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SENARAI CAJ DALAM PERINTAH FI (PERUBATAN) (PINDAAN) 2017
JADUAL B
CAJ WAD
BAHAGIAN 2
BILIK PROSEDUR (OBSTETRIK)
Bil. Bilik Prosedur (Obstetrik) Procedure Room (Obstetric) (RM)
1 Bilik bersalin (setiap kemasukan)
Labour room (per admission) 120 (Kelas Satu sahaja)
2 Dewan bedah (setiap kemasukan)
Operation theater (per admission)
120 (Kelas Satu sahaja)
JADUAL B
CAJ WAD
BAHAGIAN 1
WAD AM
Bil. Kelas Class
Tidak berhawa
dingin
Berhawa dingin
(Caj sehari)
(Caj sehari)
(RM) (RM)
Kelas Satu: First Class:
1 Bilik dengan satu katil One bedded room 90 120
2 Bilik dengan dua katil Two bedded room 60 90
3 Bilik dengan tiga katil
atau lebih Three bedded room or
more 45 60
4 Kelas Dua Second Class 25 40
5 Kelas Tiga Third Class 3 3
2
JADUAL B
CAJ WAD
BAHAGIAN 3
WAD PSIKIATRIK
Bil. Kelas Class Caj sehari (RM)
1 Kelas Satu First Class 15
2 Kelas Dua Second Class 10
3 Kelas Tiga Third Class Percuma
JADUAL B
CAJ WAD
BAHAGIAN 4
WAD EKSEKUTIF
Bil.
Caj sehari (RM)
1 Bilik dengan satu katil (Orang kenamaan) One bedded room (VIP) 225
2 Bilik dengan satu katil One bedded room 180
3 Bilik dengan dua katil Two bedded room 150
JADUAL C
CAJ RAWATAN
BAHAGIAN 1
RAWATAN PESAKIT DALAM
Bil. Kelas Class Caj sehari
(RM)
1 Kelas Satu First Class 15
2 Kelas Dua Second Class 5
3 Kelas Tiga Third Class Percuma
3
JADUAL C
CAJ RAWATAN
BAHAGIAN 2
ACCOUCHEMENT DAN BERSALIN
Bil. Jenis rawatan Type of treatment
Kelas wad
Kelas Satu
Kelas Dua
Kelas Tiga
(RM) (RM) (RM)
1 Pembedahan Caesarean Caesarean operation 1200 400 100
2 Bersalin dengan bantuan: Assisted delivery:
3 Forseps/ songsang/ vakum Forceps/ breech/ vacuum 600 200 50
4 Bersalin kembar Twin delivery 600 200 50
5 Bersalin biasa Normal delivery 450 150 10
JADUAL C
CAJ RAWATAN
BAHAGIAN 3
FISIOTERAPI
Bil. Jenis rawatan Type of treatment
Setiap lawatan
Kelas Satu
Kelas Dua
Kelas Tiga
(RM) (RM) (RM)
Modaliti elektroterapi Electrotherapy modalities
1 Biomaklumbalas/miomaklumbalas
Biofeedback /myofeedback 30 20 5
2 Arus terus/ iontoforesis Direct current / iontophorosis 30 20 5
3 Arus dwidinamik Didynamic current 30 20 5
4 Arus terus terganggu Interrupted direct current 30 20 5
5 Terapi interferens Interferential therapy 30 20 5
6 Diatermi gelombang pendek Shortwave diathermy 30 20 5
7 Stimulasi saraf transkutan elektrik
Transcutaneous electrical nerve stimulation
30 20 5
8 Terapi ultrasound Ultrasound therapy 30 20 5
9 Ultrasound masa nyata Realtime ultrasound 30 20 5
10 Stimulasi elektrik fungsional Functional electrical stimulation 30 20 5
11 Terapi gelombang kejut Shockwave therapy 30 20 5
4
Bil. Jenis rawatan Type of treatment
Setiap lawatan
Kelas Satu
Kelas Dua
Kelas Tiga
(RM) (RM) (RM)
Terapi Haba/Krioterapi
Thermal therapy/cryotherapy
12 Pek panas Hot pack 15 10 2
13 Mandi lilin Wax bath 15 10 2
14 Sinaran inframerah Infrared radiation 15 10 2
15 Krioterapi Cryotherapy 15 10 2
Fototerapi Phototherapy
16 Terapi laser Laser therapy 30 15 5
17 Terapi sinar ultraungu Ultraviolet light therapy 30 15 5
Terapi kardiorespiratori Cardiorespiratory therapy
18 Teknik Pernafasan Kitaran Aktif (ACBT)
Active Cycle Breathing Technique (ACBT)
30 15 5
19 Senaman pernafasan Breathing exercise 30 15 5
20 Sedutan bronkiol Bronchial suction 30 15 5
21 Spirometer insentif Incentive spirometer 30 15 5
22 Fluter Flutter 30 15 5
23 Latihan otot inspiratori Inspiratory muscle training 30 15 5
24 Terapi penyedutan Inhalation therapy 30 15 5
25 Perkusi/ Getaran Percussion/vibration 30 15 5
26 Tekanan ekspirasi positif Positive expiratory pressure 30 15 5
27 Penyaliran postural Postural drainage 30 15 5
Terapi mekano Mechano therapy
28 Tarikan servikal Cervical traction 20 10 2
29 Tarikan lumbar Lumbar traction 20 10 2
30 Pam berangkai Sequential pump 20 10 2
Hidroterapi Hydrotherapy
31 Senaman kolam Pool exercise 20 10 2
32 Pusaran air Whirlpool 20 10 2
Terapi manual Manual therapy
33 Manipulasi tisu lembut Soft tissue manipulation 20 10 2
5
Bil. Jenis rawatan Type of treatment
Setiap lawatan
Kelas Satu
Kelas Dua
Kelas Tiga
(RM) (RM) (RM)
34 Lepasan miofasia Myofascial release 20 10 2
35 Penyaliran limfa secara manual Manual lymphatic drainage 20 10 2
36 Akutekanan Accupressure 20 10 2
37 Pemitaan/pembalutan/pengikat
Taping/bandaging/strapping 30 20 Percuma
38 Terapi mampatan (limfoedema)
Compression therapy (lymphoedema)
30 20 Percuma
Teknik khas Special techniques
39 Teknik reposisi Canalith Canalith repositioning technique
30 20 2
40 Senaman penstabilan renungan Gaze stabilisation exercise 30 20 2
41 Pengaisan atau pemberusan Icing or brushing 30 20 2
42 Mobilisasi sendi Joint mobilization 30 20 2
43 Teknik McKenzie McKenzie technique 30 20 2
44 Program pembelajaran semula motor
Motor re-learning programme 30 20 2
45 Akupunktur atau penjaruman kering
Acupuncture or dry needling 30 20 2
46 Teknik perkembangan neuro Neurodevelopmental technique 30 20 2
47 Pemudahan proprioseptif saraf otot
Proprioceptive neuromuscular facilitation
30 20 2
Terapi senaman Exercise therapy
48 Aktif, pasif atau berbeban Active, passive or resisted 20 10 2
49 Ambulasi atau latihan gaya jalan Ambulation or gait training 20 10 2
50 Senaman antenatal dan postnatal
Antenatal and postnatal exercise
20 10 2
51 Latihan imbangan Balance training 20 10 2
52 Latihan pundi kencing/ usus Bladder/bowel training 20 10 2
53 Latihan litar Circuit training 20 10 2
54 Senaman bola gim Gymnic ball exercise 20 10 2
55 Teknik tahan kemutan untuk otot lantai pelvis
Counter bracing technique for pelvic floor muscle
20 10 2
56 Aktiviti kefungsian Functional activities 20 10 2
57 Senaman berkumpulan Group exercise 20 10 2
6
Bil. Jenis rawatan Type of treatment
Setiap lawatan
Kelas Satu
Kelas Dua
Kelas Tiga
(RM) (RM) (RM)
58 Senaman isokinetik Isokinetic exercise 20 10 2
