This service provides funding for the initial assessment for COVID-19.
Previous funding eligibility can be found on history of claiming criteria page in the related resource section below.
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.
Any Pinnacle practice in Lakes can offer and claim for this service.
Patients requiring assessment for COVID-19. See the Ministry of Health for further guidance on testing.
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.
Prices are GST inclusive.
All COVID-19 assessments are to be provided at no cost to eligible patients.
COVID-19 – No swab: $69
COVID-19 assessment in person or virtual – where no swab was taken.
COVID-19 - Swab: $138
COVID-19 assessment and swab of a patient who has been assessed as requiring a COVID-19 swab.
NB: This also includes any asymptomatic border workers, asymptomatic people advised through contact tracing to be tested, asymptomatic workers required to have regular testing due to crossing Alert Level borders or asymptomatic people required to have a test to cross Alert Level borders.
You can only claim one type of assessment for a patient per episode of care.
Claims can only be submitted for the initial assessment – you cannot claim for notifying the patient of their results.
Swabs required for international travel are not funded.
Follow up assessments of any type can no longer be claimed.
See the Ministry of Health for further guidance on testing.
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.
Please include the patient’s symptoms in the notes.
Please document whether the swab was taken in your practice or the patient referred to a swabbing centre.
For HIS swab - please indicate how the patient meets HIS criteria, including the location/area the person has been if relevant. Please refer to the Ministry of Health primary care quick reference guide and the COVID-19 contact tracing locations of interest as key resources.
No. There can be no co-payment charged.
The service is funded by Lakes DHB.
Primary options team, Pinnacle Midlands Health Network
0800 646 764