers of the government.
3. All fees and charges are to be paid to general revenue.
4. The Minister of Health may, by notice published in the Gazette, exempt any person or class of persons from the payment of any fees or charges listed in the
Schedule and such exemptions may be made subject to such conditions as the Minister may specify.
SCHEDULE
MEDICAL FEES AND CHARGES
PART I
TONGA SUBJECTS
1. Certificates
| (a) | Health certificate required to fulfil Tongan Passport and Immigration requirements | $8.00 |
| (b) | Health certificate required to fulfil Passport and Immigration requirements of countries other than Tonga | $9.00 |
| (c) | Health certificate required to obtain employment | $5.00 |
| (d) | Health certificate, other than for Passport and employment requirements | $9.00 |
| (e) | Re-issuance of live birth certificate | $6.00 |
| (f) | Re-issuance of death certificate | $6.00 |
X-ray Examinations for Passport and Immigration Requirements
(1) Film size Price
| | Film size | Film costs | Professional Fees | Total Costs |
| (a) | 17" x 14" | $8.00 | $17.00 | $25.00 |
| (b) | 15" x 12" | $7.50 | $17.00 | $24.50 |
| (c) | 14" x 14" | $7.00 | $17.00 | $24.00 |
| (d) | 12" x 10" | $4.50 | $17.00 | $21.50 |
| (e) | 10" x 8" | $4.00 | $17.00 | $21.00 |
| (f) | 17" x 7" | $4.75 | $17.00 | $21.50 |
3. Laboratory Examinations for Passport and Immigration Requirements
| (a) | HIV | $8.00 |
| (b) | RPR | $3.50 |
| (c) | Microfilariae | $2.50 |
| (d) | HBs Ag | $3.50 |
| (e) | Urine tests | $2.50 |
| (f) | Pregnancy Test | $5.00 |
| (g) | Stool tests (O/C/P) | $5.50 |
| (h) | Other tests | $2.50 |
4. Vaccination and Inoculations for Passport and Immigration Requirements
| (a) | B.C.G | $ 6.00 |
| (b) | Typhoid | $ 6.00 |
| (c) | H.B.V | $10.00 |
| (d) | Others | $10.00 |
5. In- Patients Food and Domestic Services
| (a) | Single Ward | $5.00 per day |
| (b) | 2 bed Ward | $2.00 per day |
| (c) | 4 bed Ward | $1.00 per day (when the duration exceeds two |
| | | weeks, there is no charge) |
Exemption
These medical fees and charges are not payable in respect of X-rays, laboratory test, operations and other similar services rendered to an in-patient of the hospital;
(i) Patients under the age of 12 years
(ii) Patients over the age of 70
(iii) Patients in the Infectious Disease Ward
(iv) Patients in the Psychiatric Ward
(v) Patients isolated in - ward for Infection Control purposes
6. Ophthalmology
| (a) | Eye Testing for Employment | $4.00 |
| (b) | Refraction for prescription of spectacles | $4.00 |
7. Dental
| (a) | Manufacture and fitting of complete set of dentures | $80.00 |
| (b) | Partial denture - for first tooth | $10.00 |
| | -each additional tooth | $ 5.00 |
| (c) | Repair(s) | $ 5.00 |
| (d) | Relining | $10.00 |
| (e) | Re-base | $20.00 |
8. Mortuary Charges
| Use of Mortuary cooler per day | $13.00 |
| | |
9. Physiotherapy
Where physiotherapy equipment is loaned to patients a deposit of $20.00 is payable and is refundable on return of equipment in good working condition. The Director of Health may waive payment of deposit in cases of extreme financial difficulty.
PART II
OTHERS
10. Certificates
| (a) | Health Certificate required to fulfil Tongan Passport or Immigration requirements | $10.00 |
| (b) | Health certificate required to fulfil Passport and Immigration requirements of foreign countries | $15.00 |
| (c) | Health certificate required to obtain employment | $10.00 |
| (d) | Health certificate, other than for Passport, Immigration and employment requirements | $12.00 |
| (e) | Issuance and re-issuance of live birth certificate | $10.00 |
| (f) | Issuance and re-issuance of death certificate | $10.00 |
These charges shall be in addition to any fee for consultations.