59 Senaman mekanikal Mechanical exercise 20 10 2
60 Senaman otot lantai pelvis Pelvic floor muscle exercise 20 10 2
61 Teknik relaksasi Relaxation technique 20 10 2
62 Pendidikan semula sensori Sensory re-education 20 10 2
63 Rejim tangan khas Special hand regime 20 10 2
UJIAN KHAS SPECIAL TEST
Alat diagnostik Diagnostic tool
64 Ujian imbangan Berg Berg’s balance test 50 30 5
65 Ujian Klinikal bagi Interaksi Sensori dan Imbangan (CTSIB)
Clinical Test for Sensory Interaction and Balance (CTSIB)
50 30 5
66 Postugrafi dinamik berkomputer
Computerized Dynamic Posturography
50 30 5
67 Penilaian tangan berkomputer Computerized hand evaluation 50 30 5
68 Indeks gaya jalan dinamik Dynamic gait index 50 30 5
69 Penilaian otot lantai pelvis Pelvic floor muscle assessment 50 30 5
70 Ujian sensori Sensory testing 50 30 5
71 Lengkungan tempoh kekuatan Strength duration curve 50 30 5
72 Ujian otot voluntari Voluntary muscle testing 50 30 5
73 Ujian vestibular Vestibular test 50 30 5
74 Ujian bangun dan pergi bermasa
Timed up and go test 50 30 5
75 Ujian jangkauan fungsi Functional reach test 50 30 5
7
CAJ RAWATAN
BAHAGIAN 4
RAWATAN RADIOTERAPI DAN ONKOLOGI
Bil. Jenis rawatan Type of treatment Kelas Satu (RM)
Kelas Dua
(RM)
Kelas Tiga (RM)
Pesakit Luar
Rujukan Pengamal
Persendirian
Rujukan Pegawai
Perubatan
Kerajaan
(RM) (RM)
Simulasi dan perancangan berkomputer
Simulation and computerized planning
1 Penandaan setempat
Mark on set 45 30 Percuma 45 15
2 Simulasi konvensional
Conventional simulation
450 200 Percuma 450 75
3 Simulasi CT: CT simulation: 450 200 Percuma 450 75
Biasa (tanpa kontras)
Normal (without contrast)
4 Simulasi CT: CT simulation: 450 200 Percuma 450 75
Rumit (dengan kontras)
Complex (with contrast)
5 Simulasi CT: CT simulation:
450 200 Percuma 450 75
Radioterapi Keamatan Bermodulasi (IMRT)
Intensity Modulated Radiotherapy (IMRT)
6 Simulasi CT: CT simulation: 450 200 Percuma 450 75
Penyinaran Seluruh Badan (TBI)
Total Body Irradiation (TBI)
7 Simulasi CT: CT simulation: 450 200 Percuma 450 75
Penyinaran Seluruh Nodal (TNI)
Total Nodal Irradiation (TNI)
8 Simulasi CT: CT simulation: 450 200 Percuma 450 75
Elektron Suluruh Badan (TBE)
Total Body Electron (TBE)
9 Simulasi CT: CT simulation:
450 200 Percuma 450 75
Radioterapi Stereotaktik (SRT)
Stereotactic Radiotherapy (SRT)
10 Simulasi CT: CT simulation: 450 200 Percuma 450 75
Radiosurgeri Stereotaktik (SRS)
Stereotactic Radiosurgery(SRS)
8
Bil. Jenis rawatan Type of treatment Kelas Satu (RM)
Kelas Dua
(RM)
Kelas Tiga (RM)
Pesakit Luar
Rujukan Pengamal
Persendirian
Rujukan Pegawai
Perubatan
Kerajaan
(RM) (RM)
11 Simulasi CT: CT simulation:
450 200 Percuma 450 75
Radioterapi Stereotaktik Badan (SBRT)
Stereotactic Body Radiotherapy (SBRT)
Rawatan radioterapi
Radiotherapy treatment
12 2D/ medan tunggal/ selari setentang (setiap pecahan)
2D/single field/parallel opposed (per fraction)
100 50 12 100 25
13
3D/apa-apa rancangan dengan 3 atau lebih medan (setiap pecahan)
3D/any plans with 3 or more fields (per fraction)
100 50 12 100 25
14 IMRT (setiap pecahan)
IMRT (per fraction)
100 50 12 100 25
15 TBI (setiap pecahan)
TBI (per fraction) 100 50 12 100 25
16 TNI (setiap pecahan)
TNI (per fraction) 100 50 12 100 25
17 SRT (setiap pecahan)
SRT (per fraction) 100 50 12 100 25
18 SRS SRS
7000 (rawa
tan pakej untuk sekali
caj sahaj
a)
5000 (rawatan
pakej untuk sekali
caj sahaj
a)
12 (setiap
rawatan)
7000 (rawatan
pakej untuk sekali caj sahaja)
500 (rawatan
pakej untuk
sekali caj sahaja)
19 SBRT SBRT
7000 (rawa
tan pakej untuk sekali
caj sahaj
a)
5000 (rawatan
pakej untuk sekali
caj sahaj
a)
12 (setiap
rawatan)
7000 (rawatan
pakej untuk sekali caj sahaja)
500 (rawatan
pakej untuk
sekali caj sahaja)
9
Bil. Jenis rawatan Type of treatment Kelas Satu (RM)
Kelas Dua
(RM)
Kelas Tiga (RM)
Pesakit Luar
Rujukan Pengamal
Persendirian
Rujukan Pegawai
Perubatan
Kerajaan
(RM) (RM)
Rawatan brakiterapi
Brachytherapy treatment
20 Intrakavitari: Dobi/sumber satu baris (setiap sesi)
Intracavitary : dhobbies/single line source (per session)
75 30 6 75 15
21 Intrakavitari: ovoid berpasangan (setiap sesi)
Intracavitary : paired ovoids (per session)
75 30 6 75 15
22 Intrakavitari: intrakavitari penuh (setiap sesi)
Intracavitary : full intracavitary (per session)
75 30 6 75 15
23
Intrakavitari: bagi kanser nasofaringeal (NPC) (setiap sesi)
Intracavitary : for nasopharyngeal cancer (NPC) (per session)
75 30 6 75 15
24
Intraluminal: Esofagus, bronkus, anorektal (setiap sesi)
Intraluminal : Esophagus, bronchus, anorectal (per session)
75 30 6 75 15
25
Implan brakiterapi interstisial: implan brakiterapi payudara (setiap sesi)
Interstitial brachytherapy implants : breast brachytherapy implants (per session)
75 30 6 75 15
26
Implan brakiterapi interstisial: implant ekstremiti (setiap sesi)
Interstitial brachytherapy implants : extremities implants (per session)
75 30 6 75 15
27
Implan brakiterapi: implan kaviti oral/ anorektal/ prostat/ mata dan lain-lain (setiap sesi)
Brachytherapy implants : oral cavity/ anorectal/ prostate/eye and other implants (per session)
75 30 6 75 15
10
Bil. Jenis rawatan Type of treatment Kelas Satu (RM)
Kelas Dua
(RM)
Kelas Tiga (RM)
Pesakit Luar
Rujukan Pengamal
Persendirian
Rujukan Pegawai
Perubatan
Kerajaan
(RM) (RM)
28 Prosedur brakiterapi prostat (rawatan pakej)
Prostate brachytherapy procedure (package treatment)
7,000 5,000 6 - -
Rawatan anti-neoplastik
Anti-neoplastic treatment
29
Rawatan anti-neoplastik untuk kanser (selain terapi sasaran) (setiap rawatan)
Anti-neoplastic for cancer (besides targeted therapy) (per treatment)
400 200 50 400 100
30
Rawatan terapi sasaran untuk kanser (setiap rawatan)
Targeted therapy treatment for cancer (per treatment)
600 400 50 600 150
31
