Please be aware this service is not live until 1 October 2025
Oral antibiotic treatment for patients aged 15 years and older with moderate cellulitis.
This service is part of the Primary Options for Acute Care (POAC) programme.
Your Pinnacle Services Contract applies to this service. By claiming for this service, you have indicated that you have read and agreed to the business rules set out here.
This is NOT a clinical guideline.
Guidance on the clinical management of cellulitis can be found on Community HealthPathways.
All Pinnacle practices in the Waikato region can claim for this service.
Exclusion criteria to access POAC funding should not preclude emergency treatment of any medical conditions.
Initial consultation Not funded
Patients pay a co-pay at the standard consultation rate as the initial consultation is considered a routine primary care appointment.
First follow up Not funded
Patients pay a co-pay at the standard consultation rate as the first follow up is considered a routine primary care appointment for low-risk patients.
Subsequent follow up Funded
Subsequent GP/NP* in-person follow up consult
Maximum of 5 visits within 7 days of initial appointment
*or registered clinician with prescribing rights working within their scope of practice
Initial consultation (Day 1) Not funded
Patients pay a co-pay at the standard consultation rate as the initial consultation is considered a routine primary care appointment.
First follow up (Day 2) Funded
Patients will receive a phone or in person clinical follow up (usually nurse led) within 72 hours. Whether this is virtual or in person is up to clinician discretion.
Subsequent follow up (Days 3-7) Funded
Subsequent GP/NP* in-person follow up consult.
Maximum of 5 visits within 7 days of initial appointment.
*or registered clinician with prescribing rights working within their scope of practice.
High risk patients
The initial 15-minute GP/NP consultation incurs the usual consultation fee paid by the patient. All POAC services thereafter are provided at no cost to the patient. If the claim cannot be funded by POAC, the patient may be liable to the practice for the fees incurred.
Prices listed below are GST inclusive.
Please make your claim via Primary Options, select Cellulitis and then attach the appropriate invoice(s).
Please include the date of the initial consultation when the antibiotics were prescribed.
Standard cellulitis GP/NP*: $109.25
Maximum of 5 visits within 7 days of initial appointment for oral antibiotic management of cellulitis.
*or registered clinician with prescribing rights working within their scope of practice
Must be an in person visit
The first two visits are unfunded
High risk patients
Please indicate how the patient meets the high risk eligibility within your claim.
High risk cellulitis RN: $44.85
Funded first follow up within 72 hours of initial appointment (one only) - can be in person or virtual
High risk cellulitis GP/NP*: $109.25
Maximum of 5 visits (after a funded first follow up) within 7 days of initial appointment for oral antibiotic management of cellulitis.
Must be an in person visit
*or registered clinician with prescribing rights working within their scope of practice
The purpose of these visits is to ensure the infection is improving, monitor medication compliance and ensure other comorbidities and social circumstances are addressed.
These invoices are a package of care i.e. they include an allocation for staff time as well as consumables, they cannot be claimed along with any other claims.
Practices are required to provide sufficiently detailed consultation notes to determine appropriate use of POAC funding.
It has been recommended that in addition to a good assessment and history, the full range of appropriate observations should be documented, especially where the diagnosis is undetermined. It is important to state the time of consultations and interactions with the patient.
Please include the date of the initial consultation when the antibiotics were prescribed.
If you are claiming under the high risk category, please indicate how the patient meets the high risk eligibility.
The initial 15-minute GP/NP consultation incurs the usual consultation fee paid by the patient. All POAC services thereafter are provided at no cost to the patient.
The service is funded by Te Whatu Ora.
Primary options team, Pinnacle Midlands Health Network
infoprimaryoptions@pinnacle.health.nz
027 687 7312
Antibiotic treatment for patients aged 15 years and older with moderate cellulitis funded by ACC. Oral antibiotic therapy is the preferred option.
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