What Healthcode Actually Is, and Whether You Need It

Healthcode is two separate products that practitioners constantly confuse. The Private Practice Register is an online profile that AXA Health, Aviva and Vitality use to decide whether to recognise you, and Healthcode publishes no practitioner price for it. The Clearing Service is the billing pipe, and from 1 April 2026 it costs £9.20 per month per payee provider plus a transaction fee of 27p to 54p per invoice, both plus VAT. You can need one without the other, and a self-pay practice needs neither.

Nobody writes about this company from the practitioner's side. Healthcode says it holds 57,432 registered practitioners on the register and processed 7,430,928 invoices between January and July 2026, and yet the only material explaining what any of it means is written for insurers and hospitals.

So here is the practitioner-side version, taken from Healthcode's own pages and terms, and from the provider sites of the insurers that use it, as at 9 October 2026.

What is the Private Practice Register?

The Private Practice Register, usually shortened to the PPR, is a single online profile that holds your practising information and documents, and shares them with the insurers and hospitals you work with.

Healthcode describes it as "an efficient and secure way to store, manage and share practising information and documents" across 17 detailed profile areas. Its own terms are more specific about what the thing is for: the PPR "enables specialists, consultants and health professionals to submit information to Private Medical Insurers in support of new application for recognition; or update information for insurers with whom they are already recognised."

Read that twice. The PPR is not a directory, and it is not a marketing listing. It is the shared file the insurers keep on you, and you are the one who maintains it.

That distinction explains almost everything else about how it behaves. Your profile carries a completion percentage, and it has to reach 100% on the mandatory sections before it goes Active and becomes visible to insurers at all. An incomplete profile is not a half-finished application. It is an invisible one.

What does the PPR hold about you?

Mandatory first, because these are the sections that gate everything.

The optional sections matter more than "optional" suggests, because Healthcode says the profile is "used as the single source of truth" for its appointment booking platform as well as by insurers and hospitals. They are: About You, Qualifications, Professional Bodies, Publications, Insurer Recognition, Appraisal, Fitness to Practise and Medical Secretary.

There is also a section for your Information Commissioner's Office registration, because if you process patient information you pay an annual data protection fee to the ICO. The PPR records the expiry date.

Before you open the form, Healthcode's own setup guide says to have these ready. Uploads must be under 5MB and in PDF, PNG, JPG or GIF format.

• A formal head-and-shoulders photograph
• Your current professional indemnity certificate
• Your current Disclosure and Barring Service certificate
• Certificates for any medical or clinical training you have done
• Details of any time your practising privileges have been withdrawn
• Details of any criminal or professional investigation or proceedings, anywhere in the world
• An NHS written reference, if your profession needs one

That last one catches people out. Healthcode requires a written NHS reference confirming your employment for anaesthetists, audiologists, healthcare science practitioners, neuropsychologists, ophthalmic science practitioners, orthotists, pathologists, physicians, practitioner podiatric surgeons, psychiatrists, radiologists and surgeons. Physiotherapists, osteopaths, chiropractors, dietitians, psychologists and speech and language therapists are not on that list. If you are on it and you have no suitable referee, Healthcode publishes a template you complete and upload.

Which payers use the PPR, and which do not?

This is the question the whole topic turns on, and the answer is messier than "the insurers use Healthcode".

Healthcode's PPR page says five private medical insurers subscribe. It does not name them, and the recognition routes above are what each payer publishes about itself.

The practical shape: the PPR is the recognition gateway for AXA Health, Aviva and Vitality, and the Clearing Service is the billing route for nearly everyone, including the two insurers that run their own recognition process. Conflating the two is how practitioners end up paying a subscription they did not need, or missing a register they did.

For the wider picture of how insurer panels, networks and clearing fit together, we have a separate piece on how private health insurance panels work in the UK.

What does Healthcode cost?

Published prices, all excluding VAT, effective from 1 April 2026.

Two definitions do real work in that table, and Healthcode sets them out itself. A payee provider is "a practitioner or practice/clinic that is recognised by an insurer for electronic invoicing and receives payment directly from them". A fee earner is "a practitioner who is recognised as overseeing the treatment provided but does not necessarily receive payment directly from the insurers", and several fee earners can sit under one payee provider.

So a four-therapist clinic that invoices insurers in the clinic's name is one payee provider at £9.20 a month, not four. Four sole traders who each get paid directly are four.

On the PPR price, Healthcode's terms say "It may be that we do not charge for all our Services and the details will be set out on our website," and no PPR price is set out on the website as at 9 October 2026. Ask Healthcode to confirm in writing before you budget either way.

Work a month through it. Forty insured sessions at £45, all invoiced individually, is forty transactions in the £100.01 to £250 band at 39p, so £15.60 of transaction fees plus the £9.20 subscription. Call it £25 a month plus VAT to bill £1,800. That is about 1.4%, which is cheaper than card acquiring and considerably cheaper than chasing a rejected paper invoice. Cost is rarely the reason to avoid it.

