Service Schedule

The service schedule below gives a brief summary around eligibility and programme fees. For more information, click on the programme name which will take you to the programme information sheet.

Programme 

Fee

Eligibility 

ACC GP Referred MRI

$148.35 (incl. GST)

Eligibility

• 16 years of age or older.

• Able to provide informed consent for the referral (or this can be provided by the person who has the legal right to make decisions on the client's behalf).

• Has an approved ACC claim no older than 6 months.

• Has been assessed by a trained GP as meeting the clinical criteria for relevant pathways.


Exclusions

• Patients under Accredited Employers are NOT eligible for this programme.

After Hours Under 14

$92.00 (incl. GST)
Mon-Fri - 6pm to 11pm, or the Weekend - 8am to 11pm

 

$172.50 (incl. GST)
11pm to 8am

 

$172.50 (incl. GST)
Home Callout

Eligibility

• Patients aged 0-13 years.

• Presenting to the clinic outside of normal business hours.

 

Exclusions

• Practices cannot claim GMS if the patient is enrolled in a WellSouth Practice, if not enrolled with WellSouth then GMS can be claimed.

Bowel Screening

$81.10 (incl. GST)

Eligibility

• Patients ages 60—74 who have had a positive FIT (faecal immunochemical test) result, notified to their general practice,  this must have been via the national screening programme.

 

Exclusions

• Patients with historic or current bowel cancer.

• Colonoscopy within last 5 years.

• Already on surveillance programme (polyps, bowel cancer, family history, IBD).

• Current treatment for IBD.

• Those currently experiencing symptoms (see GP outside of screening programme).

• Patients who have had a result via an over the counter iFOBT kit.

 

Key Information

• Please advise the patient of their positive test results within 10 working days of the result being reported. Claims older than 10 working days will be rejected.  

COPD Ambulance Diversion

$81.10 (incl. GST)
Standard Consult

 

$131.81 (incl. GST)
Extended Consult

Eligibility

• This programme is available for practices for their patients only when St John has been called, and a conversation has been had between the St John crew and the practice team.

• Using the agreed St John pathway, crew will determine that the patient could be treated without being taken to ED.

• If the practice has capacity to see the patient, and the patient agrees, the patient can be transported to the practice by ambulance, or by family if this is an option.

Please Note: The patient will still incur usual ambulance charges if transported to the practice by St John.

 

Exclusions

• Patients who do not have COPD. 

• Patients who have not been assessed and referred by St John. 

COPD Hospital Discharge

$81.10 (incl. GST)

Eligibility

• Any patient discharged from the hospital, following a COPD admission.

• Appointment must have been made by the discharging team, or by the WellSouth call centre.

 

Key Information

• Prior to discharge from hospital, the discharge nurse or discharge coordinator will contact the patients usual GP to arrange a follow-up appointment. This appointment is expected to occur with 14 days of discharge. 

• Appointment can be with RN, NP, or GP.

• This is for one appointment only, further follow ups if deemed necessary are not covered under this programme.

CVD Management

$46.00 (incl. GST)

Eligibility

• Funding is available for eligible patients who had a funded CVD funded risk assessment with a risk of 15% or greater.

• See CVD Risk Assessment programme information sheet for eligibility. 

 

Exclusions

• Patients who are not enrolled.

• Patients who have had a non-funded CVD risk assessment.

CVD Risk Assessment

$50.67 (incl. GST)

 

Eligibility

Funding is available for the following group of patients:

• Maori, Pacific & South Asian* MEN aged 30-74.

• Maori, Pacific & South Asian* WOMEN aged 40-74.

• All other ethnicities MEN aged 45-74 (must have CSC or HUHC or be Quintile 5).

• All other ethnicities WOMEN aged 55-74 (must have CSC or HUHC or Quintile 5).

• Patients with severe mental illness (Schizophrenia, major depressive disorder, Bipolar disorder, Schizoaffective disorder from age 25).**

 

Extended Criteria

Eligible patients previously risk assessed:

• Previous risk < 15% last funded CVDRA must have been a minimum of 5 years ago.

