83 OG No. 4, 275 (January 26, 1987)
HOSPITAL CATEGORY | |||
BENEFIT | PRIMARY | SECONDARY | TERTIARY |
1. Room and Board | P | P | P |
2. Medical Expense (per single period of confinement) | | | |
2.1 Ordinary Cases | | | |
2.1.1 Drugs & Medicines | 175 | 200 | 300 |
2.1.2 X-ray / Laboratories / Others | 75 | 150 | 350 |
2.2 Intensive Care Cases | | | |
2.2.1 Drugs & Medicines | 375 | 400 | 500 |
2.2.2 X-ray / Laboratories / Others | 125 | 200 | 500 |
2.3 Catastrophic Cases | | | |
2.3.1 Drugs & Medicines- | | 800 | 1.000 |
2.3.2 X-ray / Laboratories / Others | | 400 | 1.000 |
3. Medical / Dental Practitioner's Fee shall be | | | |
3.1 For Ordinary Cases (per single period of confinement) | 200 | 200 | 200 |
3.2 For intensive Care / Catastrophic Cases (Per single period of confinement) | 300 | 300 | 300 |
4. Surgeon's Fee shall be in accordance with the relative value scheme prescribed by the Commission not to exceed | | | |
5. Anesthesiologist's Fee not to exceed 30% of the allowed Surgeon's fee. | | | |
6. Operating Room Fee for Surgical Procedures with Relative Unit Value of: | | | |
0 - 5 | 30 | 35 | 65 |
5.1 - 10 | - | 120 | 165 |
10.1 - Above | - | 170 | 225 |
7. Fees for surgical family planning procedures as may be determined by the commission | | | |
HOSPITAL CATEGORY | |||
BENEFIT | PRIMARY | SECONDARY | TERTIARY |
1. Room and Board | P | P | P |
2. Medical Expense Benefits (Per single period of confinement) | | | |
2.1 For Ordinary Cases | | | |
2.1.1 Drug & Medicines | 150 | 175 | 250 |
2.1.2 X-ray / Laboratories / Others | 50 | 75 | 100 |
2.2 For Intensive Care Cases | | | |
2.2.1 Drug & Medicines | 250 | 300 | 350 |
2.2.2 X-ray / Laboratories / Others | 100 | 125 | 250 |
2.3 Catastrophic Cases | | | |
2.3.1 Drugs & Medicines | - | 400 | 450 |
2.3.2 X-ray / Laboratories / Others | - | 150 | 300 |
3. Medical / Dental Practitioner's Fee shall be | | | |
3.1 For Ordinary Cases (per single period of confinement) | 200 | 200 | 200 |
3.2 For Intensive Care / Catastrophic Cases (per single period of confinement) | 300 | 300 | 300 |
4. Surgeon's Fee shall be in accordance with the relative value scheme prescribed by the Commission not to exceed | | | |
5. Anesthesiologist's Fee not to exceed 30% of the allowed Surgeon's Fee | | | |
6. Operating Room Fee for Surgical Procedures with relative Unit Value of: | | | |
0 - 5 | 30 | 35 | 65 |
5.1 - 10 | - | 120 | 165 |
10.1 - above | - | 170 | 225 |
7. Fees for surgical family planning procedures as may be determined by the Commission | | | |