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Capitation rates

Capitation rates from 1 July 2012. All rates exclude GST and are annualised amounts.

1. First Level Health Services by Access Practices for Enrolled Persons
Access First Contact HUHC
Age Group Gender N Y
00–04 F $385.0764 $575.6200
  M $405.4312 $575.6200
05–14 F $121.8892 $369.0744
  M $114.0900 $369.0744
15–24 F $112.4724 $355.5300
  M $61.9016 $355.5300
25–44 F $98.8340 $355.5300
  M $63.8880 $355.5300
45–64 F $135.3716 $389.3904
  M $101.1076 $389.3904
65+ F $233.2848 $417.6072
  M $201.1820 $417.6072

2. First Level Health Services by Non-Access Practices for Enrolled Persons
Non-Access First Contact HUHC
Age Group Gender N Y
00–04 F $375.7932 $575.6200
  M $399.8960 $575.6200
05–14 F $96.7516 $369.0744
  M $91.6968 $369.0744
15–24 F $112.4724 $355.5300
  M $61.9016 $355.5300
25–44 F $98.8340 $355.5300
  M $63.8880 $355.5300
45–64 F $135.3716 $389.3904
  M $101.1076 $389.3904
65+ F $233.2848 $417.6072
  M $201.1820 $417.6072
 
3. Health Promotion Services
Health Promotion Non High Use Health Card Holders
Māori/Pacific Non Māori/Non Pacific
Deprivation deciles 1–8 $2.6068 $2.1724
Deprivation deciles 9–10 $3.0412 $2.6068

4. Services to Improve Access for High Need Groups
  Non High Use Health Card Holders
Services to Improve Access Māori/Pacific Non Māori/Non Pacific
Age Group Gender Deprivation deciles 1–8 Deprivation deciles 9–10 Deprivation deciles 1–8 Deprivation deciles 9–10
00–04 F $74.0248 $148.0496 $0.0000 $74.0248
  M $77.9372 $155.8756 $0.0000 $77.9372
05–14 F $23.4308 $46.8620 $0.0000 $23.4308
  M $21.9324 $43.8636 $0.0000 $21.9324
15–24 F $21.6208 $43.2416 $0.0000 $21.6208
  M $11.8996 $23.7992 $0.0000 $11.8996
25–44 F $18.9992 $37.9988 $0.0000 $18.9992
  M $12.2816 $24.5628 $0.0000 $12.2816
45–64 F $26.0224 $52.0460 $0.0000 $26.0224
  M $19.4364 $38.8728 $0.0000 $19.4364
65+ F $44.8452 $89.6908 $0.0000 $44.8452
  M $38.6744 $77.3480 $0.0000 $38.6744
5. Care Plus Services

$244.0852

6. Fees for Administering Vaccine Episodes
Childhood immunisation $19.40
Influenza immunisation $19.40

7. Rural Workforce Retention
Rural ranking score Rate per capita
35–40 $7.72
45–50 $11.60
55–65 $15.46
70+ $19.31
8. Management Services
  1. If the number of Enrolled Persons in the PHO is 40,000 or below and the DHB has approved the PHOs’ Management Services Plan then the rate will be $15.5928 per person up to 20,000 and $0.8992 per person from 20,001 to 40,000.
  2. Otherwise, if the number of Enrolled Persons in the PHO is 75,000 or below the rate will be $11.0960 per person up to 20,000 and $5.3960 per person from 20,001 to 75,000.
  3. If the number of Enrolled Persons in the PHO is 75,001 or above then the rate will be $518,700.00 plus $6.0596 per person over 75,000 enrolees.
9. Very Low Cost Access Payment

Individual practice component of payment available to each eligible PHO practice – annual rates.

Age Group Gender Annual Rate
00–04 F $94.5888
  M $99.5881
05–14 F $29.5469
  M $27.6563
15–24 F $27.2246
  M $14.9836
25–44 F $23.9230
  M $15.4643
45–64 F $32.7670
  M $24.4734
65+ F $56.4674
  M $48.6969

10. Zero Fees for Under Six Year Olds Payment
Age Bands Gender Annual Rate
00–04 F $70.9415
  M $74.6913
05–14 F $2.2163
  M $2.0743
15–24 F $0.0000
  M $0.0000
25–44 F $0.0000
  M $0.0000
45–64 F $0.0000
  M $0.0000
Over 65 F $0.0000
  M $0.0000

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Page last updated: 28 June 2012