11. Examinations
(1) X-ray Examinations
| Examination | Film size | No. of Films | Price | Professional Fees | Total Cost |
| CXR | | | | ||
| (a) Adult | 17x14 | 1 | $ 8.00 | $17.00 | $25.00 |
| (b) Child | 12x10 | 1 | $ 4.50 | $17.00 | $21.50 |
| (c) NB | 10x8 | 1 | $ 4.00 | $17.00 | $21.00 |
| AXR | | | | ||
| (d) Adult | 17x14 | 1-s | $ 8.00 | $17.00 | $25.00 |
| | | 2-s+e | $16.00 | $17.00 | $33.00 |
| (e) Child | 12x10 | 1-sup | $ 4.50 | $17.00 | $21.50 |
| | | 2-s+e | $9.00 | $17.00 | $26.00 |
| SPINE | | | | ||
| (f) Cervical | 12x10 | 4(AP/Lat/Obls) | $18.00 | $17.00 | $35.00 |
| (g) Thoracic | 17x7 | 2 | $ 9.50 | $17.00 | $26.50 |
| (h) Lumbar | 17x7 | 2 | $ 9.50 | $17.00 | $26.50 |
| SKULL/SINUSES | 12x10 | 2 | $ 9.00 | $17.00 | $26.00 |
| SHOULDER | 12x10 | 1 | $ 4.50 | $17.00 | $21.50 |
| | 10x8 | 1 | $ 4.00 | $17.00 | $21.50 |
(2) Ultrasound
| | Examination | Processing Costs | Professional Fees | Total Costs |
| (a) | Abdominal | $11.00 | $35.00 | $46.00 |
| (b) | Pelvis | $ 8.00 | $35.00 | $43.00 |
| (c) | Obstetrics | $10.00 | $35.00 | $45.00 |
| (d) | Small body organs | $11.00 | $35.00 | $46.00 |
| (e) | Echocardiography | $20.00 | $20.00 | $40.00 |
(3) Special Examinations
| | Examination | Film size | Processin | Contrast/Media | Professio | Total |
| | | | g Costs | | nal Fees | Cost |
| (a) | Barium meal | (14x14)x2 | $23.00 | $7.00 Ba | $45.00 | $ 77.00 |
| | | (12x10)x2 | | $2.00 Med fizz | | |
| (b) | Barium enema | (17x14x5 | $61.00 | $98.00 Ba | $65.00 | $230.00 |
| | | (14x14)x2 | | $6.00 Med Prep | | |
| | | (12x10)x2 | | | | |
| (c) | Gastrograffin | (17x14)x3 | $24.00 | $60.00 | $45.00 | $129.00 |
| | (follow | | | Gastroview | | |
| | through) | | | | | |
| (d) | Gastrograffine | (17x14)x2 | $23.00 | $120.00 | $50.00 | $193.00 |
| | nema | (14x14)x1 | | Gastroview x2 | | |
| (e) | IVP | (17x14)x2 | $41.00 | $25.00 M/D 76 | $50.00 | $153.00 |
| | | (12x10)x2 | | $6.00 Med prep | | |
| | | | | $31.00 | | |
| (f) | Retrograde Pyelogram | (14x14)x1 (12x10)x1 | $11.50 | $25.00 M/D 76 | $45.00 | $81.50 |
| (g) | Venogram | (14x14)x4 | $28.50 | $25.00 M/D 76 | $55.00 | $108.50 |
| (h) | Myelogram | (14x14)x4 | $21.50 | $212.00 Myodil | | |
| | | (12x10)x3 | | ampoule | | |
(4) Laboratory Examinations
| (1) | BLOOD TEST | | |
| (a) | HIV | $ 8.00 | |
| (b) | RPR | $ 3.50 | |
| (c) | Microfilariae | $ 2.50 | |
| (d) | HBs Ag | $ 3.50 | |
| (e) | FBC | $ 4.00 | |
| (f) | ESR | $ 2.00 | |
| (g) | Platelet count | $ 2.00 | |
| (h) | Reticulocyte count | $ 2.50 | |
