2015 GEMS Billing FP Change:
Scheme Rate
Whereas in the past, claims were submitted REPI1, REPI2 and REPI3, GEMS REO have now requested that consultations (0190) be submitted at the “FP Network Consultation Fee”.
Medscheme themselves will add the enhanced fee.
GEMS, themselves, will add the enhanced consultation fee.
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E.g.
Practice submits GEMS REO claim 0190 at R309.70
For a Category 1 FP practice, remittance will show payment of R309.70 in your favour PLUS an enhanced fee in the comment line of R44.20 – total payment therefore R353.90
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