PMB Mental Health conditions

These PMB mental conditions must be covered by medical aids without charging the member out-of-pocket expenses, assuming that protocols and DSPs (Designated Service Providers) are followed.

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

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