Moderator Fees and EPS Copayments
Taking into account the increase in the legal minimum wage in force for the year 2023, set by Decree 2613 of 2022; Law 1955 of 2019, article 49; Decree 1652 of 2022, Resolution 001264 11/18/2022 issued by the DIAN, which specifies the increase of 11,60% of the Tax Value Unit (UVT) for the year 2023 and the provisions of Agreement 260 of 2004 in relation to the collection of moderator fees and co-payments, we allow ourselves to communicate their value for the year 2023, which are valid for authorized services as of January 1, 2023.
In the Subsidized Regime of the General System of Social Security in Health, moderator fees are not charged.
The moderating fees are additional contributions in money that the affiliate makes when accessing health services and are intended to regulate the use of the health service and encourage its proper use, promoting enrollment in affiliates in comprehensive care programs developed for the EPS. The moderator fees will be paid at the time of using each of the services independently.
They must be paid by the contributing affiliates and beneficiaries. The collection of moderator fees will be applied to the following services:
| SERVICE | STRATUM 1 | STRATUM 2 | STRATUM 3 |
| General Medicine Consultation | $ 4.100 | $ 16.400 | $ 43.000 |
| Pediatric consultation | $ 4.100 | $ 16.400 | $ 43.000 |
| Specialized Medical Consultation | $ 4.100 | $ 16.400 | $ 43.000 |
| Psychology first time and control | $ 4.100 | $ 16.400 | $ 43.000 |
| Clinical laboratory | $ 4.100 | $ 16.400 | $ 43.000 |
| Simple Diagnostic Imaging | $ 4.100 | $ 16.400 | $ 43.000 |
| Outpatient Medications | $ 4.100 | $ 16.400 | $ 43.000 |
| odontology | $ 4.100 | $ 16.400 | $ 43.000 |
| Consultation by Optometry | $ 4.100 | $ 16.400 | $ 43.000 |
| SERVICE | STRATUM 1 | STRATUM 2 | STRATUM 3 |
| General Medicine Consultation | $ 4.000 | $ 14.800 | $ 25.600 |
| Pediatric consultation | $ 4.000 | $ 14.800 | $ 25.600 |
| Specialized Medical Consultation | $ 4.000 | $ 14.800 | $ 25.600 |
| Psychology first time and control | $ 4.000 | $ 14.800 | $ 25.600 |
| Clinical laboratory | $ 4.000 | $ 14.800 | $ 25.600 |
| Simple Diagnostic Imaging | $ 4.000 | $ 14.800 | $ 25.600 |
| Outpatient Medications | $ 4.000 | $ 14.800 | $ 25.600 |
| odontology | $ 4.000 | $ 14.800 | $ 25.600 |
| Consultation by Optometry | $ 4.000 | $ 14.800 | $ 25.600 |
The value per calendar year allowed for co-payments will be determined for each beneficiary based on the income of the contributing affiliate expressed in current legal monthly minimum wages, as follows:
| BY EVENT* | BY EVENT* | ANNUAL | ANNUAL | |
| SALARY RANGE AT SMLMV | MAXIMUM STOP IN % | MAXIMUM LIMIT IN WEIGHTS | MAXIMUM STOP IN % | MAXIMUM LIMIT IN WEIGHTS |
| LEVEL I | 28,7% | $ 304.583 | 57,5% | $ 610.227 |
| LEVEL II | 115% | $ 1.220.455 | 230% | $ 2.440.909 |
| LEVEL III | 230% | $ 2.440.909 | 460% | $ 4.881.808 |
*The value applies according to the rate agreed by the EPS and the IPS
| BY EVENT* | BY EVENT* | ANNUAL | ANNUAL | |
| SALARY RANGE AT SMLMV | MAXIMUM STOP IN % | MAXIMUM LIMIT IN WEIGHTS | MAXIMUM STOP IN % | MAXIMUM LIMIT IN WEIGHTS |
| LEVEL 0 | DOES NOT APPLY | DOES NOT APPLY | DOES NOT APPLY | DOES NOT APPLY |
| LEVEL 1 | DOES NOT APPLY | DOES NOT APPLY | DOES NOT APPLY | DOES NOT APPLY |
| LEVEL 2 | 50% | $ 530.632,42 | 100% | $ 1.061.264,84 |
*The value applies according to the rate agreed by the EPS and the IPS
It's important to remember:
| SALARY | VALUE 2023 |
| Legal Monthly Minimum Wage in Force 2023 | $ 1,160,000 Pesos |
