🏥 PhilHealth RVS Code Finder
2025–2026 Tariff
Benefit Rate:
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📌 Billing Rules & Claims Guidance
- Health Care Institution (HCI) Fee: Deducted from hospital charges (room and board, lab tests, supplies, operating room use).
- Professional Fee (PF): Deducted directly from the attending surgeon and anesthesiologist professional charges.
- Second Case Rate Rule: When two qualifying surgical procedures are performed during the same admission, the primary surgery receives 100% of the case rate, while the secondary approved surgery receives 50% under official PhilHealth circular guidelines.
- No Co-Payment (NBB Policy): Indigent and sponsored members admitted to basic/ward accommodations in accredited government hospitals are entitled to zero out-of-pocket balance.
❓ Frequently Asked Questions
Where do I find the RVS code on my hospital bill?
The 5-digit Relative Value Scale (RVS) code is listed on your hospital Statement of Account (SOA), PhilHealth Claim Form 2 (CF-2), or the doctor’s surgical operative technique report.
What is the difference between an ICD-10 code and an RVS code?
ICD-10 codes represent medical diagnoses/illnesses (e.g., Dengue, Pneumonia, Hypertension), whereas RVS codes represent specific surgical, diagnostic, and medical procedures (e.g., C-Section, Biopsy, Dialysis).
Can a doctor bill in excess of the PhilHealth Professional Fee?
In private hospitals or non-ward admissions, doctors may charge agreed co-payments above the PhilHealth PF allowance. In government hospital ward beds under the No Balance Billing policy, additional co-pays are strictly prohibited.
Regulatory Sources:
PhilHealth Circular 2024-0037 (Annex B) |
PhilHealth Case Rates Search |
PhilHealth Circular 2013-0031