Dear General Practitioner
Momentum Health Scheme Rate for 2016
Thank you for partnering with us in 2015. Your on-going support in 2016 will help ensure the provision of world class healthcare to our members.
We would like to confirm the increase in the reimbursement rates for 2016, which will be effective from 1 January 2016. The standard GP consultation rate (tariff code 0190) will be R323. Through our on-going quarterly profiling process, practices who qualify and comply can earn an additional R60 or R30 per consult, subject to being a Category 1 or 2 GP respectively. Your practice will receive a separate communiqué, should you qualify for this benefit.
For any other procedure, Momentum Health will be increasing the general Scheme Rate by 5%. This increase will be applicable on the current rate payable for procedures, and can be viewed on our website at www.provider.momentum.co.za.
Dispensed medicines and consumable products used as part of in-room procedures will be reimbursed as follows:
- All dispensed medicines (including unscheduled) are priced according to the SEP / List Cost Price + 30% to a maximum of R23.40 per item
- All unscheduled consumable products (0201) used during procedures are priced according to List Cost Price + 31% mark-up
- All scheduled consumable products (schedule 0 to 8) used during procedures are priced according to SEP + 30% to a maximum of R23.40 per item.
We thank you once again for being the custodians of our members’ healthcare, and wish you and your staff all the best for 2016.
Dewald van Jaarsveld