BERMUDA HOSPITALS BOARD (HOSPITAL FEES)AMENDMENT REGULATIONS 2005

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BR 12 / 2005

BERMUDA HOSPITALS BOARD ACT 1970

1970 : 384

BERMUDA HOSPITALS BOARD (HOSPITAL FEES)AMENDMENT REGULATIONS 2005

The Bermuda Hospitals Board, with the approval of the Ministerof Health and Family Services, in exercise of the power conferred upon itby section 13 of the Bermuda Hospitals Board Act 1970 makes thefollowing Regulations:

Citation and commencement1 (1) These Regulations, which amend the Bermuda HospitalsBoard (Hospital Fees) Regulations 1980 (the "principal Regulations"),may be cited as the Bermuda Hospitals Board (Hospital Fees)Amendment Regulations 2005.

(2) These Regulations shall come into operation on 1 April2005.

Amends regulation 4 of principal Regulations2 Regulation 4 is amended by deleting the figure "$497" andsubstituting the figure "$522".

Revokes and replaces Schedules 1 and 2 to principal Regulations2 Schedules 1 and 2 to the principal Regulations are revoked andreplaced by the following —

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"SCHEDULE 1

IN-PATIENT TREATMENTPART A Residents' Rates

1 The general per diem rate for patients, other than new-borninfants and patients classified as geriatric, shall be $806 for public wardaccommodation, $963 for semi-private accommodation and $1,156 forprivate accommodation.

2 The per diem rate for patients classified as geriatric shall be$310.

3 The per diem rate for newborn infants shall be $345.

4 The per diem rate for hospice care shall be $419.

PART B Non-Residents' Rates

The general per diem rate for patients who are non-residents shall be asfollows—

(a) for public ward accommodation $1,210

(b) for semi-private accommodation $1,445

(c) for private accommodation $1,735

(d) for nursery $ 519

(e) for patients classified as geriatic $ 465

(f) for St. Brendan’s Hospital $ 783

SCHEDULE 2

OUT-PATIENT TREATMENT

Radiology Department$

(extra views done within 24 hours $22 per view)(after 24 hours will be charged as per part being x-rayed)

Catherization for x-ray 62

Special Procedures

Angiography 454Angioplasty 975

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Arterial Stenting 2,711PTC 292Biliary drain 1,008Biliary Stent 2,639IVC filter 1,504Renal Angioplasty 1,226Renal Stent 2,384Nephrostomy 630Antegrade Stent 810Varicocele embolisation 1,399arthrogram - double contrast 380bronchogram 203dacryocystogram 302femoral arteriogram - one side 936femoral arteriogram - bilateral 1,785fistulagram or venogram 342myelogram - cervical and / or dorsal 389myelogram - lumbar 367needle biopsy of lung 390salpingogram 320scanogram 171sialogram 342sinogram 402tomogram 327tomogram over 15 films , charge per extra film 12translumber 1,735ureterogram 334portable charge 109magnetic resonance imaging (MRI) 1,158stereotactic breast biopsy 869

Head and Neck

facial bones 164internal auditory meatus 204jaw 164mastoids 212nose 164optic foramen 172orthopantomogram OPG 164

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PNS post nasal space 172salivary glands 164sinuses 164skull 170teeth, 1 to 16 315teeth, full set 315temporomandibular joints 141

Genito-urinary Tract

cystogram voiding or stress 292pyelogram, intravenous 348pyelogram, retrograde 348vasogram 287

Obstetrical and Gynaecological

erect lateral pelvimetry 211pelvimetry 270survey film 159

Chest

standard 147standard with screening 237

Abdomen

erect and supine 180plain 159

Gastro-intestinal Tract

barium enema 280barium enema with air contrast 344barium meal 238barium meal with follow through 327barium swallow 238cholangiogram 218cholecystogram 234small bowel ft only 211

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Extremities

ankle 158elbow 151femur 168fingers 1, 2 or more 158foot/heel 159forearm 158hand 158hip 170humerus 171knee 166amk knee 323shoulder/clavicle 171sterno-clavicular joints 171subtalar views 190tibia and fibula 170toes 1, 2 or more 158wrist 158

