Yes, a fee is payable to CAAS upon application for a Medical Assessment for pilot licence applicants/holders. This is referred to as the 'Fee for Medical Evaluation' in paragraph 12(2)(h) of the Twelfth Schedule of the Air Navigation Order. The fee would also cover any follow-up monitoring or ad hoc requirements for the licence holder to maintain his/ her Medical Assessment during the period of validity. This fee is to be paid online when you apply for a Medical Assessment via the ELMeRS portal. You will have to pay your Designated Medical Examiner (DME) separately for his/her professional services provided in conducting the medical examinations and investigations for you. The DME's charges are not under the purview of CAAS.