WellSouth Funded Programmes

Programme 

Fee

Eligibility 

ACC GP Referral MRI

$129.00 +GST 

Patient over 16 yrs.

Are 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).

Who claim (from date of claim lodged with ACC) is not older than 6 months.

After Hours Under 14 

$80.00 +GST (Mon-Fri 6pm - 11pm, W/E 8am and 11pm

$150.00 +GST (Between 11pm and 8am and callouts)

Patients aged 0-13 years.

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

COPD Ambulance Diversion

$60.00 +GST (Standard Consult)

$100.00 +GST (Extended Consult)

Patient must have arrived at the Practice as an Ambulance Diversion - Not a walk in COPD presentation.

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 by ambulance, or by family if this is an option.

COPD Hospital Discharge

$60.00 +GST

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 Nurse or GP.

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

COVID 19 Care in the Community - Advanced Prescriptions for Therapeutics

$90.00 +GST (Initial Prescriptions)

$60.00 +GST (No Prescriptions Issued)

$45.00 +GST (Initial Prescription Expired)

For those who meet anti-viral criteria.

COVID 19 Care in the Community - Assessment

Proactive Initial Clinical Assessment $90.00 +GST (Standard)
$135.00 +GST (After hours/Weekend)

Prescriber Support for Pharmacist Initiated supply
$37.50 +GST

Consultation and Testing (PCR/RAT) 
$90.00 +GST (Standard)
$135.00 +GST (After hours/Weekend)

For those who meet anti-viral criteria.

COVID 19 Temporary Medical Exemption

$60.00 +GST (Standard, Virtual Assessment)

$120.00 +GST (Complex, In-Person Assessment)

Exemptions will be limited to situations where a suitable alternative to the COVID-19 vaccine is not readily available for the individual. The application may only be on the grounds that the person meets the specified exemption criteria. Potential examples of COVID-19 vaccine exemption criteria include:

• Acute illness—Recent COVID-19 infection, acute moderate to severe illness, or high dose immunosuppressives; or

• Significant adverse reaction to previous dose; or;

• Pre-existing condition impacting on vaccination.

COVID 19 Novavax Consult

$60.00 +GST 

The Novavax COVID-19 vaccine is provided as an
alternative to the Pfizer vaccine for people who meet
the vaccine eligibility criteria and have:

• Medical contraindications to the Pfizer vaccine; or

• Not completed the primary course or had all booster
doses that they are recommended to have, and are
hesitant about receiving the Pfizer vaccine.

COVID 19 Third Dose Consult 

$120.00 +GST Accepted Signed Consent & Prescription Issued—
Complex (In-Person Assessment)

$60.00 +GST Accepted Signed Consent & Prescription Issued—
Standard (Virtual Assessment)

$60.00 +GST Patient Declined Third Dose

$60.00 +GST Patient Not Eligible for Third Dose

The eligibility criteria only applies to people who are severely immunocompromised:  

• Individuals with primary or acquired immunodeficiency states at the time of vaccination; 

• Individuals on, or recently on immunosuppressive therapy at the time of vaccination; 

• Individuals with chronic immune-mediated inflammatory disease who were receiving or had received immunosuppressive therapy prior to vaccination; 

• Individuals receiving long-term haemodialysis or peritoneal dialysis.

COVID 19 Vaccine Consult 2nd Booster

$60.00 +GST

6 months after first booster.

3 months after testing positive.

Cryptosporidiosis

$40.00 +GST

Anyone presenting at the practice who meets the criteria and requires testing.

CVD Risk Assessment

$30.00 +GST

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)*

*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.

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

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

Use of this programme should be in conjunction with the Southern Health Pathway for Cardiovascular Risk Assessment (CVRA).

Diabetes Annual Review 

$40.00 +GST

All patients with Diabetes, either Type 1 or Type 2.  Next review can be completed after 11 months.

Diabetes - Insulin Initiation 

$391.30 +GST

Diabetes Medication Transition

Former Refugee Subsidy 

$100.00 +GST (Initial consult)

up to $80.00 max (Subsidy consult)
Value can be changed when submitting claim.