Spine and Pelvis

acetabular views 225cervical spine 178lumbar spine 179pelvis 176pelvis and hip 186ribs 180sacroiliac joints 178sacrum and / or coccyx 178screening with image intensifier up to 5 mins. 218screening with image intensifier more than 5 mins 284screening for scoliosis, erect and supine 204skeletal survey 241soft tissue neck 171sternum 178thoracic spine/ dorsal 180additional copy of any plate 30aml series 247additional views within 24 hours 24additional charge per patient done outside normalhours or public holidays 103

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Nuclear Medicine Department

an additional $145 for scans done outsideof normal hours and public holidays 144

Scanning

bone scan- static 710bone scan- 3 phase 710bone-whole body survey 747Brain with flow, time-activity curves 779cardiac investigations:cardic stress/rest 804white cell labelling 753strontium 89 inject. 727cardic muga 714cardic stress 93cardic rest 717gallium - specific site 957gallium - whole body 1,011G.I. bleed 717hepato - biliary 702I.13 m.ibg 1,051liver and / or spleen 667lung - perfusion only 714lung - ventilation and perfusion - same day 756meckels - ectopic gastric mucosa 702myocardial infarction assessment 721parathyroid 848renogram 720salivary glands study 702scintimammography 747testicular - flow & statics 690thyroid uptake scan 958thyroid 690gastric emptying 702v. cug 456DMSA renal 674DTDA lung clearance 668Diuretic renogram 674

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1-131 whole body 189radioisotope iodine 131 3m Ci 100radioisotope iodine 131 10m Ci 114radioisotope iodine 131 15m Ci 129radioisotope iodine 131 20m Ci 147radioisotope iodine 131 25m Ci 160radioisotope iodine 131 30m Ci 171radioisotope gallium 67 3m Ci 262radioisotope gallium 67 5m Ci 398radioisotope strontium 89 4m Ci 2,170radioisotope thallium 201 2m Ci 207radioisotope thallium 201 3m Ci 256radioisotope 131 MIGB 0.5 mCi 292radioisotope sesta MIBI 5 units 1,682spec. - single pos. emission cts 321captopril renogram 674

C.T. Scan

c.t. head plain 654c.t. head special 838c.t. body 848c.t.body special 893c.t. body biopsy 829c.t.body drainage 832c.t. intravenous enhancement 252c.t. special reconstructions 203c.t.copy 31c.t. reproductions of original films 67additional charge per patient study done outside of normalhours and public holidays 363

Diagnostic Ultrasound

B Scans

abdomen 271aorta 271pre and post bladder 271breast 271carotoid doppler study 462colour doppler 349

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doppler as additional study 101gallbladder 271head 271intra cavity 283intra cavity pelvic 283liver/spleen 271obstetrics and gynaecology 271pancreas 271pelvis 271renal 271thyroid 271testicles 271fertility drug serial - the first and every other 271infant hips 271tendons 271shoulders 271soft tissue 271leg veins 271drainage 279arm veins 279leg arteries 297sonohysterograms 279vascular studies 297review/repeat scan 137portable study charge/additional 14

Biopsy and Amniocentesis

(does not include standard b scan charge) 279additional charge per patient done outsidenormal working hours or on public holidays 215

ECG/EEG Department

electrocardiogram 82electroencephalogram 271holter monitor of heart with analysis 294stress test 302adult echocardiography - complete study

2d & doppler / colour flow 969paediatric echocardiography - complete study

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2d & doppler / colour flow 1,109pacemaker clinic 125cardiologist attendance fee(echo)-adult 96

-paediatric 174signal averaged ecg 90sleep apnea study 459sedation for pediatric clients - echo 62

Pathology Department

Haematology/Coagulation

bleeding time 56blood draw for send away specimens 31body fluid count (pleural,ascitic or spinal) 52bone marrow examination with aspiration 278cbc, esr, sickling 109coagulation screen 83complete blood count 44erythrocyte sedimentation rate 58factor v111 69factor 1x 69fibrinogen 68f.d.p. 44f.d.p. titir 65film examination for parasites 78foetal haemoglobin 131haemoglobin a 1 c 71haemoglobin electrophoresis 90hepatitis c antibody 89k.p.t.t. 44l.e.screen 76infectious mononucleosis screen 44prothrombin time 69reticulocyte count 55rheumatoid factor - titration 93rubella antibodies 55screening test - r.a. 60sickle test 39sperm count 116