Rawatan kanser yang memerlukan kelulusan khas Ketua Pengarah Kesihatan (KPK) (setiap rawatan)
Cancer treatment that needs special approval from the Director General of Health (per treatment)
800 200 50 800 200
Perubatan nuklear Nuclear medicine
Isotop radioaktif: Radioactive isotopes:
32 (i) Diagnosis (i) Diagnosis 150 50 25 150 25
33 (ii) Terapi (ii) Theraphy 750 250 125 750 125
11
JADUAL C
CAJ RAWATAN
BAHAGIAN 5
NEFROLOGI
Bil. Jenis rawatan Type of treatment
Kelas Satu
Kelas Dua
Kelas Tiga
(RM) (RM) (RM)
1
Dialisis berselang-selang peritoneal (setiap rawatan)
Intermitent peritonial dialysis per treatment
275 100 50
2
Rawatan Dialisis Peritoneal Ambulasi Berterusan (CAPD) (sebulan)
Continuous Ambulatory Peritoneal Dialysis (CAPD) treatment (monthly)
750 200 100
3 Hemodialisis setiap rawatan: Hemodialysis per treatment:
4 (i) satu kegunaan buah pinggang tiruan
(i) one use of artificial kidney 190 50 25
5 (ii) kegunaan semula buah pinggang tiruan
(ii) re-use of artificial kidney 75 20 10
6
Biopsi buah pinggang (tidak termasuk laporan)
Renal biopsy (excluding report) 75 20 10
7
Pengkateteran femoral/ subklavian untuk hemodialisis
Femoral/subclaviancatheterisation for hemodialysis
75 20 10
8 Hemoperfusi Haemoperfusion 375 100 50
9 Implantasi kateter tenkoff Implantation of tenchkoff catheter 150 40 20
10 Rawatan dialisis prapemindahan
Pretransplant dialysis treatment 1500 400 200
11 Lawatan di rumah bagi setiap hemodialisis
Home visit per hemodialysis 100 (setiap lawatan)
JADUAL C
CAJ RAWATAN
BAHAGIAN 6
RAWATAN PSIKIATRIK
Bil. Kelas Class
Setiap kemasukan
(RM)
1 Kelas Satu First Class 1125
2 Kelas Dua Second Class 300
3 Kelas Tiga Third Class Percuma
12
JADUAL C
CAJ RAWATAN
BAHAGIAN 7
TERAPI CARA KERJA
Bil. Jenis rawatan Type of treatment
Kelas Satu
Kelas Dua
Kelas Tiga
(RM) (RM) (RM)
PENILAIAN ASSESSMENT
Penilaian aktiviti kehidupan seharian (ADL)
Activities of Daily Living (ADL) Assessment
1 Ukuran Pelaksanaan Terapi Cara Kerja Kanada (C.O.P.M)
Canadian Occupational Therapy Performance Measure (C.O.P.M)
20 10 Percuma
2 Jadual Pendek Penafsiran Keperluan Camberwell (CANSAS)
Camberwell Assessment of Needs Short Schedule (CANSAS)
20 10 Percuma
3 Penilaian Keupayaan Kefungsian (FAA)
Functional Ability Assessment (FAA)
20 10 Percuma
4 Ukuran Kebebasan Kefungsian (FIM)
Functional Independence Measure (FIM)
20 10 Percuma
5 Penilaian Kemahiran Hidup Kohlman (KELS)
Kohlman Evaluation of Living skill (KELS)
20 10 Percuma
6 Aktiviti instrumental skala kehidupan seharian Lawton
The Lawton instrumental activities daily living scale
20 10 Percuma
7 Indeks terubah suai Barthel (MBI)
Modified Barthel Index (MBI) 20 10 Percuma
8 Terapi cara kerja bagi penilaian jantung
Occupational therapy for cardiac assessment
20 10 Percuma
9 Inventori penilaian kehilangan upaya pediatrik (PEDI)
Pediatric Evaluation Disabilities inventory (PEDI)
20 10 Percuma
10 Penilaian Pelaksanaan Kemahiran Pengurusan Diri (PASS)
Performance Assessment of Self Care Skills (PASS)
20 10 Percuma
11
Penilaian Kemahiran Motor dan Pemprosesan bagi Kesihatan Mental (AMPS)
Assessment of Motor and Process Skills in Mental Health (AMPS)
20 10 Percuma
13
Bil. Jenis rawatan Type of treatment
Kelas Satu
Kelas Dua
Kelas Tiga
(RM) (RM) (RM)
Penilaian fizikal Physical assessment
12 Ujian Manual Otot (MMT)
Muscle Manual Test (MMT) 20 10 Percuma
13 Kekuatan dinamometer/ tolok kutil
Strength-dynamometer/ pinch gauge
20 10 Percuma
14 Ujian pembezaan 2 titik 2 point discrimination test 20 10 Percuma
15 Ujian pasak 9 lubang 9 hole peg test 20 10 Percuma
16 Ujian imbangan Berg Berg balance test 20 10 Percuma
17 Papan pasak beralur Grooved peg board 20 10 Percuma
18 Ujian fungsi tangan Jebsen Taylor
Jebsen Taylor hand function test
20 10 Percuma
19 Ujian kecakatan manual Minnesota
Minnesota manual dexterity test
20 10 Percuma
20 Skala kesakitan Pain Scale 20 10 Percuma
21 Ujian kecakatan jari O’Connor
O’Connor finger dexterity test 20 10 Percuma
22 Ujian kecakatan penyepit O’Connor
O’Connor tweezer dexterity test
20 10 Percuma
23 Ton otot Muscle Tone 20 10 Percuma
24 Ujian papan pasak Purdue
Purdue pegboard test 20 10 Percuma
25 Julat pergerakan sendi (Goniometer)
Range of motion (Goniometer)
20 10 Percuma
26 Ujian aptitud manipulatif Roeder
Roeder manipulative aptitude test
20 10 Percuma
14
Bil. Jenis rawatan Type of treatment
Kelas Satu
Kelas Dua
Kelas Tiga
(RM) (RM) (RM)
27 Ujian monofilamen Semmes-Weinstein
Semmes-Weinstein monofilaments test
20 10 Percuma
28 Profil sensori Sensory profile 20 10 Percuma
29 Ujian stereognosis Stereognosis test 20 10 Percuma
30 Getaran Vibration 20 10 Percuma
31 Volumeter Volumeter 20 10 Percuma
32 Ujian imbangan Tinnetti Tinnetti balance test 20 10 Percuma
33 Alat Senaman Anggota Atas Mikrokomputer (MULE)
Microcomputer Upper Limb Exerciser (MULE)
20 10 Percuma
Penilaian perkembangan normal
Normal development assessment
34 Ujian Bruininks-Oseretsky
Bruiniks-Oseretsky test 20 10 Percuma
35 Carta tapisan perkembangan Denver
Denver developmental screening chart
20 10 Percuma
36 Skala pengadaran motor oral
Oral motor rating scale 20 10 Percuma
37 Peabody Peabody 20 10 Percuma
Penilaian persepsi dan kognitif
Perceptual and cognitive assessment
38
Ujian Perkembangan Integrasi Visual-Motor Beery Buktenica (Beery VMI)
The Berry Buktenica Development Test Of Visual –Motor Integration (Berry VMI)
20 10 Percuma
15
Bil. Jenis rawatan Type of treatment
Kelas Satu
Kelas Dua
Kelas Tiga
(RM) (RM) (RM)
39
Bateri Penilaian Neurologi Terapi Cara Kerja Chessington (C.O.T.N.A.B)
Chessington Occupational Therapy Neurological Assessment Battery (C.O.T.N.A.B)
20 10 Percuma
40 Skala keresahan dan kemurungan hospital
Hospital anxiety depression scale
20 10 Percuma
41 Penilaian Kognitif Terapi Cara Kerja Lowerstein (LOCTA)
