Blog/ Hospital management
SUS Table update: what changed in 2026
Ordinance 9,760/2025 set the 2026 funds, and the Supreme Court will decide whether courts can revise the amounts paid to hospitals.
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- Rivio, Editorial team
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The 2026 update of the SUS Table was set by Ordinance GM/MS 9,760, of December 26, 2025, which allocated R$ 1 billion to the nonprofit providers that serve Brazil's Unified Health System (SUS). In October 2026, the matter reached the Supreme Federal Court (STF), which will decide whether courts can revise the amounts the SUS pays to private and philanthropic hospitals.
Both fronts start from the same problem: for many years, SUS remuneration had no revision rule, while the cost of admissions, surgeries and tests kept rising. Law 14,820/2024 created that rule, and the ordinances published since then show how far the annual revision reaches.
What the SUS Table is and why it weighs on hospital cash flow
SUS Table is the informal name of the SUS Table of Procedures, Medications, Orthoses, Prostheses and Special Materials. Managed by the Ministry of Health and consulted through SIGTAP (the Procedure Table Management System), it assigns each procedure a code, a description and a reference value.
For a hospital that serves the SUS, the table defines the revenue from each admission, surgery, test or consultation. Admissions are billed through the Hospital Admission Authorization (AIH), and the amount paid comes from that reference. When it falls below cost, the hospital covers the difference with other sources of revenue.
The weight is heavier on nonprofit providers, such as Santas Casas and charitable hospitals. According to the Ministry of Health, there are 1,846 such units with hospital output in the SUS, present in 1,317 municipalities, accounting for 40% of the system's beds and about 60% of its care (data released in August 2026).
The gap between table and cost shows up in common procedures. In May 2026, the Federation of Santas Casas and Charitable Hospitals of the State of São Paulo (Fehosp) told Futuro da Saúde about childbirth: R$ 480 under the national table, an amount the São Paulo SUS Table program tops up with R$ 2,380 without covering the full cost, according to the federation.
What Law 14,820/2024 establishes
Law 14,820, of January 16, 2024, amended article 26 of the Organic Health Law (Law 8,080/1990), which deals with the criteria and amounts of remuneration for services provided to the SUS. Under the new paragraph 5, those amounts are now set in December of each year, by an act of the Ministry of Health.
The text calls for guaranteeing the quality of care, the economic and financial balance of the services and the preservation of the real value of the remuneration, “subject to budgetary and financial availability”. The law fixes the date and the goals of the revision and leaves the size of the adjustment to each year's budget, with no minimum correction index.
That is why the Confederation of Santas Casas and Philanthropic Hospitals (CMB) considers that the annual adjustment corrects current amounts close to IPCA inflation and leaves the accumulated gap without recovery.
The December 2024 ordinances: the first adjustment
The law's first cycle came out on December 30, 2024, with two Ministry of Health ordinances:
- Ordinance GM/MS 6,464: a 3.5% adjustment to transfers to philanthropic providers, adding R$ 634.87 million to the Medium and High Complexity (MAC) ceiling of states, the Federal District and municipalities.
- Ordinance GM/MS 6,465: a revision of SUS Table values in specialized care, adding R$ 700.56 million.
Together, the two measures added about R$ 1.34 billion to the funding of high complexity and medium complexity care, according to the figures released by the ministry.
The 2026 SUS Table update: Ordinance 9,760/2025
For 2026, the rule is Ordinance GM/MS 9,760/2025, with financial effects from January 1, 2026. It allocates R$ 1 billion to nonprofit providers serving the SUS and ties the funds to the Agora Tem Especialistas program, created by Law 15,233/2025.
| Component | Amount | How it reaches the hospital |
|---|---|---|
| Operating funds for providers | R$ 800 million | Up to two installments from the National Health Fund to the state, district and municipal funds, which pass the amount on to each facility |
| Table adjustment | R$ 200 million | Incorporated into the MAC ceiling, with incentives in the SUS Table adjustment defined by the Secretariat of Specialized Health Care (SAES) |
The split of the R$ 800 million follows each facility's output recorded in SIA/SUS and SIH/SUS between January and December 2024, with a floor of R$ 1,000. The use of the funds is reported in the state's or municipality's Annual Management Report.
According to the Ministry of Health, the two R$ 400 million installments had been paid by August 2026, and the 2027 Annual Budget Bill (PLOA) raises the amount from R$ 1 billion to R$ 1.45 billion. The CMB recorded the payment of the second installment on August 6, 2026.
For managers, the money passes through the National Health Fund and then the state or municipal fund before reaching the hospital. Tracking the local transfer and checking that 2024 output was recorded correctly determines how much of the ordinance reaches the cash register.
The SUS Table at the Supreme Court: what is at stake in Topic 1,491
On October 19, 2026, the STF recognized, by 9 votes to 1, the general repercussion of Extraordinary Appeal (RE) 1,612,904, reported by Justice Gilmar Mendes, according to the Cescon Barrieu law firm. The case became Topic 1,491, and the ruling on the merits will apply to similar cases across the country.
The dispute involves private and philanthropic hospitals under SUS agreements that ask to be paid at the values of the National Procedure Equivalence Table (TUNEP) or the Reimbursement Valuation Index (IVR). These are the references the National Supplementary Health Agency (ANS) uses to charge health plans for reimbursing the SUS when their members are treated in the public network.
On the merits, the STF will define the limits of that judicial revision, how the cost is split among the federal government, states and municipalities, and which entities must answer the lawsuits. In 2021, in Topic 1,133, the court had treated the issue as infra-constitutional, which blocked appeals on the subject.
The federal government estimates the impact at R$ 24 billion, according to the newspaper O Hoje. No nationwide suspension of proceedings was ordered, and the ruling on the merits has no date yet.
With the SUS Table at its limit, health plan revenue has to arrive in full
For a hospital that serves both the SUS and health plans, every real lost in health plan billing weighs more when public remuneration does not cover costs. Avoidable claim denials, services performed but not billed and late payments cut precisely the revenue that offsets the gap. In hospitals affiliated with Anahp, the initial denial rate was 15.93% in 2025, according to the Anahp Observatory 2026, and that impact of claim denials hits cash flow directly.
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Frequently asked questions about the SUS Table update
When is the SUS Table updated?
Law 14,820/2024 requires SUS remuneration amounts to be set in December of each year, by an act of the Ministry of Health, subject to budget availability. For 2026, that act was Ordinance GM/MS 9,760/2025.
How much does Ordinance 9,760/2025 allocate to philanthropic hospitals?
R$ 1 billion in 2026: R$ 800 million in operating funds, split according to each provider's 2024 output, and R$ 200 million incorporated into the MAC ceiling for the table adjustment of nonprofit providers.
What will the STF decide about the SUS Table?
In Topic 1,491, the STF will define whether courts can order the government to pay contracted hospitals at TUNEP or IVR values, how that cost is split among the federal government, states and municipalities, and who answers the lawsuits. General repercussion was recognized on October 19, 2026, and the ruling on the merits has no date yet.
What is TUNEP?
It is the National Procedure Equivalence Table, used by the ANS, alongside the IVR, to charge health plans for reimbursing the SUS when a plan member is treated in the public network. Contracted hospitals ask the courts to make those values the reference for SUS remuneration.
Does Law 14,820/2024 close the SUS Table gap?
The law guarantees a revision every December, but the amount depends on the budget and there is no minimum index. For the CMB, the adjustments track inflation and leave the accumulated gap uncorrected.
