Table 26: Estimated OHIP costs for SCS treatment.
| Treatment Phase | Cost (Canadian Dollars) | Fee Schedule Codes (FSC) and description of code | |
|---|---|---|---|
| A | Total costs for psychological Assessment | $51 | FSCK032: Physician reimbursement for neurocognitive assessment. Ontario fee schedule code |
| Trial phase | $328.24 | FSC244: Physician reimbursement for percutaneous diagnostic stimulation of brain or spinal cord or trigeminal nerve root and/or ganglion (IOP). | |
| $240.11 | Upper limit of expected cost for anesthesia services for the trial phase surgery The Anesthetist costs are the number of units/case and a unit cost of $12.01 for an anesthetist. For the trial phase an upper limit of 20 units are estimated. This includes 8 base units + 1 unit for each 15 minutes in the first hour of treatment + 2 units for every 15 minutes thereafter) |
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| B | Total professional fees for trial phase | $568 | |
| Permanent insertion phase | $307.38 | FSCZ823: Physician payment for implantation/revision of stimulation pack leads | |
| $328.24 $384.17 |
FSCZ244: Physician reimbursement for percutaneous diagnostic stimulation of brain or spinal cord or trigeminal nerve root and/or ganglion (IOP) Total costs for anesthesia services for permanent insertion phase. Anesthetist costs for permanent insertion phase include 8 base units + 1 unit for each 15 minutes in first hour + 2 units for every15 minutes thereafter. A unit fee for anesthetists is $12.01 Two FSC charges are used for this phase: FSCZ244 charged for 2 hours of service and FSC823 charged for 1 hour of service). Assumption: Base units for each FSC code of 8 units + time units of 32 units = expected number of units (8 base units under FSCZ823 + 8 base units under Z244 + 12 time units under FSCA823 + 4 time units under FSCZ244) |
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| C | Total Profession medical fees for Permanent insertion phase | $1,020 | |
| D | Follow-up assessments | Any of the following FSC codes are applicable: | |
| $127.50 $25.14 $102.00 $26.52 |
FSCA185: neurology consult FSCA188: neuorology partial assessment FSCA045: neurosurgery consult FSCA044: neurosurgery partial assessment |
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| Total expected post operative physician costs | $333 | Estimated 1 consult by each of neurosurgery and neurology plus 2 partial assessments by each | |
| Total estimated professional medical fees per SCS case | $2,270 | Use total costs found in row A, B, C, D $51/(70%*70%) + $568/70% + $1,020 + $333 |
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| Total estimated professional medical fees based on 53 annual permanent insertion phases. | $120,286 | 53 × $2270 |