Lowerstein Occupational Therapy Cognitive Assessment (LOCTA)
20 10 Percuma
42 -LOCTA-A (bagi kes dewasa am)
-LOCTA-A (for adult general cases)
43 -LOTCA-G (bagi kes geriatrik)
-LOTCA-G (for geriatric cases)
44 -LOTCA-D (bagi kes kanak-kanak/ perkembangan)
-LOTCA-D (for children/developmental cases)
45 Pemeriksaan Mini Keadaan Mental (MMSE)
Mini Mental State Examination (MMSE)
20 10 Percuma
46 Penilaian Kognitif Montreal (MoCA)
Montreal Cognitive Assessment (MoCA)
20 10 Percuma
47 Bateri penilaian persepsi kederiaan Rivermead
Rivermead preceptual assessment battery
20 10 Percuma
Penilaian prasekolah Preschool assessment
48 Penilaian pelajar prasekolah Miller
Miller assessment pre schoolers
20 10 Percuma
49 Penilaian Fungsi Sekolah (SFA)
School Function Assessment (SFA)
20 10 Percuma
50 Ujian kemahiran tulisan tangan
Test of handwritting skill 20 10 Percuma
16
Bil. Jenis rawatan Type of treatment
Kelas Satu
Kelas Dua
Kelas Tiga
(RM) (RM) (RM)
Penilaian tingkah laku Behavior assessment
51 Grid Penilaian Ambang (TAG)
Threshold Assessment Grid (TAG)
20 10 Percuma
52 Skala keresahan dan kemurungan hospital
Hospital anxiety and depression scale
20 10 Percuma
53 Keteriritasian (skala kemurungan dan keresahan)
Irritability (depression anxiety scale)
20 10 Percuma
54 Soal selidik fungsi Sharman
Sharman's function questionaire
20 10 Percuma
55 Skala kemurungan Beck The Beck depression scale 20 10 Percuma
56 Skala amnesia pascatrauma (skala PTA)
Post Traumatic Amnesia scale (PTA scale)
20 10 Percuma
57 Penilaian kerusi roda Wheel chair assessment 20 10 Percuma
Penilaian pemanduan Driving assessment
58 Penilaian pra-memandu Pre driving assessment 150 100 Percuma
59 Penilaian tapisan pemanduan pesakit strok
Stroke driving screening assessment
150 100 Percuma
Penilaian rumah/ tempat kerja/ sekolah
Home/work place/ school assessment
60 Alat Tapisan Kejatuhan dan Kemalangan dalam Rumah (FAST)
Home falls and accidents screening tool (FAST)
20 10 Percuma
17
Bil. Jenis rawatan Type of treatment
Kelas Satu
Kelas Dua
Kelas Tiga
(RM) (RM) (RM)
Penilaian kerja/vokasional
Work/vocational assessment
61 Penilaian kapasiti kefungsian
Functional capacity evaluation
150 100 Percuma
62 Penilaian LAM bagi Kesediaan Pekerjaan (LASER)
LAM Assessment of Employment Readiness (LASER)
150 100 Percuma
63 Senarai semak peranan Role check list 150 100 Percuma
Latihan aktiviti kehidupan seharian
Activities of daily living training
64 Kebolehan untuk menggunakan telefon
Ability to use telephone 20 10 Percuma
65 Ambulasi awal Early ambulation 20 10 Percuma
66 Kebersihan diri Self hygiene 20 10 Percuma
67 Pindah Transfer 20 10 Percuma
68 Kebolehan mengendalikan kewangan
Ability handle finance 20 10 Percuma
69 Mandi Bathing 20 10 Percuma
70 Pengurusan pundi kencing
Bladder management 20 10 Percuma
71 Pengurusan usus Bowel management 20 10 Percuma
72 Kerja pembersihan Cleaning work 20 10 Percuma
73 Penjagaan peralatan Device care 20 10 Percuma
18
Bil. Jenis rawatan Type of treatment
Kelas Satu
Kelas Dua
Kelas Tiga
(RM) (RM) (RM)
74 Kemahiran domestic Domestic skill 20 10 Percuma
75 Memakai pakaian Dressing 20 10 Percuma
76 Makan/ Memberi makan Eating/feeding 20 10 Percuma
77 Penyediaan makanan/ hidangan
Food/meal preparation 20 10 Percuma
78 Kefungsian komunikasi Functional communication 20 10 Percuma
79 Kefungsian mobiliti Functional mobility 20 10 Percuma
80 Hias diri Grooming 20 10 Percuma
81 Eminens kesihatan Health eminence 20 10 Percuma
82 Penyelenggaraan isi rumah
Household maintenance 20 10 Percuma
83 Pengemasan rumah Housekeeping 20 10 Percuma
84 Dobi Laundry 20 10 Percuma
85 Mod pengangkutan Mode of transportation 20 10 Percuma
86 Pengurusan wang Money management 20 10 Percuma
87 Tanggungjawab bagi pengubatan
Responsibility for medication 20 10 Percuma
88 Prosedur keselamatan Safety procedure 20 10 Percuma
89 Fungsi seksual Sexual function 20 10 Percuma
90 Beli-belah Shopping 20 10 Percuma
19
Bil. Jenis rawatan Type of treatment
Kelas Satu
Kelas Dua
Kelas Tiga
(RM) (RM) (RM)
91 Penjagaan tandas Toileting 20 10 Percuma
Alat bantuan dan adaptasi (bagi setiap pengubahsuaian peralatan yang dibekalkan)
Aids and adaptation (for each modification equipment supplied)
92 Perkakas memasak Cooking utensil 20 10 Percuma
93 Mengenakan pakaian Dressing 20 10 Percuma
94 Perkakas makan/ minum Feeding/drinking utensil 20 10 Percuma
95 Mobiliti Mobility 20 10 Percuma
96 Mandi Bathing 20 10 Percuma
97 Membaca/ Menulis Reading/writing 20 10 Percuma
98 Dudukan kerusi roda Wheel chair seating 20 10 Percuma
99 Rehabilitasi penglihatan terhad
Low vision rehabilitation 20 10 Percuma
100 Intervensi persepsi dan kognitif
Cognitive and perceptual intervention
101 Konsep asas Basic concepts 20 10 Percuma
102 Pengenalpastian bahagian badan
Body part identification 20 10 Percuma
103 Stimulasi kognitif Cognitive stimulation 20 10 Percuma
20
Bil. Jenis rawatan Type of treatment
Kelas Satu
Kelas Dua
Kelas Tiga
(RM) (RM) (RM)
104 Aktiviti pembelajaran Educational activities 20 10 Percuma
105 Pembezaan kanan/ kiri Right/left discrimination 20 10 Percuma
106 Diskriminasi bentuk dan persekitaran
Figure-ground discrimination 20 10 Percuma
107 Orientasi realiti Reality orientation 20 10 Percuma
108 Aktiviti orientasi topografi
Topographical orientation activities
20 10 Percuma
109 Penjujukan Sequencing 20 10 Percuma
110 Pengkategorian Categorization 20 10 Percuma
111 Terapi cermin Mirror therapy 20 10 Percuma
112 Terapi tingkah laku Behavioral therapy 20 10 Percuma
Terapi kreatif Creative therapy
113 Terapi seni Art therapy 20 10 Percuma
114 Drama/ Lakon peranan Drama/role play 20 10 Percuma
115 Terapi muzik Music therapy 20 10 Percuma
Intervensi kemahiran sosial
Social skill intervention
116 Latihan asertif Assertive training 20 10 Percuma
