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Latest updates from Bupa

All specialities  Type Size
HDU and ITU Funding request form PDF 0.6MB
Extension of in-patient stay funding request form PDF 0.5MB
NHS to private transfer funding request form PDF 0.5MB
Varicose veins funding request form PDF 995KB
Cardiology  Type Size
TAVI (transcatheter aortic valve implementation) pre-authorisation form PDF 0.6MB
Percutaneous coronary intervention (PCI) Funding request form PDF 0.4MB
Retrospective funding request form following percutaneous coronary intervention (PCI) PDF 0.4MB
Atrial fibrillation (AF) ablation pre-authorisation form  PDF 1.0MB
Biventricular pacemaker (CRT-P) pre-authorisation form PDF 0.2MB
Follow up cardiology consultation pre-authorisation PDF 0.1MB
ICD pre-authorisation form PDF 0.8MB
Watchmen pre-authorisation form PDF 0.6MB
CRT-D pre-authorisation form PDF 0.7MB
Dermatology  Type Size
Skin procedures funding request form PDF 0.6MB
Mental health  Type Size
Funding request form: In-patient Addiction Treatment Programme PDF 4.1MB
Funding request form: Extension to in-patient Addiction Treatment Programme PDF 0.8MB
Funding request form: Further treatment for a mental health condition PDF 0.6MB
Funding request form: In-patient mental healthcare admission PDF 0.6MB
Oncology  Type Size
Funding request form: CAR-T treatment for cancer patients PDF 0.7MB
Funding request form: Genetic testing PDF 3.9MB
Funding request form: Out of licence drug/regimen PDF 3.1MB
Pallbociclib treatment request form PDF 0.5MB
Treatment plan form for breast cancer patients PDF 0.5MB
Stem cell transplant funding request form PDF 0.6MB
Trauma and orthopaedics  Type Size
Funding request form: knee arthroscopy PDF 3.6MB
Funding request form: Spinal surgery PDF 0.5MB
Physiotherapy, osteopathy and chiropractic documents  Type Size
The Therapies Management form is now only available on Providers Online. Please log into your account and select the forms option in the left-hand menu to complete your musculoskeletal therapies funding request.

Changes to Bupa Schedule of procedures

Document  Type Size
Advance notification of changes to Bupa Schedule of
procedures - 15 February 2024

PDF  0.6MB 
Advance notification of changes to Bupa Schedule of
procedures - 15 January 2024

PDF  0.5MB 
Advance notification of changes to Bupa Schedule of
procedures - 15 December 2023

PDF  0.1MB 
Advance notification of changes to Bupa Schedule of
procedures - 15 November 2023

 PDF   0.1MB
Advance notification of changes to Bupa Schedule of
procedures - 15 October 2023

 PDF   0.2MB
Advance notification of changes to Bupa Schedule of
procedures - 15 September 2023

PDF  0.2MB 


Changes to separately chargeable drugs list

Document  Type Size
Notification of changes to separately chargeable
drugs list - 15 February 2024
PDF  14KB 
Notification of changes to separately chargeable
drugs list - 15 January 2024
PDF  22KB 
Notification of changes to separately chargeable
drugs list - 15 December 2023
PDF  39KB 
Notification of changes to separately chargeable
drugs list - 15 November 2023
 PDF  79KB
Notification of changes to separately chargeable
drugs list - 15 October 2023
 PDF  15KB
Notification of changes to separately chargeable
drugs list - 15 September 2023
 PDF  86KB


Changes to Bupa impairment codes

Document  Type Size
Notification of changes to Bupa
impairment codes - 15 February 2024
PDF   57KB
Notification of changes to Bupa
impairment codes - 15 January 2024
PDF   65KB
Notification of changes to Bupa
impairment codes - 15 December 2023
PDF   64KB
Notification of changes to Bupa
impairment codes - 15 November 2023
 PDF   64KB
Notification of changes to Bupa
impairment codes - 15 October 2023
 PDF   57KB
Notification of changes to Bupa
impairment codes - 15 September 2023
PDF   65KB


Changes to Prosthesis and Appliance list

Document  Type Size
Notification of changes to Prosthesis and Appliance list -
15 February 2024
 PDF  14KB
Notification of changes to Prosthesis and Appliance list -
15 January 2024
 PDF  21KB
Notification of changes to Prosthesis and Appliance list -
15 December 2023
 PDF  21KB
Notification of changes to Prosthesis and Appliance list -
15 November 2023
 PDF  21KB
Notification of changes to Prosthesis and Appliance list -
15 October 2023
 PDF  13KB
Notification of changes to Prosthesis and Appliance list -
15 September 2023
 PDF  21KB
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