| (i) | Blood film | $ 3.50 | |
| (j) | Blood Group - ABO | $ 2.50 | |
| (k) | Blood group - Rh | $ 2.50 | |
| (l) | HCV | $10.00 | |
| (m) | Prothrombin time | $ 4.00 | |
| (n) | APTT | $ 4.00 | |
| (o) | FDP | $ 4.00 | |
| (p) | Direct Coomb's | $ 2.50 | |
| (q) | Paul Bunnell | $ 3.50 | |
| (r) | LE cells | $ 3.50 | |
| (s) | Urea | $ 2.00 | |
| (t) | Sodium | $ 2.00 | |
| (u) | Potassium | $ 2.00 | |
| (v) | Creatinine | $ 2.00 | |
| (w) | ALP | $ 2.00 | |
| (x) | ALT | $ 4.00 | |
| (y) | AST | $ 2.00 | |
| (z) | Amylase | $ 2.00 | |
| (aa) | Bilirubin | $ 2.00 | |
| (bb) | Clacium | $ 2.00 | |
| (cc) | Cholesterol | $ 2.50 | |
| (dd) | CK | $ 2.00 | |
| (ee) | GGT | $ 2.00 | |
| (ff) | Glucose | $ 2.00 | |
| (gg) | Phosphate | $ 4.00 | |
| (hh) | Triglyceride | $ 2.50 | |
| (ii) | Urate | $ 2.00 | |
| (2) | URINE TEST | | |
| (a) | Alb/sugar | $ 2.50 | |
| (b) | Urinalysis (chemical) | $ 3.50 | |
| (c) | Microscopy | $ 3.50 | |
| (d) | Culture | $ 5.00 | |
| (e) | Others | $ 2.50 | |
| (3) | STOOL TEST | | |
| (a) | O/C/P | $ 5.50 | |
| (b) | Culture | $ 5.50 | |
| (4) | BLOOD CULTURE | $10.00 | |
| (5) | STAINING | | |
| (a) | AFB and Gram | $ 5.00 | |
| (b) | TB Culture | $10.00 | |
| (6) | OTHER CULTURE | $ 5.00 | |
| (7) | FUNGAL SCRAPINGS | $ 5.00 | |
| (8) | CYTOLOGY EXAMINATIONS | $10.00 | |
| (9) | HISTOLOGY EXAMINATIONS | $15.00 | |
| (a) | FNA procedure | $15.00 | |
| (b) | Bone marrow aspiration/biopsy | $25.00 | |
| (10) | OVERSEAS TESTS All tests referred overseas are to be charged the full cost as that charged by the overseas laboratory performing the tests plus
transport costs. | | |
12. Vaccination/Inoculations for Passport Requirements
| (a) | Typhoid | $12.00 |
| (b) | HBV | $20.00 |
| (c) | Others | $20.00 |
13. In-Patients
Food and Domestic Services
| (a) | Single Bed Ward | $15.00 |
| (b) | 2 bed Ward | $12.00 |
| (c) | 4 bed Ward | $9.00 |
Exemption
These medical fees and charges are not payable in respect of X-rays, laboratory test, operations and other similar services rendered to an in-patient of the hospital;
(i) Patients over the age of 70
(ii) Patients in the Infectious Disease Ward
(iii) Patients in the Psychiatric Ward
(iv) Patients isolated in Ward for Infection Control purposes
All supplies such as drugs, dressing etc will be charged for at landed cost, and X-rays and Laboratory tests in accordance with the scale of charges. No fees are payable where the patient is accommodated in the Infectious Diseases Ward, Psychiatric Ward or isolated in Ward for Infection Control purposes.