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sweat chloride test 185children for I.M. injections 37

Blood Transfusion

antibody identification 103antibody screen 83antibody titre 110antigen subtyping - saline per antigen 13antigen subtyping - ahg per antigen 15antigen profile 198beta hcg (total) 95blood group and antibody screen 103cold agglutinins 198coombs direct 55hiv check 84htlv 111 antibody screen 103ige 95kleihauer 79pregnancy test 63rhesus genotype 78rhogam 191

Microbiology

afb culture (dir.) 3 specimens 237afb culture (conc.) 3 specimens 261a.n.a. fluorescent antibody technique 74blood culture 164body fluid (csf, joint) micro and culture 116c.difficile toxin 67catheter tip culture 116chlamydia serology 74conjunctional swabs - chlamydia by f.a. 74cryposporidium stain - regular 74csf culture 162dark ground microscopy with clinical examination 207ear swab - routine culture 83eye swab - routine culture 83faecal fat stain 39

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fluorescent treponemal antibody 71fungus culture 99genital culture 108gram stain 9helicobacter pylori AB 50herpes culture 79india ink prep 9knee aspirate crystals 96legionella, culture and identification (sputum,bronchial washing, pleurl fluid, trachaelaspirate) 148mrsa screentest 83ova and parasites 68respiratory culture 116rotavirus latex afflutination 126rsv (respiratory syncytial virus) dfa 105semen for culture 98sperm count 115sputum or tissue for tb smear only 143stool (or rectal swab) for culture 108syphillis serology 72tissue culture 176throat swab 83urine micro and culture 83vre screening test 84wound culture 162

Histology/Cytology

cytochemical stain (e.g.pas, diastase, grocott) 78single tissue specimen for examination 143two tissue specimen for examination 180three tissue specimens 215four tissue specimens 353five tissue specimens 422six tissue specimens 502seven tissue specimens 573barr body count 58bone marrow biopsy 292colposcopy biopsy 143cytology (pap) 58fine needle aspiration (assisted) 292

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frozen section and examination 258hormonal evaluation 58immuno peroxidase technique (cea, lca, afp, l26) 125non-gynaecological smear (e.g. sputa, fluids) 112p.a.p. peroxidase technique 98resin section 95thin prep. 66tissue section-single 143tissue section for macro examination 69additional set of slides requested by doctor 49estrogen reception assay 480**where the examination covers more than one organeach additional organ will be charged at half price

Nuclear Medicine In-vitro Studies

free PSA 95troponin 95homocystine 95acid phosphatase (pap) 62australian antigen 64b12 74ca 125 74cea 74ck-mb 74cyclosporine 95digoxin 83estradiol 95ferritin 83folate 73free t4 131fsh 95hepatitis b antibody 83hepatitis b core antibody 83lh 95progesterone 95prolactir 95prostatic specific antigen (psa) 74schilling test 379testosterone 95t.s.h. 83

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free t3 83total t4 131thyroid profile (free t3, free t4, tsh &t4) 293

Biochemistry

acetominophen 58acid-base balance ( blood gases) 87albumin only 42alcohol (blood or urine) 44alkaline phosphatase 42amylase 42b12 74bence jones protein screen 56baby bilirubin 42bilirubin direct 42bilirubin total 42blood sugar (glucose) (fasting, random) 42blood sugar (glucose) (1-6hour p.c.) 56body fluid chemistry (amylase, bili, chloride,creat, glucose, sodium, potassium, LDH, phos, BUN, etc.) 44calcium 42carbamazepine/tegretol 56cardiac enzymes (sgot & ldh) 90csf protein only 43csf sugar only 42csf chloride only 42chemistry profile 445chloride 42cholesterol 42clinic profile (u&e, glu, cret, uric) 108coronary profile (hdl, ldl, vcdl,trdg, chol) 82creatinine 42creatinine clearance 87creatinine phosphokinase (cpk) 42dilantin/phenytoin 58drug testing for abuse - separate charge for each

