PMB list
Below is a list of the PMB condition treatment pairs for Mental Illness.. Your medical aid has to pay for the treatment, and cannot use funds from your savings, even if the treatment is given out-of-hospital.
To see the rest of the 270 PMB conditions, please see our “List of PMBs” page.
For an explanation of general treatments (example: “Medical Management”) please read our explainer.
Mental Illness
| CODE | CONDITION | TREATMENT |
|---|---|---|
| 182T | Abuse or dependence on Psychoactive substance, including alcohol | Hospital-based management up to 3 weeks/year |
| 910T | Acute delusional mood, anxiety, personality, perception disorders and organic mental disorder caused by drugs | Hospital-based management up to 3 days |
| 901T | Acute stress disorder accompanied by recent significant trauma, including physical or sexual abuse | Hospital admission for psychotherapy / counselling up to 3 days, or up to 12 outpatient psychotherapy / counselling contacts |
| 910T | Alcohol withdrawal delirium; alcohol intoxication delirium | Hospital-based management up to 3 days leading to rehabilitation |
| 908T | Anorexia Nervosa and Bulimia Nervosa | Hospital-based management up to 3 weeks/year or minimum of 15 outpatient contacts per year |
| 903T | Attempted suicide, irrespective of cause | Hospital-based management up to 3 days or up to 6 outpatient contacts |
| 184T | Brief reactive psychosis | Hospital-based management up to 3 weeks/year |
| 910T | Delirium: Amphetamine, Cocaine, or other psychoactive substance | Hospital-based management up to 3 days |
| 902T | Major affective disorders, including unipolar and bipolar depression | Hospital-based management up to 3 weeks/year (including inpatient electro-convulsive therapy and inpatient psychotherapy) or outpatient psychotherapy of up to 15 contacts |
| 907T | Schizophrenic and paranoid delusional disorders | Hospital-based management up to 3 weeks/year |
| 909T | Treatable dementia | Admission for initial diagnosis; management of acute psychotic symptoms – up to 1 week |
To see the rest of the 270 PMB conditions, please see our “List of PMBs” page.
How does your medial aid plan cover this benefit?
What you see above is the minimum level of cover for each condition. Medical aids can offer more benefits than the limits above.To see how your plan pays out for a condition, find your plan here, and view your plan’s full benefits.
You can also compare any two medical aid plans side by side, to see which one suits your needs best.
Remember, a medical aid can still impose conditions on how PMBs are treated. For example, the scheme can impose network service providers (DSPs), a medicine formulary or even require that you be treated in a state hospital. You can read a full explanation on how medical aids must pay for PMBs here.
