Capitation rates

Capitation rates from 1 July 2018. 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.

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 $623.1732 $416.8884
M $623.1732 $438.9252
05–14 F $399.5640 $131.9592
M $399.5640 $123.5148
15–24 F $384.9012 $121.7640
M $384.9012 $67.0152
25–44 F $384.9012 $106.9992
M $384.9012 $69.1656
45–64 F $421.5588 $146.5548
M $421.5588 $109.4604
65+ F $452.1060 $252.5568
M $452.1060 $217.8024

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 $623.1732 $406.8384
M $623.1732 $432.9324
05–14 F $399.5640 $104.7444
M $399.5640 $99.2712
15–24 F $384.9012 $121.7640
M $384.9012 $67.0152
25–44 F $384.9012 $106.9992
M $384.9012 $69.1656
45–64 F $421.5588 $146.5548
M $421.5588 $109.4604
65+ F $452.1060 $252.5568
M $452.1060 $217.8024

3. Health promotion services

Health Promotion Non High Use Health Card Holders
Māori/Pacific Non Māori/Non Pacific
Deprivation deciles 1–8 $2.7504 $2.2920
Deprivation deciles 9–10 $3.2088 $2.7504

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 $78.1128 $156.2256 $0.0000 $78.1128
M $82.2408 $164.4840 $0.0000 $82.2408
05–14 F $24.7248 $49.4496 $0.0000 $24.7248
M $23.1432 $46.2864 $0.0000 $23.1432
15–24 F $22.8144 $45.6288 $0.0000 $22.8144
M $12.5568 $25.1136 $0.0000 $12.5568
25–44 F $20.0484 $40.0968 $0.0000 $20.0484
M $12.9588 $25.9200 $0.0000 $12.9588
45–64 F $27.4596 $54.9204 $0.0000 $27.4596
M $20.5092 $41.0196 $0.0000 $20.5092
65+ F $47.3220 $94.6440 $0.0000 $47.3220
M $40.8108 $81.6192 $0.0000 $40.8108
 
5. Care Plus services

$256.0032

6. Fees for administering vaccine episodes

Childhood immunisation  $21.00
Influenza immunisation $21.00

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 $16.3548 per person up to 20,000 and $.9432 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 $11.6376 per person up to 20,000 and $5.6592 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 $544,008 plus $6.3552 per person over 75,000 enrolees.

9. Very Low Cost Access General practice

Enrolled Person Annual Rate
Age Group Gender CSC Non CSC
00-04 Female $81.0720 $81.0720
  Male $85.3572 $85.3572
05-14 Female $62.5824 $58.5084
  Male $62.4360 $58.3464
15-24 Female $56.1336 $31.0164
  Male $34.1184 $17.0712
25-44  Female $78.0900 $27.2544
  Male $86.0064 $17.6184
45-64 Female $155.5104 $37.3296
  Male $159.7140 $27.8820
65+ Female $205.3068 $64.3308
  Male $219.4224 $55.4784

Non VLCA – Community Services Card Rates

Enrolled Person Annual Rate
Age Group Gender CSC
00-04 Female $0.0000
  Male $0.0000
05-14 Female $4.0740
  Male $4.0896
15-24 Female $56.1336
  Male $34.1184
25-44  Female $78.0900
  Male $86.0064
45-64 Female $155.5104
  Male $159.7140
65+ Female $205.3068
  Male $219.4224

Maximum co-payment thresholds for VLCA

0–12 year olds 13–17 year olds 18 and above
$0.00 $12.50 $18.50

10. Zero Fees for Under 6 Year Olds payment

Age Bands Gender Annual rate
00–04 F $81.0720
M $85.3572
05–14 F $2.5260
M $2.3640

11. Zero Fees for Under-14s

Age Bands Gender Annual rate
00–04 F $81.0720
M $85.3572
05–14 F $58.5084
M $58.3464
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