Fee Navigator®

    Governing Rule: 4.12


    • 4.12.1

      The benefit for care of a healthy newborn in hospital does not apply when the infant is ill. In these circumstances, the daily hospital visit HSCs apply.

    • 4.12.2

      If newborn and premature care is provided by a pediatrician,

      1. HSC 03.05G may be claimed for care of a healthy newborn infant referred by anyone practicing obstetrics and in this instance no consultation benefit may be claimed;
      2. if an infant appears initially well but becomes ill after a number of days and consultation is required as well as continuing daily care, benefits may be claimed for consultation under HSC 03.08A or 03.08AZ and the appropriate number of hospital days involved;
      3. if consultation is requested during the newborn period and continuing care is not required, a consultation benefit may be claimed, but not HSC 03.05G and
      4. subject to GR 4.12.1 routine care of a premature infant may be claimed as HSC 03.07A or 03.07AZ for the initial visit and continuing daily care benefits may be claimed as HSC 03.03D.
    • 4.12.3

      Routine care is considered to include minor conditions.

    • 4.12.4

      Routine follow-up visits provided for a premature infant after 90 days and 180 days of age may each be claimed under HSC 03.03A or 03.03AZ.