21
Bil. Jenis rawatan Type of treatment
Kelas Satu
Kelas Dua
Kelas Tiga
(RM) (RM) (RM)
117 Latihan kemahiran daya tindak
Coping skill training 20 10 Percuma
118 Kumpulan sokongan Group support 20 10 Percuma
119 Terapi berkumpulan Group therapy 20 10 Percuma
120 Terapi individu Individual therapy 20 10 Percuma
121 Kemahiran interpersonal Interpersonal skill 20 10 Percuma
122 Aktiviti kesedaran diri Self awareness activities 20 10 Percuma
123 Kawalan diri Self control 20 10 Percuma
124 Ekspresi diri Self expression 20 10 Percuma
125 Pelakuan sosial Social conduct 20 10 Percuma
126 Latihan kemahiran sosial Social skill training 20 10 Percuma
127 Pengurusan masa Time management 20 10 Percuma
128 Senarai semak peranan Role checklist 20 10 Percuma
Pendidikan terapi cara kerja untuk pesakit dan penjaga
Patient's and carer's occupational therapy education
129 Mekanik dan ergonomik badan
Body mechanic and ergonomic
20 10 Percuma
130 Kawalan dan pencegahan edema
Edema control and prevention
20 10 Percuma
131 Penjimatan tenaga/ pemudahan kerja
Energy conservation/work simplification
20 10 Percuma
22
Bil. Jenis rawatan Type of treatment
Kelas Satu
Kelas Dua
Kelas Tiga
(RM) (RM) (RM)
132 Terapi persekitaran Environment therapy 20 10 Percuma
133 Teknik penjagaan sendi Joint protection techniques 20 10 Percuma
Main dan santai Play and leisure
134 Senarai semak santai Leisure check list 20 10 Percuma
135 Eksplorasi main dan santai
Play and leisure exploration 20 10 Percuma
136 Latihan main dan santai Play and leisure training 20 10 Percuma
Relaksasi Relaxation
137 Biomaklumbalas Biofeedback 20 10 Percuma
138 Pernafasan dalam Deep breathing 20 10 Percuma
139 Pernafasan diafragma Diaphragmatic breathing 20 10 Percuma
140 Relaksasi khayalan Imaginary relaxation 20 10 Percuma
141 Teknik relaksasi otot progresif
Progressive muscular relaxation techniques
20 10 Percuma
Latihan sensori Sensory training
142 Penyahpekaan sensori Sensory desensitization 20 10 Percuma
23
Bil. Jenis rawatan Type of treatment
Kelas Satu
Kelas Dua
Kelas Tiga
(RM) (RM) (RM)
143 Integrasi sensori Sensory integration 20 10 Percuma
144 Pendidikan semula sensori
Sensory re-education 20 10 Percuma
145 Stimulasi sensori Sensory stimulation 20 10 Percuma
146 Fluidoterapi Fluidotherapy 20 10 Percuma
Latihan motor Motor training
147 Prostesis atas siku Above elbow prosthesis 20 10 Percuma
148 Prostesis atas lutut Above knee prosthesis 20 10 Percuma
149 Senaman bantuan aktif Active assisted exercise 20 10 Percuma
150 Prostesis bawah siku Below elbow prosthesis 20 10 Percuma
151 Prostesis bawah lutut Below knee prosthesis 20 10 Percuma
152 Integrasi bilateral Bilateral integration 20 10 Percuma
153 Garis tengah bersilang Crossing midline 20 10 Percuma
154 Latihan ergonomik Ergonomic training 20 10 Percuma
155 Kemahiran motor halus Fine motor skills 20 10 Percuma
156 Prostesis jari Finger prosthesis 20 10 Percuma
157 Latihan gaya jalan Gait training 20 10 Percuma
24
Bil. Jenis rawatan Type of treatment
Kelas Satu
Kelas Dua
Kelas Tiga
(RM) (RM) (RM)
158 Aktiviti motor kasar Gross motor activities 20 10 Percuma
159 Koordinasi tangan dan mata
Hand and eye coordination 20 10 Percuma
160 Tambah baik keseimbangan
Improve balance 20 10 Percuma
161 Pendidikan semula motor
Motor re-education 20 10 Percuma
162 Teknik perkembangan neuro
Neuro developmental technique
20 10 Percuma
163 Penormalan ton otot Normalize muscle tone 20 10 Percuma
164 Stimulasi otot mulut Oral muscle stimulation 20 10 Percuma
165 Senaman meningkatkan kekuatan
Strengthening exercise 20 10 Percuma
166 Latihan ketahanan Endurance training 20 10 Percuma
167 Penyusutan ton otot Reduce muscle tone 20 10 Percuma
168 Intervensi orientasi dan mobiliti
Orientation and mobility intervention
20 10 Percuma
25
JADUAL C
CAJ RAWATAN
BAHAGIAN 7
TERAPI CARA KERJA
Bil.
0 hingga 12 bulan
1 hingga 18 tahun 18 tahun dan ke atas
Kelas Satu dan
Kelas Dua
Kelas Tiga
Kelas Satu dan
Kelas Dua
Kelas Tiga
Kelas Satu dan
Kelas Dua
Kelas Tiga
(RM) (RM) (RM) (RM) (RM) (RM)
Terapi mampatan
Compression therapy
1 Tiub cengkaman
Tubegrip 10 Percuma 20 Percuma 20 Percuma
2 Pembalut Coban
Coban bandage
10 Percuma 15 Percuma 20 Percuma
Pakaian tekanan
Pressure garment
3 Strap jari Finger strap - - 5 Percuma 5 Percuma
4 Gauntlet Gauntlet 10 Percuma 15 Percuma 15 Percuma
5 Sarung tangan Glove 15 Percuma 20 Percuma 20 Percuma
6 Sarung lengan Forearm sleeve
10 Percuma 15 Percuma 20 Percuma
7 Sarung lengan penuh
Full arm sleeve
15 Percuma 20 Percuma 25 Percuma
8 Baju lengan panjang
Vest with long sleeve
30 Percuma 40 Percuma 60 Percuma
9 Baju lengan pendek
Vest with short sleeve
20 Percuma 30 Percuma 50 Percuma
10 Strap dagu Chin strap 10 Percuma 10 Percuma 15 Percuma
26
Bil.
0 hingga 12 bulan
1 hingga 18 tahun 18 tahun dan ke atas
Kelas Satu dan
Kelas Dua
Kelas Tiga
Kelas Satu dan Kelas
Dua
Kelas Tiga
Kelas Satu dan Kelas
Dua
Kelas Tiga
(RM) (RM) (RM) (RM) (RM) (RM)
11 Topeng muka Mask 20 Percuma 30 Percuma 40 Percuma
12 Seluar pendek Short pants 20 Percuma 30 Percuma 40 Percuma
13 Seluar panjang Long pants 30 Percuma 40 Percuma 60 Percuma
14 Sarung paha Thigh strap 15 Percuma 20 Percuma 25 Percuma
15 Sarung betis Calf strap 15 Percuma 20 Percuma 25 Percuma
16 Stoking (1 unit) Socks (1 unit) 15 Percuma 20 Percuma 25 Percuma
17 Penganduh dinamik
Dynamic splint
- Percuma
150 + harga mekanisme (mengikut harga pasaran)
Percuma
150 + harga
mekanisme (mengikut
harga pasaran)
Percuma
Penganduh statik
Static splint
18 Jari/ ibu jari kaki
Finger/toe - - 5 Percuma 5 Percuma
19 Tangan/ kaki Hand/foot 10 Percuma 10 Percuma 15 Percuma
20 Tangan hingga lengan bawah
Hand to forearm
15 Percuma 25 Percuma 40 Percuma
21 Jari hingga lengan bawah
Finger to forearm
15 Percuma 30 Percuma 60 Percuma
27
Bil.
