2026 Medical Scheme Tariff Rates: Medprax’s Dual Tariff Rates Solution for South African Practices

The arrival of the 2026 tariff season is a crucial time for South African Healthcare providers as it highlights the evolving complexity of medical scheme rates, contracted tariffs, practice payment arrangements and discipline-specific billing rules in our healthcare landscape. Practices face the need for accurate tariff codes, Rand Value Units (RVU), Rand Conversion Factors (RCF), co-payment details, and custom scheme profiles to ensure compliant, efficient billing for every consultation and procedure.

Two Powerful Ways to Update Your Tariff Rates

Integrated PMA Partner Software

Practice management applications (PMAs) integrated with Medprax provide real-time updates to medical scheme rates, tariff codes, modifier changes, unit types, and excluded tariffs—eliminating errors while boosting billing accuracy.
PMA partner systems link your practice to Medprax’s automated data pipeline, ensuring the full spectrum of network rates, independent practitioner association rates, payment arrangement tariffs, and discipline-specific contract rules are always up to date.
For PMAs, the Medprax integration delivers value, time savings, and ensures clients have access to custom business rules and ongoing scheme payment notifications.

Independent Access via the Medprax Assist Dashboard

For practices not using a PMA partner, the recently launched Medprax Assist Dashboard offers an intuitive, self-service online platform. Dashboard users benefit from two key features: the easy online lookup of consultation tariffs, procedure codes, and contract-specific rates, plus the ability to track which rates have been published and updated on the Dashboard.
Includes the functionality to export a list of billing codes and their rates per scheme and discipline.

Why Medprax Leads in Tariff Rate Solutions

Medprax sources and consolidates all key codes—ICD-10, NHRPL, SAMA—as well as scheme-based rates, specialist payment arrangement rates and private cash options across GP, Specialists, Dental, Allied, Optometry and Orthotists disciplines.
The system supports scheme-specific business rules, contract percentages, modifiers, and exclusions for Discovery Health, GEMS, and all other schemes, addressing the needs of both network and non-network providers.
All tariff data is released in clear, rand value format for every discipline and consultation, eliminating rounding errors and enhancing claim accuracy.

Practices can update their internal billing profiles and management software with validated releases, versioning, and precise rule updates for every medical scheme in the country.

Get Started and Stay Ahead

For PMA vendors: Integration with Medprax brings comprehensive access to up-to-date tariff databases, percentage adjustment factors, and direct scheme payment arrangement feeds—delivering unmatched value to end users.
For individual practices: Register on the Medprax Studio Dashboard, export bespoke scheme codes and tariff rates, and keep your process current with weekly updates.

Choose Medprax to eliminate financial losses, prevent incorrect billing and secure accurate, compliant medical aid payments for every discipline and contract. Update your practice’s workflow with integrated or independent access—streamlining medical billing for the 2026 tariff year and beyond.