14. Out-Patients
(1) Equipment
| (a) | Single Use of Equipment | $12.00 |
| - | Dynamap, oxymeter, defibrillator, ECG, oxygen flowmeter, suction, aurioscope, nebuliser, glucometer, | |
| (b) | Single Use of Instrument Trays | $ 6.00 |
| - | Dressing, suturing, minor operation, incision, circumcision, VE | |
(2). General Activities
| | Service | Cost |
| (a) | Dressing | $ 10.00 |
| (b) | Injuries | $ 10.00 |
| (c) | Sutures or removal of | $ 15.00 |
| (d) | Nebuliser | $ 10.00 |
| (e) | Minor operation | $ 10.00 |
| (f) | Echocardiography | $ 15.00 |
| (g) | MVA | $ 50.00 |
| (h) | Emergency cases - asthma, cardiac | $ 50.00 |
| (i) | Patient admission | $ 15.00 |
| (j) | Ambulance service | $ 3.00 per km |
| (k) | Resuscitation | $150.00 |
15. Consultation and Medical Attendance
(1) Consultation at a Hospital or Health Centre
(a) During normal office hours $20.00
(b) Outside office hours $30.00
(2) Consultation at place other than Hospital or Health Centre
(a) During normal office hours $20.00
(b) Outside office hours $30.00
(3) Visit to any ships or vessel
(a) Alongside wharf $30.00
(b) At anchorage$60.00 and cost of launch/boat hire
16. Midwifery
(1). Antenatal clinic services
| (a) | First visit | $25.00 |
| (b) | Return visit | $20.00 |
| (c) | Weekly visit | $15.00 |
(2). Gynaecological clinic services
| (a) | First visit | $25.00 |
| (b) | Return visit | $20.00 |
| (c) | Weekly visit | $15.00 |
| (c) | Pap smear screening | $20.00 |
(3). Labour and Delivery
| (a) | Normal vaginal delivery | $100.00 |
| (b) | Operative vaginal delivery | $140.00 |
| (c) | Caesarean section | $200.00 |
17. Operations in Theatre
| (a) | Minor Operations | $30.00-$110.00 | According to the complexity of the operation |
| | | | |
| (b) | Major Operations | $120.00-$800.00 | According to the complexity of the operation |
| | | | |
| (c) | Administration Anaesthetics | $ 60.00-$100.00 | According to technique used. |
The following shall be deemed Major Operations,
(a) Operations on ear, nose or throat,
(b). Operations on the lung, kidney, spleen, liver, gall bladder, intestines, stomach, pancreas and the genitourinary system, prostatectomy, cystostomy,
(c). Operations or amputations involving bones or joints,
(d) Operations on the skull or brain,
(e). Operations in case of empyema, throacotomies for any cause,
(f). Excision of breast lumps, mastectomies,
(g). Thyroid and parathyroid operations,
(h). Operations of the salivary glands,
(i). All hernia repairs and hydrocelectomy,
(j). Operations of varicose veins,
(k). Operations of major lacerations and fractures
(l). Caesarean sections, hysterectomy, ovarian cystectomy and other gynaecological operations,
(m). Freeing and repair of tendons,
(n). Excision of dupuytrens contractures
(o). Gastroscopy, colonoscopy and bronchoscopy
18. Eye Clinic
| (a) | Eye Testing for Employment | $20.00 |
| (b) | Consultation at Eye Clinic | |
| | (i) normal office hours | $20.00 |
| | (ii) outside office hours | $30.00 |
| (c) | Refraction-for perscripiton of spectacles | $20.00 |
| (d) | Visit to Ships and Vessels | |
| | (i) alongside wharf | $30.00 |
| | (ii) at anchorage | $60.00 and cost of launch/boat hire |
| (e) | Laser Treatment | |
| | (i) Argon Photocoagulation for diabetes | Free |
| | (ii) Yag laser for glaucoma and capsulotomy | Free |
| (f) | Minor Eye Operations (including immediate post operative care according to complexity of operation) | $100.00-$200.00 |
| (g) | Major Eye Operations (including immediate post operative care according to complexity of operation) | $350.00-$500.00 |