drug tested 58ed profile 85electrolytes 64ethosuximide 53

BERMUDA HOSPITALS BOARD (HOSPITAL FEES)AMENDMENT REGULATIONS 2005

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gentamicin 56ggt 42glucose challenge 64glucose drink 9glutamic- oxalacetic transaminase (sgot) 42glutamic- pyruvic transaminase 42high density lipoprotein (hdl) 425-hydroxy indoleacetic acid screen (5 hiaa) 55iron profile (iron, tibc, %sat) 95ldh 42lipid profile (chol, trif) 55lithium 49liver function test (bilirubin,sgpt,total protein,albumin, globulin) 121low density lipoprotein 42lytes, glucose, bun (lgb) 64magnesium 41phenobarbital 56phosphorous 42porphyrins (early morning spec.) 52potassium 42post dialysis profile 108pre dialysis profile 315primidone 53protein (body fluid) 43proteins (includes albumin and globulin) 52protein electrophoresis 74quinidine 53salicylate 36sodium (na) 42stool/ urine reducing substances 25tegretol 56theophylline assay 56triglycerides 42urea & electrolytes (Na, K, Cl, BUN) 64urea nitrogen (bun) 42uric acid 42uric acid - urine 44urine calcium 44urine for bile pigments 52

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urine for bile products (urobilinogen) 5224hr urine chemistry (creat, glucose, sodium,potassium,uric acid, BUN,amylase, calcium, etc.)

60

urine for glucose 44urine for protein 44urine for prophyrins 44valproic acid/ epilim 56vancomycin 56xylose test 832hr gtt 823hr gtt 964hr gtt 1125hr gtt 1326hr gtt 148note: any test sent to a commercial or referencelaboratory will be charged according to current chargesof that commercial or reference laboratory plus a hand-ling charge of $45 for express postal specimens and$151 for specimens requiring air freight and/or dry ice.

Operating Rooms - General

amputation fingers or toes 549anal and urethral dilatation 505anal fistula 505arteriograms 815arthroscopy & injection of depomedral 765arthroscopy - removal loose body 765

removal plica 765chrondroplasty 765meniscectomy 765

arthroplasty - small joints 652bilateral augmentation mammoplasty 680biopsy prostate 505breast needle localization 649bronchoscopy 680cardioversion 449carpal tunnel release/ dequervains 549catheterization 477cautery of cervix 541circumcision 622

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colonoscopy 740closed reduction of fracture - no cast 740closed reduction of fracture - minor cast 740closed reduction of fracture - full cast or body jacket 740cystoscopy 477cystoscopy - t.u.r. (t) 526cystoscopy, dormia 621cystoscopy retrograde pyelogram 621cystoscopy - ureteroscopy 794cystometry 526debridement 505declotting a.v. fistula 549dermoid or bartholin's cyst 477dilatation and curettage 495dilatation and curettage, tubal washings/polypectomy 524dilatation and curettage and cone biopsy 549dorsal slit penis 477ear lobe repair/ bat ears 553electro convulsive therapy 578ERCPendoscopic retrograde cholangio pancreatography 764examination under anaesthesia 477excision - breast lumps 680excision - deep cyst or ganglion 534excision - gynaecomastia 561excision - ingrown toenail 505excision and biopsy - basal cell carcinoma 505excision and biopsy - bursa 505excision and biopsy - digital nerve 505excision and biopsy - epithelioma 505excision and biopsy - extradiets 505excision and biopsy - fibroma 505excision and biopsy - granulomas 505excision and biopsy - hair follicles 505excision and biopsy - keloids 505excision and biopsy - lesions 505excision and biopsy - leukoplakia 505excision and biopsy - liver 505excision and biopsy - melanoma 505excision and biopsy - moles/warts 505excision and biopsy - sebaceous cyst 505

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excision and biopsy - superficial cyst 505excision of lumps/ xyphoid bone 505excision scars 505excision of mass 505excision neuromas 505failed procedures 444gastroscopy 581haemorrhoids 549hammer toe / hallux valgus/ chevron osteotomy 505hernia repair 578hymenectomy 477hysteroscopy 505incision and drainage of abscess or haematoma 505insertion of PTFE graft 1,301insertion of intra-uterine contraceptive device/estrogen 477insertion or removal quinton central line 526