• Previous risk >= 15% last funded CVDRA must have been a minimum of 2 years ago.

 

Key Information

• Patients who do not meet the eligibility criteria may still be assessed using the CVD Risk Calculator, without a claim for funding (New Non-Funded Risk Assessment).

*South Asian includes: Indian, Fijian Indian, Sri Lankan, Afghani, Bangladeshi, Nepalese, Pakistani, and Tibetan.

**Patients with a severe mental illness - assessment must be commenced as a new Non-Funded Assessment, once severe mental illness is ticked, the claim will update to a funded Assessment.

Diabetes Annual Review

$50.67 (incl. GST)
Diabetes Review

 

$57.50 (incl. GST)
Māori/Pasifika Diabetes Review

Eligibility

• All patients with Diabetes, either Type 1 or Type 2.

 

Exclusions

• Patients with Pre Diabetes.

• Patients who have had a DAR less than 11 months ago.

Diabetes - Insulin Initiation

 

$450.00 (incl. GST)

Eligibility

Patient must be:

• Enrolled in WellSouth

• Enrolled in Careplus or had a CLIC CHA

• Diagnosed Type 2

• Have had two HBA1C readings >64mmol/mol (8%)

• On appropriate oral medication

• Compliant with medications

• 18 years and over

 

Exclusions

• Patients under 18 years of age.

• Patients non compliant with medication.

Diabetes Medication Transition

$69.00 (incl. GST)
Initial Consult

 

$46.00 (incl. GST)
Follow Up

Eligibility

• For the initial consultation the patient must have Type 2 diabetes and be either:
- Maori
- Pasifika
- A Community Services Card holder

And 

• Eligible to be transitioned onto one of:
- Empagliflozin
- Dulaglutide
- Liraglutide

Former Refugee Subsidy

$184.00 (incl. GST)
Initial Consult

 

Up to a $92.00 (incl. GST) max
Subsidy Consult (value can be changed when submitting claim)

Eligibility

• Former Refugee patients enrolled in a WellSouth practice within Dunedin and Invercargill are eligible for funded GP and Nurse appointments for the first 3 years of their resettlement.

• The patient must be registered on the programme by WellSouth at the time of arrival (ahead of first appointment).

Hāpai Atu

(Formerly Quick CLIC)

$115.00 (incl. GST)
Quick CLIC Assessment

 

$69.00 (incl. GST)
Quick CLIC Review

Key Information

• Hāpai Atu (formerly Quick CLIC) is best for patients who have a well-managed LTC (long term condition) usually, but are experiencing a short term exacerbation, or an acute episode of another health problem.

• These patients are expected to return to their usual level of wellness, after a short period of increased support and intervention from their practice team. E.g. patient is usually well managed with an LTC but has had a recent new event such as a MI (myocardial infarction), or is having an acute mental health exacerbation.

• A review can be completed for a patient at anytime within the ensuing 6 months. This review is there to identify what interventions and outcomes have occurred for the patient. Review can take place at anytime from a few weeks after initial assessment, through to the full 6 months.

Hepatitis C Treatment - Maviret

$111.53 (incl. GST)

Eligibility

• Patient must be HCV positive with a positive HCV viral load. 

• Patients should not have been treated previously.

 

Exclusions

• Patient with known cirrhosis.

• Patient with co–infection with Hepatitis B or HIV. 

HPV Primary Screening

$40.25 (incl. GST)
Standard Consult - Māori, Pacific & CSC

 

$57.50 (incl. GST)
Unscreened and Underscreened

 

$57.50 (incl. GST)
Follow Up

 

 

Eligibility

• Māori, Pacific, & CSC holder women and people with a cervix aged 25-69.

 

• Unscreened:
- Any woman or persons with a cervix who has
  never been screened aged 30-74.

 

Underscreened:
- No cytology in 5 yrs (3 years if immune deficient) or HPV in 7 yrs aged 30 to 69.
- Aged 70 to 74 but has not had 2 consecutive normal cervical cytology results between 62 to 69 years.
- Aged 70 to 74 but has not had an ‘HPV not detected’ result in the five years prior to age 70.

