HIV prophylaxis

Any Pinnacle practice in Taranaki and South Taranaki Rural Health can claim for this service, via a GP with an understanding of how to prescribe.

Further information can be found under the Related Resources tab at the bottom of this page.  

• One extended GP consultation per annum per eligible patient. 
• One standard consultation per annum per eligible patient. 

• Any person meeting the PReP Special Authority criteria, found under the Related Resource tab.  
• This programme is also funded for casual patients who may be referred to you via another service or may be drop ins. In these cases, you can only invoice for this service and no other off set can be claimed. 

Patients living outside your Te Whatu Ora region do not have funding provided under this programme. 

The service is complete when the outcome and claim are submitted. 

Payment will be made once the patient’s treatment has been completed and an outcome has been lodged for the case. 

A referral is submitted via Primary Options using the initial condition coding: HIV prophylaxis.  

When invoicing please lodge an ‘invoice only’ or the ‘outcome and invoice’ form and select the appropriate invoice. 

Claims are all inclusive of the consult, the insertion, observation time and consumables. 

Prices listed below are GST inclusive.  

HIV initial consultation: $112.50

• Includes GP consult time (30 mins) and any consumables. 
• Maximum one per person per annum. 

HIV follow-up consultation: $75.00

• Includes consult time (15 mins) and any consumables.  
• Maximum one per person per annum. 

Practices are required to provide sufficiently detailed consultation notes to determine appropriate use of funding. This should include:  

• documented confirmation that Special Authority criteria are fulfilled based on reported patient’s history  
• informed consent obtained prior to commencing PrEP, with agreement to perform three-monthly blood/urine monitoring while taking PrEP  
• patient must be confirmed HIV negative in the past two weeks and have had a full STI screen, including syphilis testing prior to commencing PrEP 
• continued promotion of the consistent and correct use of condoms to prevent other STIs. 

• No co-payment can be charged for the PrEP start or follow up. 
• Any further follow up can be charged to the patient but please make sure the patient is aware of this. 

The service is funded by Te Whatu Ora.