Doctor Consultation CBHPM

CBHPM medical consultation pricing

In Brazil, the reference price table for medical procedures is the CBHPM (Classificação Brasileira Hierarquizada de Procedimentos Médicos), kept up to date by the CFM (Federal Council of Medicine) together with the AMB (Brazilian Medical Association). Each procedure in the current edition (CBHPM 5ª edição, revised from time to time) carries two coefficients. One is porte, which grades how complex the work is on a scale from 1A up to 10C. The other is CH (Coeficiente de Honorário). You multiply the porte unit value by this coefficient and that gives you the fee.

Private insurers such as Unimed, Bradesco Saúde, Amil and SulAmérica lean on CBHPM when they negotiate physician fees. On the public side, SUS reimbursements run on a different table, SIGTAP (Sistema de Gerenciamento da Tabela de Procedimentos), which the Ministry of Health maintains. A reference consultation under CBHPM 5ª ed. lands somewhere between R$ 100 and R$ 250, depending on the specialty and the porte. That is far above the R$ 10 ceiling you find in SIGTAP.

Applications

Negotiating contracts with health insurers, setting prices for private (particular) consultations, budgeting elective procedures and surgeries, checking how a specialty's fees stack up against the market, putting together receipts for IR tax deduction, and staying within CFM Resolução nº 1.974/2011, which covers medical advertising and disclosing fees.

FAQ

Is following CBHPM mandatory? No, it is only a reference table. Insurers and physicians are free to negotiate whatever they want. What CBHPM does is act as a floor that the AMB and the regional CRMs recommend so that fees don't get dumped below a reasonable level.

What is the difference between porte and CH? Porte captures the technical difficulty of a procedure and how long it takes. CH is the financial multiplier, expressed in R$. So the total fee comes out as porte value × CH, with any auxiliary or anesthesia coefficients added on top.

Does SUS pay CBHPM rates? No. SUS runs on SIGTAP, and those rates are much lower, often around 10–20% of what CBHPM lists. That gap is why a lot of SUS physicians keep a private practice on the side, priced by CBHPM.