The thing you are actually agreeing to when you click Apply

Here is the part nobody tells you, and it is the reason this article exists.

Inside your PPR profile there is an Insurer Recognition section listing each insurer, your provider number and your status. Healthcode's own guide describes what happens there:

Click Yes or No to indicate whether you'll stick to the insurer's fee schedule, please note that Aviva, AXA Health and Vitality only recognise practitioners who will.

Clicking Apply next to an insurer's name sets your status to Pending. Once granted it becomes Recognised, and the guide is blunt that "the insurer can also refuse recognition and can derecognise you at a later date."

Healthcode is free or nearly free. What it costs you is your pricing. The Apply button is not an administrative step. It is the point at which you accept that insurer's published fee schedule as full payment for the work, and with the big three that acceptance is a condition of being recognised at all.

AXA Health puts the consequence plainly in its terms of recognition: practitioners "must not ask our members to pay any additional amount themselves", with the sole exception of a policy excess or co-payment, and even that is capped at the amounts in AXA's own Schedule of Procedures and Fees. Whether the rate works is a question about your diary and your self-pay fee, not about Healthcode. If you have not done that arithmetic, start with what to charge for a session and compare it against the insurer's published rate before you tick anything.

The register, in other words, is the cheap part of a decision that is not cheap at all.

Is the PPR mandatory?

No statute requires it, and nothing stops you treating insured patients who pay you themselves and claim the money back. Several health cash plans work exactly that way, and they are a realistic third-party income route for therapists who will never sit on a full insurer network.

But for AXA Health, Aviva and Vitality, the PPR is not optional in any way that matters. Aviva says it is only accepting new registrations from providers who have registered through it. AXA's recognition page sends you there to accept its terms. Vitality's therapist hub sends individual therapists there to apply. "Not mandatory" and "the only door" are different statements, and only the first one is technically true.

One real limit, stated in Healthcode's terms: "Only subscribing insurers to The PPR will receive all the information you provide that is relevant to them, you may need to supply further information to non-subscribing insurers as part of your recognition application." Completing the PPR does not complete your Bupa or WPA application. Those are separate forms with separate criteria.

How do provider numbers work?

A provider number is issued by the insurer, not by Healthcode, and it is the reference that connects your invoices to your recognition.

In the PPR, your provider number appears next to each insurer in the Insurer Recognition section alongside your status, with the recognition history on the right. You will hold a different number with each payer, and some payers issue a number per practice location rather than per practitioner, so a therapist working from two sites can hold two with the same insurer. Check which arrangement applies at the point you are recognised.

Keep them where your invoicing happens rather than in a notebook. A wrong or missing provider number is one of the most common reasons an otherwise valid invoice bounces.

What happens when an invoice does not get paid?

Two very different failures wear the same word, and they have different owners.

A validation failure never reaches the insurer. The Clearing Service checks each invoice against the receiving insurer's own requirements before it goes anywhere. Healthcode describes that check as covering "provider details, patient information, treatment types, procedure codes, fees, and more", with any anomalies "flagged for correction", and says only validated invoices are then collected by the payer. A wrong provider number, a missing reference or a fee outside the schedule therefore comes back at you rather than disappearing quietly. This is the failure you want, because it is immediate and it is yours to fix.

A rejection or a short payment after submission is the insurer's. Once an invoice has validated and been collected, what happens next is a claims decision: the policy's outpatient benefit had run out, the authorisation covered six sessions and this was the seventh, the member has an excess, the treatment was not covered for that condition. Healthcode has no part in any of those and cannot overturn them. The route is the insurer's own provider line, quoting your provider number, the authorisation number and the invoice number.

The dividing line is worth memorising, because practitioners lose days ringing the wrong organisation. If it bounced before submission, it is a data problem and the validation screen will tell you which field. If it was refused or paid short after submission, it is a cover problem and only the insurer can answer it.

Both conversations get shorter if the authorisation number, the sessions authorised against the sessions used and the excess were written down against the patient before the invoice went out, rather than reconstructed from memory afterwards.

Who genuinely does not need it?

The honest answer is: more people than the insurers' pages imply.

A pure self-pay practice. If no third party pays you, there is nothing to register. The PPR exists to transmit your details to payers.

An associate who does not receive payment directly. Under Healthcode's own definitions, a fee earner inside a clinic whose payee provider is the clinic does not need a separate Clearing Service subscription. You will still usually need your own insurer recognition, and therefore your own PPR profile. Vitality states it directly: a therapy clinic must have more than one practitioner, and "all individual therapists must hold their own individual recognition with Vitality."

Practitioners paid by a clinical network rather than an insurer. Where referrals arrive through a managed network and the network pays you, the contractual relationship is with the network.

Practitioners whose only payers are Bupa and WPA. Both run their own recognition. You would still use Healthcode's Clearing Service to bill them if you wanted electronic submission, but the PPR profile is not what gets you on.