| (h) | Anaesthetics Administration | |
| | (i) Local infiltration | $10.00 |
| | (ii) Retrobulbar block plus facial nerve block | $50.00 |
19. Dental
(1) Adults
| (a) | Examination and consultation | $ 5.00 |
| (b) | Manufacture and fitting of complete set of dentures | $120.00 |
| (c) | Partial dentures - for first tooth | $ 20.00 |
| (d) | Each additional tooth | $ 10.00 |
| (e) | Denture relining | $ 20.00 |
| (f) | Denture repair | $ 10.00 |
| (g) | Denture re-base | $ 40.00 |
| (h) | X-ray | $ 5.00 |
| (i) | Extraction per tooth | $ 8.00 |
| (j) | Complete extraction | $ 50.00 |
| (k) | Prophylactics | $ 20.00 |
| (l) | Filling (amalgam and composite) | $ 5.00-20.00 |
| (m) | Treatment of gingivitis | $ 20.00 |
| (n) | Treatment of nerve canal | $ 50.00 |
(2). Children
| (a) | Examination and consultation | $ 2.00 |
| (b) | Fillings per tooth | $ 3.00 |
| (c) | X-ray | $ 5.00 |
| (d) | Extraction per tooth | $ 5.00 |
| (e) | Orthodontic - removal of appliance | $20.00 |
| (f) | Denture repair | $10.00 |
| (g) | Denture re-base | $40.00 |
| (h) | Extraction per tooth | $ 8.00 |
| (i) | Complete extraction | $50.00 |
| (j) | Prophylactics | $20.00 |
| (k) | Filling (amalgam and composite) | $ 5.00-20.00 |
| (l) | Treatment of gingivitis | $20.00 |
| (m) | Treatment of nerve canal | $50.00 |
20. Mortuary Charges
| Use of Mortuary Cooler Per Day | $25.00 |
| | |
21. Physiotherapy
(1) Equipment
| (a) | Interferential and Suction unit (5 attendances) | $10.00 |
| (b) | Muscle stimulator (course of 5 attendances | $10.00 |
| (c) | Infra-red (course of 5 attendances | $ 5.00 |
| (d) | Wax bath (course of 5 attendances | $ 3.00 |
| (e) | Hot pack (5 attendances) | $ 5.00 |
| (f) | Muscle stimulation and relaxation (5 attendances) | $10.00 |
(2) Exercises
| (a) | Programme exercises | $5.00 |
| (b) | Sling and Pulleys | $5.00 |
| (c) | Chest drainage | $5.00 |
(3).Loan of Equipment
| (a) | Wheelchairs | $100.00 |
| (b) | Crutches | $ 20.00 |
| (c) | Walking frames | $ 10.00 |
Where physiotherapy equipment is loaned to patients a deposit is refundable on return of equipment. The Director of Health may waive payment of deposit in cases of extreme financial difficulty. Deposit is refundable on return of equipment in good working condition.
22. Dietary and Catering Services
| (a) | Dietary Consultation | $10.00 |
| (b) | Special Dietary Service and Tube Feed | $17.50 per day |
Special Nutrition Products
| (a) | Complan | $10.00 per day |
| (b) | Paedisure | $6.50 per day |
23. Pharmacy
| Dispensing Fee per prescription | $5.00 plus selling costs of drugs | |
24. Other Services (Payable by Tongan subjects and Others)
| (a) | Garbage removal fees for private homes | $ 5.00 per month |
| (b) | Garbage removal fees for schools and government offices | $ 5.00 per month |
| (c) | Garbage removal from business premises | $30.00 per month |
| (d) | Disinfecting premises | $50.00 per application |
(25). Fees payable by Government Servants
An officer and his eligible dependents are entitled to free medical treatment under the officer's term of service will be charged
for tests, examinations, X-rays, vaccinations/inoculations and certificates where these are required for overseas travel otherwise
they will be treated under Part I as Tongan Subjects.
Made at Nuku‘alofa this day.......................... of ....................2000.
Dr. Viliami Tangi
Minister of Health.
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