0 hingga 12 bulan
1 hingga 18 tahun 18 tahun dan ke atas
Kelas Satu dan
Kelas Dua
Kelas Tiga
Kelas Satu dan Kelas
Dua
Kelas Tiga
Kelas Satu dan Kelas
Dua
Kelas Tiga
(RM) (RM) (RM) (RM) (RM) (RM)
22 Lengan bawah hingga lengan atas
Forearm to upper arm
15 Percuma 30 Percuma 60 Percuma
23 Tangan hingga lengan atas
Hand to upper arm
30 Percuma 60 Percuma 120 Percuma
24 Lengan atas Upper arm 20 Percuma 30 Percuma 80 Percuma
25 Kolar keras Hard collar 20 Percuma 40 Percuma 80 Percuma
26 Kaki hingga betis
Foot to calf 30 Percuma 60 Percuma 80 Percuma
27 Kaki hingga tengah paha
Foot to mid thigh
60 Percuma 80 Percuma 150 Percuma
28 Tengah betis hingga tengah paha
Mid calf to mid thigh
20 Percuma 60 Percuma 80 Percuma
29 Tapak dalam Plastazote
Plasterzote insole
5 Percuma 10 Percuma 15 Percuma
30 Siku tenis Tennis elbow - - 35 Percuma 35 Percuma
31 Sesaran ulnar Ulnar driff 5 Percuma 10 Percuma 15 Percuma
32 Sling Lengan Ergonomik (EAS)
Ergonomic Arm Sling (EAS)
- - 30 Percuma 35 Percuma
33 Semakan kulaian kaki
Foot drop check
- - 15 Percuma 20 Percuma
34 Pita Buddy Buddy strap 5 Percuma 5 Percuma 5 Percuma
35 Pendakap badan
Body brace 100 Percuma 250 Percuma 500 Percuma
36 Abah-abah pelvis
Pelvis harness 100 Percuma 180 Percuma - -
28
JADUAL C
CAJ RAWATAN
BAHAGIAN 8
TERAPI PERTUTURAN BAHASA
Bil. Kategori penilaian Assessment
Category
Kelas Satu
Kelas Dua
Kelas Tiga Pesakit
Luar
(RM) (RM) (RM) (RM)
1 Penilaian pertuturan bahasa
Speech-language assessment
50 20 Percuma 10
2 Penilaian Penelanan Klinikal (CSE)
Clinical Swallowing Evaluation (CSE)
50 20 Percuma 10
3 Penilaian suara berinstrumen
Instrumental assessment of voice
50 20 Percuma 10
4 Penilaian resonans berinstrumen
Instrumental assessment of resonance
50 20 Percuma 10
5 Penilaian Penelanan Endoskopik Serat Optik (FEES)
Fiberoptic Endoscopic Evaluation of Swallowing (FEES)
50 20 Percuma 10
6 Penilaian Penelanan Videofloroskopik (VFSS)
Videofloroscopic Swallowing Study (VFSS)
80 30 Percuma 20
Bil. Kategori rawatan Treatment category
Kelas Satu
Kelas Dua
Kelas Tiga Pesakit
Luar
(RM) (RM) (RM) (RM)
7 Terapi pertuturan bahasa
Speech-language therapy
50 20 Percuma 10
8 Elektroterapi Electrotherapy 50 20 Percuma 10
29
JADUAL C
CAJ RAWATAN
BAHAGIAN 9
PERKHIDMATAN DIETETIK
Bil. Kategori siasatan Investigation category
Kelas Satu
Kelas Dua
Kelas Tiga
Pesakit Luar
(RM) (RM) (RM) (RM)
1 Penilaian pemakanan Nutrition assessment 10 5 Percuma 1
2 Kalorimetri tak langsung
Indirect calorimetry 20 10 Percuma 5
Bil. Kategori terapi Therapy category
Kelas Satu
Kelas Dua
Kelas Tiga
Pesakit Luar
(RM) (RM) (RM) (RM)
3 Terapi diet individu
Individual diet therapy 10 5 Percuma 2
4 Terapi diet berkumpulan
Group diet therapy - - - 1
5
Terapi diet individu: Individual diet therapy: 20 10 Percuma -
tambahan pemakanan oral
Oral nutritional supplement
6
Terapi diet individu: Individual diet therapy:
50 30 Percuma - pemakanan enteral
Enteral nutrition
30
JADUAL C
CAJ RAWATAN
BAHAGIAN 10
PERKHIDMATAN PERUBATAN TRADISIONAL DAN KOMPLEMENTARI
Bil. Kelas Satu (RM)
Kelas Dua
(RM)
Kelas Tiga (RM)
Pesakit Luar (RM)
PERUBATAN TRADISIONAL MELAYU
TRADITIONAL MALAY MEDICINE
Urutan tradisional Traditional massage
1 Sakit kronik (setiap sesi) Chronic pain (per session) 20/sesi 20/sesi Percuma 20/sesi
2 Pasca angin ahmar (setiap sesi)
Post stroke (per session) 20/sesi 20/sesi Percuma 20/sesi
Penjagaan tradisional postnatal
Traditional postnatal care
3 Urutan kesegaran postnatal (setiap sesi)
Wellness postnatal massage (per session)
20/sesi 20/sesi Percuma 20/sesi
4 Penjagaan perbidanan (setiap sesi) Midwifery care (per session)
50/sesi 50/sesi Percuma 50/sesi
PERUBATAN TRADISIONAL CINA
TRADITIONAL CHINESE MEDICINE
Akupunktur Acupuncture
5 Sakit kronik (setiap sesi) Chronic pain (per session) 20/sesi 20/sesi Percuma 20/sesi
6 Pasca angin ahmar (setiap sesi)
Post stroke (per session) 20/sesi 20/sesi Percuma 20/sesi
7 Akupunktur dan moxibustion untuk sakit kronik (setiap sesi)
Acupuncture and moxibustion for chronic pain (per session)
25/sesi 25/sesi Percuma 25/sesi
8 Akupunktur dan moxibustion untuk pasca angin ahmar (setiap sesi)
Acupuncture and moxibustion for post stroke (per session)
25/sesi 25/sesi Percuma 25/sesi
9 Akupunktur dan bekam untuk sakit kronik (setiap sesi)
Acupuncture and cupping for chronic pain (per session)
25/sesi 25/sesi Percuma 25/sesi
10 Akupunktur dan bekam untuk pasca angin ahmar (setiap sesi)
Acupuncture and cupping for post stroke (per session)
25/sesi 25/sesi Percuma 25/sesi
11 Indikasi lain (setiap sesi) Other indication (per session) 20/sesi 20/sesi Percuma 20/sesi
Onkologi herba Herbal oncology
12 Terapi tambahan untuk kanser (setiap kitaran)
Adjunct therapy for cancer (per cycle)
100/ kitaran
100/ kitaran
Percuma 100/
kitaran
31
Bil. Kelas Satu (RM)
Kelas Dua
(RM)
Kelas Tiga (RM)
Pesakit Luar (RM)
PERUBATAN TRADISIONAL INDIA
TRADITIONAL INDIAN MEDICINE
Ayurveda Ayurveda
13 Shirodhara (setiap sesi) Shirodhara (per session) 50/sesi 50/sesi Percuma 50/sesi
14 Terapi basti luaran (setiap sesi)
External basti theraphy (per session)
50/sesi 50/sesi Percuma 50/sesi
15 Abhyanga (setiap sesi) Abhyanga (per session) 50/sesi 50/sesi Percuma 50/sesi
Siddha Siddha
16 Terapi Varman (setiap sesi)
Varman therapy (per session) 20/sesi 20/sesi Percuma 20/sesi
TERAPI KOMPLEMENTARI
COMPLEMENTARY THERAPY
17 Kiropraktik (setiap sesi)
Chiropractic (per session) 50/sesi 50/sesi Percuma 50/sesi
18 Osteopatik (setiap sesi) Osteopathic (per session) 75/sesi 75/sesi Percuma 75/sesi
JADUAL D
CAJ SIASATAN
BAHAGIAN 1
PEMERIKSAAN RADIOLOGI
Bil.
Kelas Satu
Kelas Dua
Kelas Tiga
(RM) (RM) (RM)
Pemeriksaan tanpa kontras media
Examination without contrast media
1 Anggota Limbs 75 20 10
2 Kepala Head 90 25 12
3 Spina Spine 90 25 12
4 Dada kecuali filem kecil dada Chest except miniature film of chest
75 20 10
5 Filem kecil dada Miniature film of chest 25 6 2
32
Bil.
Kelas Satu
Kelas Dua
Kelas Tiga
(RM) (RM) (RM)
6 Tulang pelvis, pinggul dan abdomen
Bone pelvis, hips and abdomen 90 25 12
7 Tomografi Tomography 150 40 17
8 Pelvimetri Pelvimetry 100 40 17
9 Fluoroskopi jantung, paru-paru, diafragm
Fluroscopy of heart, lungs, diaphragm
150 40 12
10 Kaji selidik skeletal Skeletal Survey 375 100 37
11 Mamografi Mammography 150 40 12
12 Intra-oral pergigian (setiap filem)
Dental intra-oral (per film) 15 5 1
13 Ortopantomogram pergigian (OPG)
Dental Orthopantomogram (OPG) 105 30 10
14 Tengkorak lateral Lateral skull 105 30 10
15 Ultrasound Ultrasound 150 40 17
16 Ultrasound (mudah) Ultrasound (simple) 75 20 10
17 Pengukuran Tomografi Pemancar Kon (CBCT) gigi
Dental Cone Beam Computed Tomography (CBCT)
350 150 Percuma
18 3D OPG 3D OPG 350 150 Percuma
19 Radiograf digital gigi Dental digital radiograph 100 40 Percuma
20 C.T. abdomen C.T. abdomen 675 200 75
21 C.T. kepala C.T. head 525 150 60
22 C.T. seluruh badan C.T. whole body 900 240 120
Pemeriksaan khas dengan media kontras
Specialised examination with contrast media
23 Arteriografi Arteriography 450 120 50
24 Pemeriksaan kontras saluran G.I.
Contrast examination of G.I. tract 150 40 17
25 Pemeriksaan kontras saluran Biliary
Contrast examination of Biliary tract
180 48 20
26 Pemeriksaan kontras saluran kencing
Contrast examination of urinary tract
150 40 17
27 Pemeriksaan kontras sistem saraf pusat
Contrast examination of central nervous system
225 60 25
28 Pemeriksaan kontras lain-lain duktus dan saluran
Contrast examination of other ducts and tracts
115 30 12
33
Bil.
