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CBHPM and AMB tables: what they are and how to apply them
Discrepancies between the table used for billing and the one set in the contract are among the main causes of denials. See how to identify the version in force, apply the calculation correctly and protect hospital billing
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- Rivio, Editorial team
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The CBHPM and AMB tables set the reference amounts that hospitals, clinics and health plans use to calculate physician fees. A hospital that bills a procedure under the CBHPM while its contract with the payer is still indexed to the AMB table runs the risk of having the charge rejected for a discrepancy. This failure generates an administrative denial, delays payment and compromises the revenue cycle.
To avoid this type of loss, the billing team needs to know which table is in force in each contract and how to apply it correctly. This article explains what the CBHPM and AMB tables are, how they differ, how the CBHPM is updated and how managing these references correctly protects the hospital’s revenue.
What the CBHPM and AMB tables are
The CBHPM (Brazilian Hierarchical Classification of Medical Procedures) is a reference table created by the Brazilian Medical Association (AMB) in 2003, with support from medical specialty societies, the Federal Council of Medicine and the National Federation of Physicians. It standardizes the nomenclature of medical procedures and sets reference amounts, organized by tier (porte), to guide fees and operating costs.
The AMB table predates the CBHPM and served as its historical basis. It still appears in older contracts between hospitals and payers, especially those that have not been renegotiated in recent years. That is why knowing both tables is still necessary for hospital billing.
Hospitals, clinics, physicians and payers use these tables for billing, auditing and contract negotiation. Neither is required by law, but both are widely adopted as market references in private healthcare.
What is the difference between the CBHPM and the AMB table
The main difference is in the structure: the CBHPM organizes procedures by tier and hierarchy, while the AMB table follows a simpler, less detailed model. The table below summarizes the most relevant points of comparison for billing.
| Criterion | CBHPM | AMB |
|---|---|---|
| Origin | Created in 2003 by the AMB as an evolution of the AMB table | Earlier table, the historical basis of the CBHPM |
| Structure | Hierarchical, organized by tier and UCO | Simpler, with no hierarchy by tier |
| Market acceptance | Higher, the current reference for most payers | Lower, limited to older contracts |
| Current use | Billing, auditing and contract negotiation | Still in force in some contracts that have not been renegotiated |
Which CBHPM edition is in force and how it is updated
The CBHPM edition in force is the 5th edition, published in 2022 by the Brazilian Medical Association (AMB). It remains the official reference while the association prepares the next update, a process that usually takes years between one edition and the next.
That does not mean the amounts stand still. The AMB periodically updates tier and UCO values through normative resolutions of the National Council for Medical Hierarchization (CNHM) and official notices, without publishing a new edition. The notice of October 18, 2025 is an example: it adjusted tier and UCO values based on the INPC/IBGE inflation index for the period (5.10%), setting the new reference value of 1 UCO at R$ 29.80, in force from October 2025 to September 2026.
That is why hospitals and clinics need to follow not only the CBHPM edition but also the notices and normative resolutions published on the AMB’s official website.
How the calculation by tier and UCO works
The amount of each procedure in the CBHPM results from the combination of the tier, which represents the complexity of the medical act, and the UCO (Operating Cost Unit), which represents the costs of facilities, supplies and support staff. The final fee adds the tier value to the product of the procedure’s number of UCOs and the current UCO value, adjusted by the percentages negotiated with each payer. To understand the full logic of the hierarchy, see how the CBHPM code is structured and which methodology guides tier calculation with the CBHPM.
How the tables affect billing and denials
A discrepancy between the table used for billing and the one set in the contract is one of the most common causes of administrative denials. When the billing team applies the CBHPM to a contract still indexed to the AMB table, or uses an outdated edition, the payer rejects the charge and the hospital has to redo the process, delaying payment.
According to the Anahp Observatory 2025, the accepted denial rate on gross revenue from health plans jumped from 0.78% in 2021 to 1.96% in 2024, more than doubling in three years. Part of this growth is linked to administrative and documentation failures, a category that includes table discrepancies.
Every contract signed between a hospital and a payer should specify which table is in force, which edition and which adjustment percentages were negotiated. Without this control, billing is exposed to avoidable denials and the hospital’s revenue loses predictability.
How to apply the CBHPM correctly in the hospital
Applying the right table to each charge takes routine, not just technical knowledge. Three practices reduce the risk of denials due to table discrepancies.
Map the table in force by contract
Keeping an up-to-date record of which table and edition is in force in each contract with payers prevents billing from applying incorrect amounts. This mapping should be reviewed whenever a contract is renegotiated.
Follow AMB notices
CNHM normative resolutions and official notices change tier and UCO values without publishing a new edition of the CBHPM. Following these publications prevents the hospital from billing outdated amounts. Understanding how the CBHPM table calculates physician fees helps quickly identify the impact of each adjustment.
Review contract adjustment clauses
Contracts with periodic update clauses reduce the need for constant renegotiation and keep billing aligned with the table in force. Hospitals that update the table without reviewing the contract run the risk of charging amounts that are not provided for, which is also linked to how the CBHPM number of incidences works in combined procedures.
Knowing the table in force is the basis for avoiding avoidable denials
Managing the CBHPM and AMB tables correctly is not limited to knowing the difference between them. It requires following updates, mapping contracts and making sure billing always applies the correct version to each charge.
Artificial intelligence tools already help hospitals automate this check, cross-checking clinical data against billing rules and reducing the risk of denials due to table discrepancies or documentation errors.
Frequently asked questions about the CBHPM and AMB tables
What is the difference between the CBHPM and the AMB table?
The CBHPM is more recent, hierarchical and more widely accepted in the market. The AMB table is older, simpler and still appears in older contracts that have not been renegotiated.
Where can the official CBHPM table be found?
The CBHPM version in force can be found on the official website of the Brazilian Medical Association (AMB), which also gathers the normative resolutions and notices that update its values.
Are the CBHPM and AMB tables required by law?
No. Neither is required by law, but both are widely adopted as references by the private healthcare industry for billing, auditing and negotiation.
How do you know which table to use in each contract?
You need to check the contract signed with each payer, since each one may specify a different table and edition. Keeping this mapping up to date prevents discrepancy denials.
Is the CBHPM updated every year?
Not necessarily with a new edition, but tier and UCO values are reviewed periodically by the AMB through normative resolutions and official notices, such as the October 2025 adjustment.
