Amending Your Patient Fees

This Year's Annual Statement of Reasonable Fee Increase

For the 2025–2026 period, the Annual Statement of Reasonable Fee Increase (ASRFI) is 3% for practices that are 'Participating Practices' under the national data-sharing arrangements.

Practices that opt out of data sharing have an ASRFI of 6.43%, reflecting the additional cost burden for practices not receiving contingent funding.

The ASRFI is based on each practice’s capitation revenue split. To calculate your practice’s exact percentage, please use the co-payment template provided below.

If your practice has any unused (‘banked’) ASRFI from previous years, you can add this to this year's ASRFI to calculate your 'Total ASRFI'. This year, the new discretionary cap for adult patient fees is $67.00, up from $65.00.

Where any fee increase exceeds the Total ASRFI and the adult patient fees are more than $67.00 (incl.GST), Health NZ will consider the increase closely. In such cases, practices could be contacted to provide further information on the context of the increase before a decision is made about whether to refer it to the Fees Review Committee (FRC). It is the FRC’s role to consider whether the increases are fair and reasonable.

The FRC’s role is to consider whether the increases are fair and reasonable. If increases are justified, the Committee is likely to recommend they be accepted. All FRC decisions are advisory only.

The ASRFI does not apply to Very Low Cost Access (VLCA) practices, as they receive additional funding for their enrolled patients and must keep fees below set thresholds.


Co-Payment Adjustment Template

To ensure the application of the Annual Statement reflects an individual practice’s situation, Health New Zealand provides a Co-Payment Adjustment Template. This template calculates your ASRFI based on your patient numbers and can show your increased fees as a percentage of change in revenue.

Practices do not need to fill out this template themselves. WellSouth will handle this process on your behalf. The template is provided solely for your transparency and interest, allowing you to see the calculations if desired.


Notification for Increasing Fees: Fees Amendment Form

Any fee changes for enrolled patients are to be notified to WellSouth and Health NZ as soon as practical, and preferably before the increase takes effect. In any case, notification to WellSouth must be made within 2 weeks of the fee increase taking effect.

Important Information:

  • It may take WellSouth up to 5 working days to process your request. 

  • WellSouth will confirm via email once we have sent Health NZ your Fee Amendment notification.

  • Health NZ have up to 20 working days after it receives notification of the Fees Amendment to refer an increase to the FRC.

  • If you do not hear from either WellSouth or Health NZ within 20 working days after receiving our confirmation email, your fee increase is considered reasonable.

     

Please submit your completed Fees Amendment Form to practicenetwork@wellsouth.org.nz.