ACC GP Referred MRI

Advance Care Plan

After Hours Under 14

Bowel Screening 

Community Cellulitis

COPD Hospital Discharge

CVD Management 

CVD Risk Assessment 

Diabetes Annual Review

Diabetes Insulin Initiation 

Programme 

Fee

Eligibility 

ACC GP Referred MRI

$186.38 (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.

Advance Care Plan

$115.00 (incl. GST)

Eligibility

Patients must be enrolled, and meet one of the below 
criteria:
• Māori, any age, or
• Pasifika, any age, or
• Former refugee (quota refugee), any age, or
• Over 60 years of age, all other ethnicities.

• Patients with severe and enduring mental illness or
addiction.

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 or another practice in the Southern district. If not enrolled with a practice in the Southern district then GMS can be claimed.

Bowel Screening

$81.10 (incl. GST)

Eligibility

• Patients ages 58—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.  

Community Cellulitis 

$44.85 (incl. GST)

Planned follow up (Proactive patient stream)

$109.25 (incl. GST)

Subsequent follow up (Proactive & Reactive patient streams)

Eligibility
Children and adults who:
• Present with cellulitis which can be safely managed in
the community
• Are eligible for NZ funded healthcare
• Are permanently residing in the Southern Region

Key Information
This funding provides for follow up care. The initial
consultation is considered normal primary care and is not
funded.
The initial presentation may be an acute presentation
initiated by the patient, a referral from a secondary service
or from another primary and community care provider.
There are two funding pathways for this programme,
Reactive and Proactive. See the pathway diagram below for
more details
No consumable costs to be charged on funded consults
(e.g wound dressings).

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.

• This appointment must occur within 14 days of discharge for funding.

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 patients whose latest funded or
unfunded CVD risk assessment in the past 2 years was
≥15% AND meet one of the following criteria:
         • Māori, Pacific & South Asian* MEN aged 30-74
         • Māori, Pacific & South Asian* WOMEN aged 40-74
• All other ethnicities MEN aged 45-74 must have:
         • CSC (community services card), or
         • HUHC (high use health card), or be Quintile 5
• All other ethnicities WOMEN aged 55-74 must have:
         • CSC, or
         • HUHC, or
         • be Quintile 5
• Patients with severe mental illness (schizophrenia,
major depressive disorder, bipolar disorder,
schizoaffective disorder aged 25-74 years)

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

Exclusions

• Patients who are not enrolled.

CVD Risk Assessment

$54.63 (incl. GST)

Eligibility

Funding is available for the following group of patients:

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

• Māori, 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

$53.20 (incl. GST)
Diabetes Review

$60.38 (incl. GST)
Māori/Pasifika Diabetes Review

Eligibility

• All patients with diabetes.

Exclusions

• Patients with Pre Diabetes.

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

Diabetes - Insulin Initiation

$472.49 (incl. GST)

Eligibility

Patient must be:

• Enrolled in WellSouth

• 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:
    - Māori
    - Pasifika
    - A Community Services Card holder

And 

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

Extended Primary Care

Refer to summary sheet for detailed time/ workforce payment schedule

Eligibility

General practices will be able to claim for providing  package of care (POC):

· To patients with an acute condition, who without support would otherwise be referred acutely to hospital (Acute Care). Available to all practices.

· For rural practice providing prolonged clinical care and observation for patients waiting on a hospital transfer (Rural Stabilisation).

· There is no age restriction.

· See sheet for presenting concerns.

Exclusions

· Unstable patients (except for rural stabilisation.) 

· ACC claimable services.

· Patients not eligible for NZ healthcare funding.

· Patients requiring non-urgent investigations.

· Services already contracted for, e.g. maternity services.

Key Information

· You may claim for patients who are not enrolled with your practice, at your discretion. You acknowledge in making a claim that no additional funding is available for this.

· No additional amount will be paid for after-hours service delivery.

· You can claim for the time spent actively treating or observing the patient. Not for the entire time the patient was in the practice. 

Focused Care - Hāpai Atu

(Formerly Quick CLIC)

$115.00 (incl. GST)
Hāpai Atu Assessment

$69.00 (incl. GST)
Hāpai Atu Review

Key Information

· Focused Care—Hāpai Atu is best for patients who have a long term condition (LTC) OR are experiencing an episode of acute mental distress.

· 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.

· 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.

Former Refugee Subsidy

$193.20 (incl. GST)
Initial Consult

Up to $96.60 (incl. GST) max
Subsidy Consult (value can be changed when submitting claim)

Eligibility

· Former Refugee patients who are enrolled in a practice who is onboarded to the Former Refugee Programme in the Southern District. These patients 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).

Gender Affirming Care

 $396.75 Enrolled at practice

$655.50 Referred from another organisation

Eligibility
• Patients 18 years and over
• Eligible for funded health care and live in the Southern
District.

Hardship Fund

This is a one-off grant, with no top-ups available.

Eligibility

• Patient has financial barriers that are preventing 
access to primary healthcare 
AND 
• has clinical need
AND 
• is eligible for New Zealand-funded healthcare

Key Information

• Practices/providers determine how much of the funding 
allocated to them under this programme they spend on each 
person.