 

• All follow up testing.

IV Antibiotics

$126.50 (incl. GST)

Eligibility/Presenting Concerns

• Pyelonephritis

• Sepsis

 

Exclusions

• ACC Presentations

• Treatment of cellulitis

IV Fluids

$166.75 (incl. GST)
1 Litre

 

$235.75 (incl. GST)
2 Litre (Max Claim) 

Eligibility

IV Fluids can be given to patients with the below conditions, to prevent hospital admission or presentation:

• Hyperemesis

• Pyelonephritis

• Dehydration

• Renal Colic

• Other (must be specified in portal)

 

Exclusions

• Fluids given to patients who will be transferred to hospital cannot be claimed under this programme. E.g. not for stabilising a patient before transport. 


Key Information 

• Please do not submit claim until after you have completed the treatment in full as you can only make one claim. 

IV Iron Infusion

$143.75 (incl. GST)

Eligibility

Presenting concerns: 

• Symptomatic Iron Deficiency, or 

• Maternity: Trimester 2 or 3 only, or

• Chronic Heart Failure, or 

• Inflammatory Bowel Disease, or 

• Chronic Kidney Disease, or 

• Postpartum, or

• Patients who have already had an IV Iron Infusion within the last 3 months and need to have a 2nd infusion because a dose of >1000mg is required or on consultant advice.*


*Must be clearly documented in the portal, and include name of consultant.

 

Exclusions

• Maternity: Trimester 1

• Any patient weighing less than 35kg.

Long Acting Reversible Contraception (LARC)

 

$142.19 (incl. GST)
Jadelle Insertion

 

$184.00 (incl. GST)
Jadelle Removal

 

$172.50 (incl. GST)
IUD Insertion

 

$69.00 (incl. GST)
IUD Removal

Eligibility

LARC Insertions

• High Needs women (Maori, Pacific, Q5) aged under 52, or CSC Holders aged under 52, or Termination of pregnancy.

 

LARC Removals

• Any patient who is High needs (Maori, Pacific, Q5) or has a CSC. May be aged over 52, but please note they will not be eligible for a new insertion if over 52.

 

Exclusions

• Women who require management of bleeding, but do not require contraception.

Palliative Care

$230.00 (incl. GST)
Registration

 

$287.50 (incl. GST)
Exit - Final Claim

Eligibility

• Registration is for all Patients who have a terminal condition with end of life likely to be within 6 months.

• Patient must be enrolled at the practice.

 

Exclusions

• Any patient residing permanently in an aged residential care (ARC) facility at the time of registration.  

• Any patient transferred into an ARC facility.

• Any patient who has previously been on palliative care. 

 

Key Information

• Exit from the programme is available on the patient's death or 6 months following registration (patients cannot be re-registered). 

• Complete the Exit claim before marking the patient as deceased in your PMS. 

Pipelle Biopsy Programme

$235.75 (incl. GST)
Pipelle Biopsy - Negative Result

 

$322.00 (incl. GST)
Pipelle Biopsy with Follow up - Positive Result

Eligibility

• Presenting concerns of heavy menstrual bleeding, or intermenstrual bleeding, or post menopausal bleeding, or endometrial cells on cervical smears. 

Key Information

• The portal form will need to be parked when a successful sample has been obtained. Once results are available the form will be able to be completed and submitted.

• For patients who have a negative result, any follow up appointments will be at the patient’s own expense. 

 

Please Note: This procedure is only carried out by identified providers.

Rheumatic Fever

$40.00 (incl. GST)


Eligibility

• Patients diagnosed with Rheumatic Fever by a hospital specialist, paediatrician or physician, and currently requiring long term prophylactic antibiotics.

 

Exclusions

• Patients who had childhood Rheumatic Fever, but no longer require long term antibiotics.

 

Key Information

• Patient is registered onto the Rheumatic Fever programme in the WellSouth Portal. This is done before a claim can be made by the practice.

