Schedule of Benefit for Medical Fees
Operations/procedures are classified using OPCS (Office of Population
Censuses and Surveys) codes. With effect from January 2006 they are also classified using CCSD (Coding, Classification and Schedule Development) codes.
These are listed in the WPA Schedule along with the benefit we will pay towards the fee your specialist charges.
If your specialist tells you that you need an operation please ask him to let us know which
code he will use and what his fee will be. We can then confirm whether
it will be met in full before your treatment starts.
In practice, the vast majority of all consultants´ fees are paid in full, in
line with the guidelines of maximum customary and reasonable charges
shown in the Schedule.
While this Schedule will mainly be used by your specialist, it is here
for your information too. If you would like to know more about this please
click on the appropriate link to the left. You can search the WPA Schedule
using the form below or alternatively you can view or print the WPA Schedule.
For multiple procedures we pay additional benefit for the second and subsequent procedures.
We calculate this as a percentage of the second and/or subsequent procedure - not as a percentage of the first procedure.
This works as follows:
- First procedure - up to 100% of the listed benefit
- 2nd procedure - up to 50% of the listed benefit for that procedure
- 3rd procedure - up to 25% of the listed benefit for that procedure
- Subsequent procedures - also up to 25% of the benefit for each of the subsequent procedures.
- If you want to look at a specific code please use the following search facility:
If you are looking for more information about a condition please visit Best Treatments. Clinical evidence for patients from the BMJ.