Former Refugee patients enrolled in a WellSouth practice within Dunedin and Invercargill are eligible for funded GP and Nurse appointments for the first 2 years of their resettlement.

The patient must have been registered on the programme by WellSouth at the time of arrival.

An initial extended appointment is available to each person at the beginning of their enrolment (usually within the first 4 weeks).

Ongoing visits can be claimed for the duration of the 2 year period at a variable rate—maximum $80.

Hepatitis C Treatment - Maviret 

$70 +GST 

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

Patients should not have been treated previously. 

HPV Primary Screening

$35.00 +GST (HPV Primary Screening—Standard)

$50.00 +GST (HPV Primary Screening—Un/Underscreened)

$50.00 +GST (HPV Primary Screening—Follow Up)

• 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 including Cellulitis

$110.00 +GST (Dose 1) 

$45.50 +GST (Follow up)

Any patient who meets criteria as per relevant Health pathway.             

Two additional treatments may be claimed for patients with Cellulitis 

One follow up to review patient.

IV Fluids

$145.00 +GST (1 litre)

$205.00 +GST (2 litre) max claim 

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

Hyperemesis

Pyelonephritis

Dehydration

RenalColic

Other

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

Follow relevant Health Pathway 

IV Iron Infusion

$125.00 +GST

Patients who meet the below criteria:

Symptomatic Iron Deficiency

Maternity: Trimester 2 or 3 only

Chronic Heart Failure

Inflammatory Bowel Disease

Chronic Kidney Disease

Postpartum 

Also eligible are 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.

Follow relevant Health Pathway 

Long Acting Reversible Contraception (LARC)

$80.00 +GST Jadelle Insertion           

$160.00 +GST Jadelle Removal           

$150.00 +GST IUD Insertion

$60.00 +GST IUD Removal                  

LARC Insertions:   High Needs women (Maori, Pacific, Q5) aged under 45 or CSC Holders aged under 45 or Termination of pregnancy.

LARC Removals:   Any patient who is High needs (Maori, Pacific, Q5) or has a CSC. May be aged over 45, but please note they will not be eligible for a new insertion if over 45.

Exclusions: women who require management of bleeding, but do not require contraception.

National Bowel Screening 

$60.00 +GST

Eligible population aged 60-74 years screened via National Bowel Screening programme only (Follow relevant Health Pathway).

Palliative Care 

$200.00 +GST (Registration)

$250.00 +GST (Exit)

 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.

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

Pipelle Biopsy Programme

$205.00 +GST (Pipelle Biopsy)

$75.00 +GST (Follow-up)

Procedures carried out by identified providers.

Quick CLIC

$100.00 +GST (CHA)

$100.00 +GST (Quick CLIC Assessment)

$60.00 +GST (Quick CLIC Review)

Comprehensive Health Assessment (CHA), patient will be stratified into a level (1, 2 or 3). This level determines the ongoing programme for the patient. 

Quick CLIC is best for patients who have well-managed LTC usually, but are experiencing a short term exacerbation, or an acute episode of another health problem. 

Quick CLIC 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. 

Rheumatic Fever

$34.78 +GST

Patient is registered onto the
Rheumatic Fever programme in the WellSouth portal. This is done
before a claim can be made by the practice.
NB: There is no payment
associated with registration. 

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. (See Health Pathway)

Sexual Health

$34.78 +GST

1. Outside of Dunedin and Invercargill for Non-High needs patients from the commencement of sexual activity under 22 years. 

2. High Needs patients from the commencement of sexual activity up to 50 years. 

Urinary Catheterisation

 $80.00 +GST

Patients presenting with Acute urinary retention (Follow relevant Health Pathway).

Zoledronic Acid Infusion

$125.00 +GST

Patient must be diagnosed with one of the following clini-cal 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:
Pagets Disease
And must meet one of the following high needs criteria
• Maori
• Pacific
• CSC holder
• Q5
Additional 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