Hepatitis C Treatment - Maviret

$118.48 (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

$59.22 (incl. GST)
Standard Consult -
Māori, Pacific & CSC

$59.22 (incl. GST)
Unscreened and Underscreened -
Non-Māori, Non-Pacific

$71.07 (incl. GST)
Unscreened and Underscreened -
Māori and Pacific

$85.28 (incl. GST)
Follow Up

Eligibility

Patients who are eligible for funded screening are:

a) Wāhine/women or person with a cervix aged 25 to
69 years who are Māori, Pacific, or CSC (community
services card) holders and require a routine screen.

b) All wāhine/women and people with a cervix who
are unscreened (have never been screened)/ or
under-screened (haven’t had a cytology test in the
past 5 years) aged 30-74 years.

c) Anyone requiring follow up. 

IV Iron Infusion

$143.75 (incl. GST)

Eligibility

Presenting concerns: 

• 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

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 (Māori, Pacific, Q5) aged under 52, or CSC Holders aged under 52, or Termination of pregnancy.

LARC Removals

• Any patient who is High needs (Māori, 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.

Long Term Conditions Support - Toitū Takata

$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

$50.67 (incl. GST)

12 Month Review

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.

Or

• Patients with severe and enduring mental illness or
addiction.

Exclusions

• Patients under 14

Measles Primary Care Services

$103.50 (incl. GST) Measles PCR

$155.25 (incl. GST) Measles PCR A/H

$103.50 (incl. GST) Measles PEP

$155.25 (incl. GST) Measles PEP A/H

$34.50 (incl. GST) Measles Serology

$51.75 (incl. GST) Measles Serology A/H

$34.50 (incl. GST) Measles PCR PHS

$51.75 (incl. GST) Measles PCR PHS A/H

$34.50 (incl. GST) Measles Vax Stat

$51.75 (incl. GST) Measles Vax Stat A/H

Eligibility
A person who has been identified by the Public Health team 
as a Measles case, suspected case or close contact of a 
measles case (and subsequently is referred to Primary Care) 
who is in one of the following groups:  
• 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 a 
Public Health Service  
and Public Health have requested the person and or whānau to either: 
Attend a primary care provider for a consultation and a PCR 
swab for measles, 
AND/OR 
Attend a primary care provider for assessment and 
administration of an MMR vaccination as post-exposure 
prophylaxis (PEP) as described in the Immunisation 
Handbook,  
AND/OR 
Attend a primary care provider for serology testing for 
measles,  
AND/OR 
Attend a primary care provider for a PCR swab for measles 
(no consultation), 
AND/OR 
Request a copy of vaccination status for measles (if the 
provider incurs costs for retrieval of the vaccination record) - 
Only 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 

Newborn Caregiver Wellbeing Check-up - Kahu Taurima

$69.00 (incl. GST)

Eligibility
Mother (or, in exceptional circumstances, 
primary caregiver) of a newborn born between 1 
October 2025-30 September 2026
AND 
• Newborn is enrolled at the practice
AND 
• Mother or newborn identifies as Māori and/or 
Pacific 
OR 
• Mother has a CSC card

Exclusions 
• Practice cannot use credit toward debt held
• Is not transferable to other family members 
unless there are exceptional circumstances 
where the mother no longer has the care of the 
newborn

Key Information

Postnatal wellbeing check emphasising mental health 
screening, physical health, and other needs that may 
affect their ability to care for the newborn.
We strongly encourage the use of Gen2040 Best Start 
tools.
Intended use is for an appointment with a GP but 
appointment can be used with Nurse practitioner or 
nurse.
Programme is to support mothers (or primary 
caregivers in exceptional circumstances) with newborn 
born between 1 October 2025-30 September 2026. 

Palliative Care

$230.00 (incl. GST)
Registration

$287.50 (incl. GST)
Exit - Final Claim

Eligibility

• Patient is terminally ill with death likely to be imminent (hours, days, or weeks). 

• 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 who has previously been on palliative care. 

Key Information

• Exit from the programme should occur at the time of the patient’s death, when they transfer to an ARC facility or after 90 days from registration.  

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

Pipelle Biopsy

$241.9 (incl. GST)
Pipelle Biopsy - Negative Result

$326.65 (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

$55.23 (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

$65.55 (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)

$492.45 (incl. GST) Standard Excision

$761.63 (incl. GST) Complex Excision 

$879.84 (incl. GST) Extremely Complex 

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.

Voucher Programme

Up to:

$60.00 (incl. GST) 
Un-enrolled/Enrolled patient, aged 14-17

$67.00 (incl. GST) 
Un-enrolled/Enrolled patient, aged 18+

$13.50 (incl. GST)
Enrolled CSC card holder, aged 14-17

$20.00 (incl. GST)
Enrolled CSC card holder, aged 18+

Eligibility

• Available for anyone* in urgent need of a GP/NP visit who cannot pay. 

• An urgent need is for a patient who is unwell and needs to be seen ASAP. Without this appointment, their immediate health would be compromised.Please consider the Extended Primary Care (EPC) programme as an alternative which may be appropriate for some urgent needs.

• All vouchers are generated electronically by WellSouth.

• Vouchers must be used within 7 days of issue, however WellSouth can re-issue if not claimed.

• This programme is not for visitors due to very limited funding.

*Patients must be enrolled in a WellSouth practice or 
another practice in the Southern district OR unenrolled but 
residing in the Southern district (enrolment should be 
facilitated)

The practice is encouraged to discuss payment plans or other 
options for reduced cost healthcare for future visits.

Zoledronic Acid Infusion

$143.75 (incl. GST)

Eligibility

Patient must be enrolled with a WellSouth practice 
AND 
Must meet one of the following high needs criteria: 
• Māori 
• Pacific  
• CSC (community services card) holder 
• Q5 
AND 
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. 

• 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.