This service provides funding for the initial testing for COVID-19. This funding incorporates both RAT and PCR swabs.
If there is a requirement for a RAT to be carried out by a clinician for an in-person consultation, this will only be funded if it is positive and the patient meets the criteria for anti-viral medications.
No simultaneous claiming against any other funding stream can be made.
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.
All practices in Tairāwhiti can offer and claim for this service.
Patients who have symptoms suggestive of COVID-19 and who meet the criteria for anti-viral medication AND who have had an in-practice PCR test or positive RAT.
All COVID-19 testing is to be provided at no cost to eligible patients.
No simultaneous claiming against any other funding stream can be made.
If the claim cannot be funded, the patient may be liable to the practice for the fees incurred.
This claim can only be made for patients who have had an in practice PCR test or positive RAT.
Submit your referral via Primary Options using the initial condition coding: COVID-19 testing.
When invoicing for the service please lodge an ‘outcome and invoice’ form and select the appropriate invoice.
The prices listed below are GST inclusive.
COVID-19 – testing: $103.50
COVID-19 – testing (after hours): $155.25
COVID-19 testing (RAT or PCR) of a patient who has symptoms suggestive of COVID-19 who meets the criteria for anti-viral medication.
Please ensure your notes indicate the date/time of day for any after-hours claims.
After-hours on weekdays is between 8pm-8am Monday-Thursday. Weekend rate covers 5pm Friday-8am Monday and any public holiday.
You can only claim one test per patient per day.
Claims cannot be made separately for testing and the initial assessment of a positive patient. You may only claim under one funding stream.
Claims can only be submitted for testing – you cannot claim for notifying the patient of their results.
Please indicate in your clinical notes which of the eligibility criteria the patient meets as well as documenting their symptoms.
Practices are required to provide sufficiently detailed consultation notes to determine appropriate use of funding.
It has been recommended that in addition to a good assessment and history, the full range of appropriate observations should be documented. It is important to state the time of consultations and interactions with the patient.
Please document whether the swab was taken in your practice and the result of any RAT performed.
Please indicate in your clinical notes which of the eligibility criteria the patient meets as well as documenting their symptoms.
Please ensure your notes indicate the date/time of day for any after-hours claims.
No. A patient co-payment cannot be charged.
Once the assessment is completed and the patient has been notified of their result, the episode is complete.
Once the patient exits the POAC programme, the case requires a clinical outcome to be lodged. No payment can be made for any claims unless the outcome is completed.
The service is funded by Te Whatu Ora.
Patients should be encouraged to do a self-test RAT at home wherever possible, with support from household members if living with others, before attending a primary care facility.
It is also important for general practice to reinforce this message with patients and accept a self-reported RAT when triaging patients on the same day as the self-test RAT.
Symptomatic household contacts of a positive case who are eligible for antivirals, can be prescribed these, without a positive test result.
Patients should be encouraged to upload their result via My Covid Record, prior to presenting at general practice or pharmacy. If a patient isn’t able to do this, the case needs to be reported either by facilitating the upload or through CCCM.
Primary options team, Pinnacle Midlands Health Network
infoprimaryoptions@pinnacle.health.nz
027 687 7312
View the COVID-19 claiming resources for primary care.
During the COVID-19 lockdown virtual consultations for POAC cases were funded. We are pleased to announce that this will be a permanent change.
Read moreTe Whatu Ora Waikato has noted the wording in their recent newsletter about the new BPAC disease notification eReferral, requires clarification. At this time COVID-19 remains a notifiable disease, but that notification does not need to come via GP practices using the BPAC form as it is generated via result uploading.
Read moreThis funding is available for a GP/NP consultation with patients eligible for an advance prescription for COVID-19 anti-viral medication, prior to them testing positive for COVID-19. There is no obligation for a clinician to issue an advance prescription.
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