Implants

insertion of vasoport 1,403instillation of bladder drugs 505instillation or injection of chemotherapy drugs 505intercostal block 505k wire to fingers or toes 526Laparoscopy 615laparoscopy- appendectomy 656laparoscopy - t.l./meth blue inj./adhesions 656laparoscopy- uterine suspension 713Liposuction 549lumbar puncture 585major suturing 578mallet finger/trigger finger 526manipulation of joints 477minor dressing and suture or insertion of catheter 505multiple superficial cysts 578nail surgery 524natural fistula/ aneurysm 578needle biopsy - joints & injection of joints 505needle biopsy - liver 505needle mammogram 505

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Ochidopexy 541open reduction 783orchidectomy 541perineal reconstruction or revision 603pessary (removal/insertion) 477pilionidal sinus 549repair fallopian tubes 713removal of - foreign body 714removal of - jaws wires 526removal of - k wires 526removal of - lipomas 526removal of - nails or pins 526removal of - neck glands 526removal of - nodes 526removal of - papillomas 526removal of - screws and plates 714removal of - ptfe shunt 526removal of - sutures 526removal of - orthofixator 526resection osteochondroma 505repositioning / reinsertion pacer lead 783revision of scars 526rubins test 505salpingogram code 334sigmoidoscopy 486skin graft/ z plasty 526sphincterotomy 477sympathetic block / quanethadine block / interpluralblock/ganglion block 505tendon repair 578termination of pregnancy 512therapeutic epidural / blood patch 588transrectal biopsy 549varicose veins ties 549vasectomy 561warts/condylomata 505wire guided biopsy 679wurms procedure/ insertion of shirodkar/ circulage 505

Eye Surgery

BERMUDA HOSPITALS BOARD (HOSPITAL FEES)AMENDMENT REGULATIONS 2005

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capsulectomy/ capsulotomy 806cataract extraction 1,079cataract - insertion of intra-ocular lens 1,575conjunctival flap 721conjunctival granuloma / angioma 721corneal crafts 1,079cryosurgery 505ectropion/ blepharosplasty 749examination under anaesthesia 675injection of retrobulbar alcohol 505insertion of contact lens extra-ocular 505intra ocular lens insertion 1,248lateral muscle resection 724meibomian cyst/ chalazia 698probing tear duct 698pterygium/ pfosis 698removal of eye sutures 675removal of foreign body 695repositioning intra-ocular lens 698retinal photocoagulation/cryo 505strabismus/ squint 771tarsorrhaphy 771trebeculectomy/ vitrectomy 806vitrectomy 1,091keratectomy 806*** detention time over six hours will result in anadditional charge of 20% of the rate for the procedure

Note: where there is more than one procedure, therewill be a charge of 100% of the rate for the mostexpensive procedure and 50% of the rate for any otherprocedures

Ear, Nose and Throat Surgery

atticotomy 549bilateral antral lavage 477biopsy oral tumour 698bronchoscopy and complete endoscopy 505cautery of expistaxis area 524cautery inferior turbinates 477direct laryngoscopy 477

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elevation fractured malar 549ent - smr (nasal) 724insertion of grommets 724micro-laryngoscopy 698modified myringoplasty 549myringotomy 477nasal polypectomy 505oesophagoscopy/ tracheoscopy 505reduction fractured nose 505removal of aural granuloma 698removal of grommets 675removal of pack with general anaesthesia 477rhinoplasty 478straight oesophageal dilation w/o oesophagoscopy 477tongue tie release 505tympanoplasty 794combination of any two - ear, nose and throat 806combination of any three - ear, nose and throat 957

Dental Surgery

jaw wiring 542minimum charge (30 minutes of time) 542over 30 minutes of time 713*** detention time over six hours will result in anadditional charge of 20% of the rate for the prodedure

note: where there is more than one procedure, therewill be a charge of 100% of the rate for the mostexpensive procedure and 50% of the rate for any otherprocedures

Physiotherapy Department

individual treatmentcategory 1: 68evaluationmuscle grading 2-4hydrotherapy (at pool)tapingprosthetic review

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open wound carerelative instructionmobilizationfrictions/massage/myofascial releaselaserassessment fee 105

category 2: 58lung functionelectrotherapymuscle grading - 1 limblumbar tractioncervical tractiontherapeutic exercisegait trainingjobst compression

category 3: 43whirlpool bathwash bathhot packsice packs

category 4: 92cybex testing and treating

missed appointment 60

Occupational Therapy (including outpatientgeriatric rehabilitation)

Individual treatment (per quarter-hour) 58note: equipment is charged at cost

Speech therapy

Individual treatment (per quarter-hour) 38

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Emergency Department

Individual treatment - minor 193-intermediate 282- major 349

individual treatment with stay over 6 hours forobservation purposes 459individual treatment with subsequent admittance 349recompression chamber 1,338crutches 128canes 33extrication cervical collars 46nurse escort 276*** note: patients subsequently admitted from the emergencydepartment will be charged for an emergency visit in additionto the inpatient room charge. This will be charged out as amajor treatment.

