The various healthcare funders update their tariff schedules on mostly an annual basis.
As a dental practitioners it is recommended that you adhere to the applicable dental tariff codes schedules so that you are able to receive direct payment from medical aid schemes.
Notification of dental tariffs code changes is usually be provided via email to all active dental care providers on the various medical aid scheme databases.
This may be further supported by them publishing their schedules on their websites.
As a general principle, the tariffs listed do not consider scheme exclusions and scope of practice, and is by no means a commitment of funding.
Benefit entitlement is governed by the relevant scheme option and rules as well as risk management interventions and protocols.
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The tariff schedules includes procedures and services for use by Oral Healthcare Providers for purposes of keeping accurate patient records, reporting procedures on patients, and processing oral healthcare related insurance claims.
The procedures are those performed by general dental practitioners, oral pathologists, prosthodontists, periodontists, orthodontists, maxillo-facial and oral surgeons and dental therapists.
The procedures codes listed in the dental schedule have, for the convenience in using the schedule, been divided into categories of services, based on the branches of clinical dental practice.
The procedures are grouped under the category of service with which the procedures are most frequently identified and should not be interpreted as excluding certain categories of Oral Healthcare Providers from performing such procedures.
Individual procedure codes consist of a procedure code, procedure description (nomenclature), and when necessary, a descriptor, that provides further definition and/or guidelines to clarify the intended use of the procedure code.
