Capitation rates

Capitation rates from 1 July 2020. All rates exclude GST and are annualised amounts.

For definitions of the terms used on this page, see the PHO Services Agreement on the CentralTAS website.

On this page:

  1. First level health services by access practices for enrolled persons
  2. First level health services by non-access practices for enrolled persons
  3. Health promotion services
  4. Services to improve access for high need groups
  5. Care Plus services
  6. Fees for administering vaccine episodes
  7. Rural workforce retention
  8. Management services
  9. Very Low Cost Access – Practice component
  10. Zero Fees for Under-6s
  11. Zero Fees for Under-14s
  12. Community Services Card Funding Rates

1. First level health services by access practices for enrolled persons 

Access First Contact High Use Health Card
Age Group Gender Y N
00–04 F $663.8172 $444.0792
M $663.8172 $467.5524
05–14 F $425.6232 $140.5656
M $425.6232 $131.5704
15–24 F $410.0052 $129.7056
M $410.0052 $71.3856
25–44 F $410.0052 $113.9784
M $410.0052 $73.6764
45–64 F $449.0532 $156.1128
M $449.0532 $116.5992
65+ F $481.5936 $269.0292
M $481.5936 $232.0080

2. First level health services by non-access practices for enrolled persons

Non-Access First Contact High Use Health Card
Age Group Gender Y N
00–04 F $663.8172 $433.3728
M $663.8172 $461.1696
05–14 F $425.6232 $111.5760
M $425.6232 $105.7452
15–24 F $410.0052 $129.7056
M $410.0052 $71.3856
25–44 F $410.0052 $113.9784
M $410.0052 $73.6764
45–64 F $449.0532 $156.1128
M $449.0532 $116.5992
65+ F $481.5936 $269.0292
M $481.5936 $232.0080

3. Health promotion services

Health Promotion Non High Use Health Card Holders
Māori/Pacific Non Māori/Non Pacific
Deprivation deciles 1–8 $2.8788 $2.3988
Deprivation deciles 9–10 $3.3588 $2.8788

4. Services to improve access for high need groups

Services to Improve Access Non High Use Health Card Holders
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 $82.2936 $164.5872 $0.00 $82.2936
M $86.6424 $173.2884 $0.00 $86.6424
05–14 F $26.0484 $52.0968 $0.00 $26.0484
M $24.3816 $48.7644 $0.00 $24.3816
15–24 F $24.0348 $48.0708 $0.00 $24.0348
M $13.2288 $26.4588 $0.00 $13.2288
25–44 F $21.1212 $42.2436 $0.00 $21.1212
M $13.6524 $27.3072 $0.00 $13.6524
45–64 F $28.9284 $57.8604 $0.00 $28.9284
M $21.6072 $43.2144 $0.00 $21.6072
65+ F $49.8552 $99.7104 $0.00 $49.8552
M $42.9948 $85.9884 $0.00 $42.9948

5. Care Plus services

$267.9600

6. Fees for administering vaccine episodes

Childhood immunisation  $22.57
Influenza immunisation $22.57

7. Rural workforce retention

Rural ranking score Rate per capita
35–40 $7.94
45–50 $11.93
55–65 $15.90
70+ $19.86

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 $17.1192 per person up to 20,000 and $0.9876 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 $12.1812 per person up to 20,000 and $5.9232 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 $569,400 plus $6.6516 per person over 75,000 enrolees.

9. Very Low Cost Access – Practice component

9.1 Very Low Cost Access  Community Services Card

Age Group Gender Rates per capita
0–4 F $88.5168
M $93.1956
5–14 F $68.3100
M $68.1492
15–24 F $61.1076
M $37.1412
25–44 F $85.0104
M $93.6288
45–64 F $169.2924
M $173.8680
65+ F $223.5024
M $238.8684

9.2 Very Low Cost Access  Non Community Services Card

Age Group Gender Rates per capita
0–4 F $88.5168
M $93.1956
5–14 F $63.8628
M $63.6852
15–24 F $33.7644
M $18.5844
25–44 F $29.6700
M $19.1796
45–64 F $40.6380
M $30.3528
65+ F $70.0320
M $60.3948

9.3 Very Low Cost Access fee changes - Practice fee changes for enrolled people for each standard consultation at or below the following amounts (GST included)

0–13 year olds 14–17 year olds 18 and above
$0.00 $13.00 $19.50

10. Zero Fees for Under-6s

Age Bands Gender Annual rate
00–04 F $88.5168
M $93.1956
05–14 F $2.7564
M $2.5800

11. Zero Fees for Under-14s 

Age Bands Gender Annual rate
00–04 F $88.5168
M $93.1956
05–14 F $63.8628
M $63.6852

12. Community Services Card Funding Rates

Age Bands Gender Annual rate
00–04 F $0.0000
M $0.0000
05–14 F $4.4472
M $4.4640
15–24 F $61.1076
M $37.1412
25–44 F $85.0104
M $93.6288
45–64 F $169.2924
M $173.8680
65+ F $223.5024
M $238.8684
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