Professions the insurers do not cover. AXA is explicit: "If your specialty is not listed, this means we are not currently accepting applications in your area of medicine." Sports therapists, massage and soft tissue therapists and most complementary practitioners are not on that list. There is a real third-party income route for those professions, but it runs through health cash plans and not through the PPR, and the accreditations those plans accept are a different set entirely.

There is also a quiet eligibility rule sitting inside the PPR itself. When you pick your regulatory or professional body, Healthcode's guide says it "must include a searchable public register and, if you practise a protected profession, you must be registered with the legally-mandated body". If your professional body has no public register, the form will not take you.

Where it goes wrong

Four failure modes, in rough order of how often they cost money.

Stale indemnity details. Insurers can see your indemnity and appraisal due dates. Healthcode's guidance is to add each new certificate as it arrives and not delete the old one, so the record shows continuity of cover. An expired certificate on the file is visible to every subscribing insurer at once.

Bank and billing details that have moved. Invoices pay to what is in the PPR. The billing address in the PPR is also what insurers give to patients who owe you a shortfall, and your bank details can be shared with those patients too if you switch that toggle on. Healthcode warns practitioners who used a home address rather than a business one to think about that.

Letting the profile drift below Active. A profile that is not at 100% on the mandatory sections is not visible to insurers.

Never confirming you are up to date. The PPR shows a banner asking you to confirm your details are current. Healthcode says clicking it regularly, even when nothing has changed, "indicates to the insurers that you're keeping an eye on your profile and could mean more referrals." Treat it as a quarterly five-minute job.

What this means for how you run the practice

Recognition is the beginning of an administrative relationship, not the end of an application. The insurer's side of it is a fee schedule, an authorisation, a session count and an audit. Your side of it is a record good enough to answer all four.

Practically, that means tracking each insured patient's provider, authorisation number, sessions authorised against sessions used, and the excess you have to collect yourself, because the insurer will not collect it for you. Atlacare holds those as a record on the patient alongside the clinical notes and the invoice, which is the arrangement that makes a query six months later answerable from the file rather than from memory. It does not submit to Healthcode, and no practice management system removes the need to be registered with the payer in the first place.

If you are weighing up whether insured work earns its place at all, the next two pieces in this set are the AXA Health application step by step and how CCSD codes work, which is the language every one of these invoices is written in.

Frequently asked questions

Is Healthcode the same as the PPR?

No. Healthcode Limited is the company. The PPR is one of its products, alongside the Clearing Service for invoices, ePractice for practice management and ICE for appointment booking. Saying "I'm registered with Healthcode" is ambiguous, and in a conversation with an insurer it is worth saying which one you mean.

Who owns Healthcode?

Healthcode Limited was incorporated on 28 October 1999, company number 03867872, and its Companies House record carries an active statement that there is no registrable person with significant control, so no single owner holds a controlling stake. Healthcode describes its own origins as "a forward-thinking family unit, made up of key players in the sector", and states that "none of our shareholders receive dividends or any other financial gain". It is best understood as sector-owned infrastructure rather than an independent vendor.

How long does recognition take once I apply?

None of the insurers publishes a timescale, and Healthcode does not either. The status simply moves from Pending to Recognised, or does not. What you can control is completeness: every document uploaded, every mandatory section at 100%, indemnity current. Chasing an application that is missing a certificate is the slowest route there is.

Do I have to use ePractice if I use the Clearing Service?

No. Healthcode's Clearing Service is reachable from ePractice, from a Healthcode account directly, or from third-party billing software. The ePractice subscription is separate and is not a condition of clearing.

Can my practice management software submit to Healthcode for me?

Only if the vendor has built that connection. Healthcode states the Clearing Service can be accessed from a Healthcode account, from ePractice or from other billing software, so third-party submission is possible in principle. Ask any vendor the question directly, because most UK practice management systems do not submit to Healthcode.

Can I be recognised and still charge my own fee?

Not to a recognised insurer's members. AXA Health, Aviva and Vitality all require agreement to their fee schedule as a condition of recognition, and AXA's terms prohibit asking the member for anything beyond the policy excess or co-payment. Your self-pay fee is a separate matter and is entirely yours to set.

What if my professional body is not in the dropdown?

Healthcode tells you to contact them, but the underlying rule is the one to check first: the body must have a searchable public register, and for a protected profession it must be the legally mandated regulator. A membership organisation with no public register will not satisfy it.

Figures and quoted wording taken on 9 October 2026 from the sources below. Healthcode prices are exclusive of VAT and the company states it reviews them annually, so confirm current rates before budgeting. This is general information about private practice administration, not financial or regulatory advice.

Sources: Healthcode, The PPR · Healthcode, Clearing Service pricing · Healthcode, changes to our subscription fees · Healthcode, registering and updating The PPR · Healthcode terms and conditions, Appendix D · AXA Health individual provider recognition · Aviva health practitioners · Vitality therapist hub · WPA information for healthcare providers

Related: How do private health insurance panels work for therapists? · How do CCSD codes work for private insurance billing? · How to get recognised by Bupa, AXA and Vitality as a physiotherapist