Kelas Satu
Kelas Dua
Kelas Tiga
(RM) (RM) (RM)
29 Artografi Artography 150 40 17
30 Bronkografi Bronkography 190 50 21
31 Limfangiografi Limfangiography 300 80 35
32 Insuflasi udara presakral Presacral air insufflation 300 80 35
33 Kolangiografi Transhepatik Perkutaneus (PTC)
Percutaneous Transhepatic Cholangiography (PTC)
225 60 25
34 Splenoportografi Splenoportography 450 120 50
35 Salpingografi Salpingography 150 40 17
JADUAL D CAJ SIASATAN BAHAGIAN 2
UJIAN MAKMAL
Bil. Kumpulan Group Kelas Satu
Kelas Dua
Kelas Tiga
(RM) (RM) (RM) Kumpulan A Group A 1 Ujian imunologi sel Cellular immunological tests 150 50 25 Kumpulan B Group B 2 Microskopi elektron Electron microscopy 120 40 20
3 Seksyen beku (termasuk pengesahan)
Frozen section (inclusive of confirmation)
120 40 20
Kumpulan C Group C 4 Ujian khas hematologi Special haematological tests 75 25 12
5 Analisis mikrobiologi produk makanan, dsb.
Microbiological analysis of food products, etc.
75 25 12
6 Assai antibiotik dan ujian pensterilan
Antibiotic assay and sterility testing 75 25 12
7 Ujian kefungsian (biokimia)
Functional test (biochemical) 75 25 12
Kumpulan D Group D 8 Ujian pakej pemakanan Package nutritional tests 60 20 10 9 Biopsi pembedahan Surgical biopsy 60 20 10
34
Bil. Kumpulan Group
Kelas Satu
Kelas Dua
Kelas Tiga
(RM) (RM) (RM)
10 Pemeriksaan sitologikal termasuk pungutan spesimen
Cytological examination inclusive of collecting of specimens
60 20 10
11 Penilaian hormon Hormonal assessment 60 20 10
12 Ujian rutin ekstensif hematologi
Extensive routine haematological test 60 20 10
Kumpulan E Group E
13 Mikroskopi fluoresen Fluorescent microscopy 60 15 7 14 Ujian antibodi fluoresen Fluorescent antibody tests 60 15 7 15 Ujian resapan gel Gel diffusion tests 60 15 7
16 Ujian siasatan hemotologi Haemotological investigative tests 60 15 7
17 Assai seminal Seminal assays 60 15 7
18 Ujian khas biokimia dan pemakanan
Special biochemical and nutritional tests
60 15 7
19 Imunoglobulin, imunoelektroforesis, ELISA
Immunoglobulin, immunoelectrophoresis, ELISA
60 15 7
20 Kuantitasi pelengkap Complement quantitation 60 15 7 Kumpulan F Group F
21 Analisis kuantitatif biokimia (Cat. A)
Quantitative biochemical analysis (Cat. A)
30 10 5
22 Pemeriksaan sitologi spesimen klinikal
Cytological examinations of clinical specimens
30 10 5
23 Ujian rutin ekstra hematologi Extra-routine haematological tests
30 10 5
24 Kultur spesimen klinikal Culture of clinical specimens 30 10 5
25 Teknik imunologi (pengaglutinatan, flokulasi, hemolisis, dsb.)
Immunological techniques (agglutination, Flocculation, haemolysis, etc.)
30 10 5
26 Kepekaan antibiotik Antibiotic sensitivity Kumpulan G Group G
27 Mikroskopi cahaya Light microscopy 15 5 2 28 Ujian rutin hematologikal Routine haemotological tests 15 5 2
29 Pemeriksaan seminal (ujian biasa)
Seminal examination (normal tests) 15 5 2
30 Analisis kuantitatif biokimia (Cat. B)
Quantitative biochemical analysis (Cat. B)
15 5 2
Kumpulan H Group H
31 Analisis kuantitatif/kualitatif biokimia
Quantitative/qualitativef biochemical analysis
10 2 1
35
JADUAL D
CAJ SIASATAN
BAHAGIAN 3
SIASATAN LAIN
Bil. Jenis siasatan Type of investigation Kelas Satu (RM)
Kelas Dua
(RM)
Kelas Tiga (RM)
SIASATAN KARDIOLOGI CARDIOLOGICAL INVESTIGATION
1 Elektrokardiografi Electrocardiography 45 10 5
2 Ujian senaman Exercise tests 150 40 20
3 Holter Holter 150 40 20
4 Ekokardiogram Echocardiogram 150 40 20
5 Pengkateteran jantung dan angiografi
Cardiac catheterisation and angiography
375 100 50
SIASATAN OFTALMOLOGI OPHTHALMOLOGICAL INVESTIGATION
6 Perimetri/ Skotometri Perimetry/scotometry 30 8 4
7 Angiografi fluoresin fundus/ Angiografi iris
Fluoresceine fundus angiografi/iris angiography
90 24 12
8 Ujian untuk penglihatan binokular
Test for binocular vision 45 12 6
9 Pembiasan dengan atau tanpa preskripsi kaca mata
Refraction with or without prescription of glasses
30 8 4
SIASATAN NEUROLOGI NEUROLOGICAL INVESTIGATION
10 Elektroensefalografi Electroencephalography 60 15 5
SIASATAN TELINGA, HIDUNG DAN KERONGKONG
EAR, NOSE AND THROAT INVESTIGATION
Audiometri Audiometry
11 Audiometri nada tulen Pure tone audiometry 15 10 10
12 Bekesy Bekesy 15 10 10
13 Impedans Impedance 15 10 10
36
Bil. Jenis siasatan Type of investigation Kelas Satu (RM)
Kelas Dua
(RM)
Kelas Tiga (RM)
14 Lain-lain (SISI, rosot nada, medan bebas)
Others (SISI, Tone, Decay Free Field)
15 10 10
15 Kalorimetri Calorimetry 15 10 10
SIASATAN PERGIGIAN DENTAL INVESTIGATION
Ujian Pergigian Dental tests
16 Kevitalan pulpa (setiap ujian)
Pulp vitality per tests 15 15 Percuma
17 Model diagnostik Diagnostic cast 40 40 Percuma
18 Kerentanan karies (setiap ujian)
Caries susceptibility per test 5 5 Percuma
JADUAL E
CAJ PEMBEDAHAN
CAJ PEMBEDAHAN TERMASUK ANESTESIA
Bil. Pembedahan Operation
Kelas Satu
Kelas Dua
Kelas Tiga
(RM) (RM) (RM)
1 Pembedahan Jenis A Operation Type A 4500 1200 200
2 Pembedahan Jenis B Operation Type B 2250 600 100
3 Pembedahan Jenis C Operation Type C 1200 400 50
4 Pembedahan Jenis D Operation Type D 450 150 20
5 Pembedahan Jenis E Operation Type E 225 80 15
6 Pembedahan Jenis F Operation Type F 75 40 10
37
JADUAL F
CAJ PERGIGIAN
RAWATAN PERGIGIAN
Bil. Jenis rawatan Type of treatment Kelas Satu (RM)
Kelas Dua
(RM)
Kelas Tiga (RM)
Pesakit Luar (RM)
1 Fluorida topikal (setiap arkus)
Topical fluoride (per arch) 15 10 Percuma 5
2 Pengapan fisur (setiap gigi)
Fissure sealant (per tooth) 15 10 Percuma 5
3 Penskaleran mulut penuh dan penggilapan
Full mouth scaling and polishing
110 80 Percuma 55
4
Pencabutan sebatang gigi kekal/ supernumerari/ akar tertinggal
Extraction permanent tooth/supernumerary/ retained root
25 20 Percuma 15
5 Pencabutan gigi desidus (setiap gigi)
Extraction deciduous (per tooth)
20 15 Percuma 10
6
Pembuangan melalui pembedahan (setiap gigi/ gigi terimpak mudah/ akar tertinggal)
Surgical removal (per tooth/simple impacted tooth/retained root)
225 80 15 40
7
Pembuangan gigi terimpak melalui pembedahan (setiap gigi) (rumit)