Vein clinic

initial visit 44treatment without ultrasound 53treatment with ultrasound 190

Ambulance *

per trip 157airport (to and from) 176

Geriatric Care

geriatric day care 62respite care 107

Orthopaedic Unit

orthopaedic unit - individual treatment 93missed appointment 60

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Diabetic Counselling

one week diabetic education programme(12 hours classroom teaching, 3 hours individual) 685follow-up ¼ hr. 17instruction ½ hr. 17dietary counselling ½ hr. sessions 52dipstick analysis 17blood glucose testing 17

Healthy Heart Programme 579

Dietetic Counselling

individual counselling (per half-hour) 58group therapy (per half-hour) 33

Renal Dialysis

haemodialysis (non-residents) 928haemodialysis (residents) 928CAPD (per month) 9,889

Chemotherapy**

individual treatment - half hour 67- three to four hours 254

oncology relationship counselling (per half-hour) 26oncology individual counselling (per half hour) 26oncology group therapy (per half-hour) 13oncology blood transfusion 67oncology iv flushing 144day long chemotherapy 578** note: required drugs will be charged at current cost

Audio-Vestibular Services

Hearing Testing

audiogram - pure tone air and bone 121audiogram - speech 121audiogram - conditioned response 121

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impedance audiometry - compliance 121impedance audiometry - stapedial reflex 121impedance audiometry - eustachian tube patency 121

Vestibular Testing

caloric testing - cold 69caloric testing - hot and cold 121postural testing 68

IV Therapy

immunoglobulin monthly therapy 637venous access device/lab work 87iv flushing 144iv antibiotic treatment 144iv education & counselling 58venous access device dressing change 87pentamidine 164

Maternity Department

external cephalic version 118foetal monitoring 67removal of shirodkar suture 160foetal monitoring- 2hr assessment 121

Colposcopy 214

Alcoholism Services

initial intake assessment 105individual counselling 36relationship counselling 69group therapy (five sessions per week) 526educational therapy ( five sessions per week) 526aftercare counselling ( seventeen sessions) 600family education (per person / 6 sessions ) 212anger management (twelve sessions) 526outpatient detox 193

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Hospice

day long care with i.v. infusion/ transfusion (6 hrs.) 186day long care 67

Psychiatric Outpatient Clinic

initial consult with a psychiatrist 147follow-up visits 109initial consult with a psychologist 123

Mammography

Examinations

initial mammogram 232follow- up mammogram 138localization with 1o.r. specimen(does not include laboratory analysis of specimen) 368fine needle biopsy(does not include laboratory analysis of specimen) 368ductogram 351x-ray of specimen 131recall for cone compression or magnification 79additional views 40cyst aspiration 351missed appointment 57

Psychiatric Counselling

new patient 147follow-up visits 109

Child & Adolescent - SBH

visit to cons psychologist 147visit to psychologist 122medication administration/management - initial 56follow-up 37

Home Health Care

medication administration/management - initial visit 56follow-up visit 37

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ulcer/wound care - simple/complex 118dressing 182laser 158dressing charge including burns - normal 72with laser 118with venous devices 108stump care 122ostomy care 88stroke rehabilitation nursing/physio/occup 56speech therapy 62tpn lab 208tpn administration 172

Asthma Management

initial visit 112reassessment & follow-up (limit 2 visits) 37

Bone Densitometry 181

Hyperbaric & Wound Care (without oxygen) 139

Hyperbaric & Wound Care (with oxygen) 202

Breastfeeding Classes 47

Prenatal Classes (six sessions) 185

Wound Management Center

wound manage- standard 91wound manage- complex 161wound manage- debridement 212

Made this 23rd day of March, 2005

ChairmanBermuda Hospitals Board

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Approved this 24th day of March, 2005

Minister of Health & Family Services