 

Please Note: There is no payment associated with registration.

Sexual Health

$60.81 (incl. GST)

Eligibility

High Needs Patients:

• Māori, Pacific, Quintile 5, CSC or HUHC holder

• Patients must be enrolled with the practice

• Maximum age limit of up to 50 years

• No lower age limit

• Available to both male and female patients


Non-High Needs Patients:

• Outside Dunedin and Invercargill

• Patients must be enrolled with the Practice

• Maximum age limit of up to 22 years

• No lower age limit

• Available to both male and female patients

 

Exclusions

• Non-enrolled patients

Skin Lesion (GPSI)

 

$375.00 (incl. GST) Standard Excision
Up to 45 minutes

 

$580.00 (incl. GST) Complex Excision 
45-75 minutes

 

$670.00 (incl. GST) Extremely Complex 
Over 75 minutes

Referral Eligibility (All Practices) 

• Any patient with a suspected skin cancer, as per 
Clinical GPSI Skin Lesion Triage Table (green area 
only).

 

Exclusions 

• Lesions where cancer is not suspected

• Wide excision

 

Excision Eligibility (Only Approved GPSI) 

• All excisions must be approved via clinical triage 
including referrals to yourself if you are a GPSI.

• Retrospective requests for funding post excision will 
be declined.

Special Ukraine Policy Visa Holder

$409.33 (incl. GST)
Initial Consult - Adult

 

$265.44 (incl. GST)
Initial Consult - Child

 

$215.63 (incl. GST)
Follow Up - Adult/Child

 

 

Eligibility

The funded health assessment is limited to the following:

• Tuberculosis (TB) assessment and screening.

• Assessment of eligibility for and provision of vaccination as per the National Immunisation Schedule.

• Supporting enrolment in general practice for continuity of healthcare. 

Toitū Takata (Long Term Conditions Programme)

$345.00 (incl. GST)
Assessment - Māori, Pacific, former refugee, severe and enduring mental illness/addiction

 

$287.50 (incl. GST)
Assessment - Q5, CSC, newly diagnosed with an LTC

Eligibility

Eligible patients will meet one (or more) of the
following demographic criteria:

• Māori

• Pacific

• Former refugee (quota refugees)

• Community Services Card (CSC) holders

• High Use Health Card holders

• Living in a Q5 area

• Newly diagnosed with a LTC (last 6 months)

 

And have one (or more) of the following long term
conditions:

• Cardiovascular disease

• Respiratory disease

• Diabetes

• Gout

• Stroke

• Any other long term condition; these patients must
account for no more than 10% of the total practice
allocation of funded spaces on Toitū Takata. These
claims will require PHO review before payment.

 

Or

• Patients with severe and enduring mental illness or
addiction.

 

Exclusions

• Patients under 14

Urinary Catheterisation

$92.00 (incl. GST)

Eligibility

• Patients presenting with Acute urinary retention.

Voucher Programme

 

$19.50 (incl. GST)

Eligibility

• Available for anyone in need who has been issued with a voucher. 

Zoledronic Acid Infusion

$143.75 (incl. GST)

Eligibility

• Must meet one of the following high need criteria: Māori, Pacific, CSC (community services card) holder, or Q5.

AND

• Patient must be diagnosed with one of the following clinical qualification criteria:

- Osteoporosis (10 year calculated hip fracture risk ≥ 3% or T score ≤ -2.5 or T score ≤ -1.5 on long-term gluco corticoid therapy)

OR

- Paget’s Disease

 

Exclusions

• Patients who have had  3 infusions in the past 5 years. 

• Non high needs patients. 

 

Key Information

• The patient must have a GFR (calculated by Cockcroft-Gault Equation) > 35ml/min within the past 3 months.

• Patients with a calculated GFR of between 25 and 35mml/min may qualify for subsidised infusion subject to Renal Specialist direction. 

• The patient must have a normal serum calcium level within the past 3 months. 

• Patient must be Vitamin D replete.