Practice Type
CBT Rates 2016
CONSULTATION RATES FOR GP & SPECIALISTS 2016
Discipline
12
14
16
17
18
19
20
21
23
24
26
27
28
30
31
32
32
34
36
40
42
44
46
52
53
CONSULTATION TARIFF CODES
0190/0191/0192 – Out of Hospital
Practice description
DERMATOLOGIST
GENERAL PRACTITIONER (GP)
GYNAECOLOGIST
PULMONOLOGIST
SPECIALIST PHYSICIAN
GASTROENTEROLOGIST
NEUROLOGIST
CARDIOLOGIST
MEDICAL ONCOLOGIST
NEUROSURGERY
OPHTHALMOLOGIST
HAEMATOLOGIST
ORTHOPAEDICS
E N T (OTORHINOLARYNGOLOGIST)
RHEUMATOLOGIST
PAEDIATRICIAN
PAEDIATRIC CARDIOLOGIST
PHYSICAL MEDICINE
PLASTIC SURGERY
RADIATION ONCOLOGIST
SURGEON
CARDIO THORACIC
UROLOGIST
PATHOLOGY CLINICAL
PATHOLOGY ANATOMICAL
Alliance, Double Plus &
First Choice
CAMAF BASE TARIFF
334.9
331.4
354.6
512.3
512.3
512.3
512.3
512.3
512.3
512.3
334.9
512.3
334.9
334.9
512.3
512.3
512.3
512.3
334.9
334.9
334.9
512.3
334.9
334.9
334.9
Alliance, Double Plus &
First Choice
80% CAMAF BASE TARIFF
267.92
265.12
283.68
409.84
409.84
409.84
409.84
409.84
409.84
409.84
267.92
409.84
267.92
267.92
409.84
409.84
409.84
409.84
267.92
267.92
267.92
409.84
267.92
267.92
267.92
Preventative Wellness consultations are paid at 100% CBT, subject to the correct ICD10 code.
Day to day consultations are paid at 80% CBT, subject to funds available in the member’s Other benefit limit.
DENTAL CONSULTATION RATES ALLIANCE, DOUBLE PLUS, FIRST CHOICE, VITAL & NETWORK CHOICE (from dentist network) 2016
Practice Type: Dentist (Pr 54)
Tariff code
8101 or
8104
CONSULTATION TARIFF CODES
8101/8104 – Out of Hospital
Practice description
DENTAL EXAMINATION
LIMITED ORAL EXAMINATION
Alliance, Double Plus, First Choice, Vital, Network Choice (from dentist network)
CAMAF BASE TARIFF
R 198.70
R 96.40
OPTOMETRIC ASSOCIATION RATES ALLIANCE, DOUBLE PLUS, VITAL, NETWORK CHOICE & FIRST CHOICE 2016
Code 11001 or 11081 wellness and pays 100% optical assistant rates
2016 Pr Type
70
70
ALLIANCE, DOUBLE PLUS & VITAL
11001 or
11081
O A RATE
482.00
562.00
NETWORK CHOICE & FIRST CHOICE
REFER TO PPN
REFER TO PPN