2019 update: What to consider when setting your consultation fees

What to consider when setting your consultation fees

Healthcare costs are rising, and consultation fees have to keep pace if medical practices are to survive; but how do you set the right fee? If it’s too high, you risk chasing patients; if it’s too low, you might not cover your costs. The basic guidelines provided by medical scheme tariffs are all very well, but they are just guidelines – and every practice is unique.

We crunched some stats in our extensive user-base, and although we are aware that there are many complex dynamics in the healthcare industry, we take you through three interesting factors we have identified that could help you to set a more suitable consultation fee for your practice.

1. Charge according to where you are located

Please note due to Northern Cape’s small sample size, findings may not be 100% representative.

Just as the prices of goods and services vary from province to province, the going rate for medical consultations varies too. Rather surprisingly, the graph based on GP consultation fees across South Africa shows that Gauteng tops the list in average consultation fees at R426.62, even though they saw a negative growth from 2017. All the other provinces appear to have had a stable increase of around 5/6%. Although interesting, averages can be deceiving: there are large variations in consultation fees even within the same province. For example, the graph below shows a 43% difference between Sunninghill and the Katlehong.

Consultation fee Graph 2

So the lesson here is to know your demographic. Know your patient volumes as well as their income/wealth levels, to set your consultation fees accordingly. A practice having many less-affluent patients can do as well as one serving a small number of wealthier patients.


2. Know which medical schemes your patients belong to

If you have a large proportion of your patients belonging to a single medical scheme, you should consider entering into preferred payment contracts with that scheme.

For example, the practice in the graph below has the majority of its patients (61%) are coming from a single medical scheme – Discovery. That suggests the GP should enter into a preferred payment contract with this scheme. The move could grow the average Discovery fee by R71.1– which equates to R7 376.63 extra per month1.

This GP could also set up the maximum acceptable rates per scheme in the PMA to ensure he/she is being paid directly from the scheme, minimising having to collect from patients.

Medical aid distribution

Graph extract from Healthbridge’s Business Insights Report


3. Include consumables in your fee

There’s no such thing as a free lunch, and that applies to medical consumables too. Consumables cost money. You have a right to charge for them, otherwise they will eat into your revenue. Too many practices regard consumables as trivial, and don’t bother capturing them as distinct cost items. Instead, they become absorbed by the practice. Charging for even R12 of consumables might seem small, but multiplied by 15 patients a day, it easily adds an extra R3 9602 to your monthly revenue – or R47 520 a year.



There are no average medical practices, and therefore there should be no average consultation fee. Your practice is unique and that is why it is important for you to engage with your business partners when setting your consultation fees. They will be able to provide practice insights and reports that will take into account your own unique set-up and influencing factors in detail.


1.Value based on an increase in rate when moving from a Discovery non-contracted to a contracted rate at current claim volume indicated in graph.
2. Figures based on 22 working day month

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