Surgical removal of impacted tooth (per tooth) (complex)
1200 400 50 200
8 Kawalan pendarahan selepas pencabutan
Control of post extraction haemorrhage
40 30 Percuma 20
9 Komplikasi selepas pencabutan
Post-extraction complication 15 10 Percuma 5
10 Operkulektomi gingiva Gingival operculectomy 20 15 Percuma 10
11 Pendawaian gigi (setiap arkus)
Dental wiring (per arch) 40 30 Percuma 20
12 Tampalan gigi kekal (satu permukaan)
Restoration of permanent tooth (one surface)
40 30 Percuma 20
13
Tampalan gigi kekal (permukaan berganda/dengan pin pegangan)
Permanent tooth restoration (multiple surfaces/with pin retention)
50 40 Percuma 25
14 Tampalan gigi desidus Deciduous tooth restoration 20 15 Percuma 10
15 Tampalan sementara Temporary restoration 20 15 Percuma 10
16 Inlai (setiap gigi)(tidak termasuk harga logam)
Inlay (per tooth) (not inclusive of metal charge)
60 45 Percuma 30
38
Bil. Jenis rawatan Type of treatment Kelas Satu (RM)
Kelas Dua
(RM)
Kelas Tiga (RM)
Pesakit Luar (RM)
17
Korona (setiap gigi)(termasuk korona sementara, tetapi tidak termasuk caj logam)
Crown (per tooth) (including temporary crown but not inclusive of metal charge)
100 75 Percuma 50
18
Jambatan (setiap gigi tupang termasuk tampalan sementara tetapi tidak termasuk caj bahan dan makmal)
Bridge (per abutment teeth including provisional restoration but not inclusive of material and lab charges)
100 75 Percuma 50
19 Rawatan kanal akar (gigi anterior)
Root canal treatment (anterior tooth)
75 60 Percuma 40
20 Rawatan kanal akar (gigi posterior)
Root canal treatment (posterior tooth)
150 115 Percuma 75
21 Pengapeksan (setiap gigi)
Apexification (per tooth) 100 75 Percuma 50
22 Pemberhentian resorpsi gigi (setiap gigi)
Arrest of tooth resorption (per tooth)
75 60 Percuma 40
23 Pulpotomi korona (setiap gigi kekal)
Coronal pulpotomy (per permanent tooth)
75 60 Percuma 40
24 Pulpotomi (setiap gigi desidus)
Pulpotomy (per deciduous tooth)
75 60 Percuma 40
25 Pulpektomi (setiap gigi desidus)
Pulpectomy (per deciduous tooth)
100 75 Percuma 50
26 Ekstirpasi pulpa (setiap gigi)
Pulp extirpation (per tooth) 25 20 Percuma 15
27 Pelunturan gigi (eksternal)(setiap rahang)
Tooth bleaching (external) (per arch)
- - - 500
28 Pelunturan gigi (internal)(setiap gigi)
Tooth bleaching (internal) (per tooth)
- - - 50
29 Mikrolelasan (setiap gigi)
Microabrasion (per tooth) - - - 50
30 Penyahpekaan (setiap arkus)
Desensitisation (per arch) - - - 25
31 Pembentukan gigi palsu penuh tidak termasuk logam (setiap rahang)
Full denture construction not inclusive of metal (per jaw)
225 170 25 110
32
Pembentukan sebahagian gigi palsu tidak termasuk logam (setiap rahang)
Partial denture construction not inclusive of metal (per jaw)
100 75 5 50
33
Penambahan setiap gigi akrilik
Addition of each acrylic tooth 15 10 1 5
39
Bil. Jenis rawatan Type of treatment Kelas Satu (RM)
Kelas Dua
(RM)
Kelas Tiga (RM)
Pesakit Luar (RM)
34 Pembaikan dentur tanpa mengganti plat landas
Denture repair without changing the base plate
35 30 1 20
35 Pembaikan dentur (penambahan setiap gigi akrilik)
Denture repair (addition of each acrylic tooth)
15 10 1 5
36 Lapikan semula/ landasan semula (setiap dentur)
Relining/rebasing (per denture)
60 45 Percuma 30
37 Impresi bagi model kerja (setiap set)
Impression for working model (per set)
- - - 40
38 Splin lembut Soft splint 25 20 Percuma 15
39 Splin keras Hard splint 100 75 Percuma 50
40 Splin lain Other splint 25 20 Percuma 10
41 Aplians atau obturator:
Dental appliances or obturators
42 Kecil Small 115 30 15 15
43 Sederhana Medium 150 40 20 20
44 Besar Large 190 50 25 25
45 Aplians tetap (setiap arkus)
Fixed appliance (per arch) - - - 500
46 Aplians sebahagian tetap (setiap arkus)
Partial fixed appliance (per arch)
- - - 300
47 Aplians boleh tanggal (pasif)(setiap arkus)
Removable appliance (passive)(per arch)
- - - 100
48 Aplians boleh tanggal (aktif)(setiap arkus)
Removable appliance (active)(per arch)
- - - 200
49 Aplians fungsi tetap Fixed functional appliance - - - 1000
50 Aplians fungsi boleh tanggal
Removable functional appliance
- - - 400
51 Penggantian komponen aplians tetap (setiap komponen)
Fixed appliance components replacement (per component)
- - - 25
52 Pembaikan komponen aplians boleh tanggal
Repair of removable appliance component
- - - 25
53
Pembaikan aplians patah (semua jenis aplians boleh tanggal/ obturator)
Repair of broken appliance (all types of removable appliances/obturator)
- - - 10
54 Pembaikan aplians fungsi boleh tanggal
Removable functional appliance (repair)
- - - 50
55 Auksiliari ortodontik Orthodontic auxiliary - - - 100
56 Arkus transpalatal Transpalatal arch - - - 100
40
Bil. Jenis rawatan Type of treatment Kelas Satu (RM)
Kelas Dua
(RM)
Kelas Tiga (RM)
Pesakit Luar (RM)
57 Arkus lingual Lingual arch - - - 100
58 Arkus transpalatal (setiap pembaikan)
Transpalatal arch (each repair)
- - - 50
59 Arkus lingual (setiap pembaikan) Lingual arch (each repair)
- - - 50
60 Arkus transpalatal (setiap penyimenan semula)
Transpalatal arch (each re-cementation)
- - - 50
61 Arkus lingual (setiap penyimenan semula)
Lingual arch (each re-cementation)
- - - 50
62 Penyenggara ruang boleh tanggal (setiap arkus)
Removable space maintainer (per arch)
- - - 100
63 Retainer tetap (setiap arkus) Fixed retainer (per arch)
- - - 100
64 Retainer Essix Essix retainer - - - 100
65 Retainer tetap (pembaikan setiap gigi)
Fixed retainer (repair per tooth)
- - - 50
66 Retainer tetap (nyahlekat setiap arkus)
Fixed retainer (debond per arch)
- - - 100
67 Peralatan pengangkoran sementara (setiap alat)
Temporary anchorage devices (per device)
- - - 150
68 Rantai emas untuk gigi terimpak Gold chain for impacted tooth
- - - 400
69 Rantai traksi untuk pergerakan gigi minor (setiap gigi)
Traction chain for minor tooth movement (per tooth)
- - - 50
70 Rawatan pengembang palatal Palatal expander treatment
- - - 100
71 Rawatan alat kepala Headgear treatment - - - 100