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Programmes » Measles - Waikato

Measles

Waikato | Respiratory | Under 18 | Over 18 | Over 65

Overview

This funding supports the community-based management of eligible patients with measles, suspected measles or who are close contacts of measles cases in line with the Ministry of Health guidelines. Eligible patients must have been referred to practice by the Public Health Team in conjunction with contact tracing.

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. 

Details

Which practices can claim for this service?

All Pinnacle practices in the Waikato region.

Who is eligible for this service?

Patients who have been requested by Public Health in conjunction with contact tracing, to attend general practice for the management of measles AND meet one of the following eligibility criteria

  • Māori
  • Pacific people
  • Disabled people
  • People with severe mental health and addiction issues
  • People living in socioeconomically deprived communities (quintile 4 & 5)
  • Other inequitably impacted population groups, including
    • Migrant ethnic communities
    • Rough sleepers
    • People in transitional housing
    • Those not enrolled in Primary care practices.
  • Others as identified as requiring funded support by the Public Health Service

Vaccination status requests are only funded for New Zealand residents/citizens born between 1969 and 2004 (ie. no NIR/AIR record) OR anyone born overseas without a NIR/AIR record OR those people who opted-off the NIR/AIR record.

Please ensure your claim demonstrates how the patient is eligible.

Some claiming options require additional eligibility. Please see the claiming criteria outlined below. 

Claiming guidelines

Please claim in the same way you claim under Primary Options by selecting the pathway name Measles and attaching the appropriate invoice.

Please ensure you select the Measles invoices to ensure you are reimbursed correctly. Please ensure you include the eligibility criteria with your claim.

Prices listed below are GST inclusive:

Measles Consultation and/or PCR swab              $103.50

A/H Measles Consultation and/or PCR swab      $155.25

MMR vaccination as PEP                                 $103.50

For assessment and administration of an MMR vaccination as post-exposure prophylaxis (PEP)

A/H MMR vaccination as PEP                         $155.25

For assessment and administration of an MMR vaccination as post-exposure prophylaxis (PEP)

Measles Serology                                              $34.50

For phlebotomy undertaken in practice

A/H Measles Serology                                      $51.75

For phlebotomy undertaken in practice

Measles PCR Swab                                            $34.50

PCR swab without a consultation

A/H Measles PCR swab                                     $51.75

PCR swab without a consultation

Request of Vaccination status                          $34.50

Vaccination status requests are only funded for New Zealand residents/citizens born between 1969 and 2004 (ie. no NIR/AIR record) OR anyone born overseas without a NIR/AIR record OR those people who opted-off the NIR/AIR record.

A/H Request of Vaccination status                  $51.75

Vaccination status requests are only funded for New Zealand residents/citizens born between 1969 and 2004 (ie. no NIR/AIR record) OR anyone born overseas without a NIR/AIR record OR those people who opted-off the NIR/AIR record.

 

Please be aware 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.

Only one consultation type per patient per day is funded.

Most standard Measles consultations are intended to be undertaken during business working hours (weekdays) with after hour reviews based on clinical need. For this programme after hours is defined as from 5pm to 8am Mondays – Thursdays; 5pm Friday – 8am Mondays and public holidays. If you are claiming an after hours consultation, please include the time and/or date of the consultation with your notes.

This funding will be available until 31 March 2026. 

There can be no co-payment charged to the patient. 

What level of clinical notes do I need to submit?

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 indicate in your clinical notes which of the eligibility criteria the patient meets, as well as documenting their symptoms/condition.

Please note that while there is additional funding for care provided after hours, most care is intended to be undertaken during business working hours (weekdays) with after hours and weekend assessments based on specified clinical need. Please ensure your notes indicate the date/time of day for any after-hours claims.

Does the patient have to pay?

There is to be no co-payment charge to the patient.

How is the service funded?

The service is funded by Te Whatu Ora.

Contact

Sally Newell, Regional Support Manager - Clinical Contracts
sally.newell@pinnacle.health.nz
021 150 8788

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