Capitation rates

Capitation rates from 1 July 2019. 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 $641.3076 $429.0204
M $641.3076 $451.6980
05–14 F $411.1908 $135.7992
M $411.1908 $127.1088
15–24 F $396.1020 $125.3076
M $396.1020 $68.9652
25–44 F $396.1020 $110.1132
M $396.1020 $71.1780
45–64 F $433.8264 $150.8196
M $433.8264 $112.6452
65+ F $465.2628 $259.9068
M $465.2628 $224.1408

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 $641.3076 $418.6776
M $641.3076 $445.5312
05–14 F $411.1908 $107.7924
M $411.1908 $102.1596
15–24 F $396.1020 $125.3076
M $396.1020 $68.9652
25–44 F $396.1020 $110.1132
M $396.1020 $71.1780
45–64 F $433.8264 $150.8196
M $433.8264 $112.6452
65+ F $465.2628 $259.9068
M $465.2628 $224.1408

3. Health promotion services

Health Promotion Non High Use Health Card Holders
Māori/Pacific Non Māori/Non Pacific
Deprivation deciles 1–8 $2.7996 $2.3328
Deprivation deciles 9–10 $3.2664 $2.7996

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 $79.5036 $159.0060 $0.0000 $79.5036
M $83.7048 $167.4120 $0.0000 $83.7048
05–14 F $25.1652 $50.3304 $0.0000 $25.1652
M $23.5548 $47.1108 $0.0000 $23.5548
15–24 F $23.2200 $46.4412 $0.0000 $23.2200
M $12.7800 $25.5612 $0.0000 $12.7800
25–44 F $20.4048 $40.8108 $0.0000 $20.4048
M $13.1892 $26.3808 $0.0000 $13.1892
45–64 F $27.9480 $55.8984 $0.0000 $27.9480
M $20.8740 $41.7492 $0.0000 $20.8740
65+ F $48.1644 $96.3288 $0.0000 $48.1644
M $41.5368 $83.0724 $0.0000 $41.5368
 
5. Care Plus services

$260.5596

6. Fees for administering vaccine episodes

Childhood immunisation  $21.37
Influenza immunisation $21.37

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 $16.6464 per person up to 20,000 and $0.9600 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 $11.8452 per person up to 20,000 and $5.7600 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 $553,704 plus $6.4680 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 $83.4312 $83.4312
  Male $87.8412 $87.8412
05-14 Female $64.4040 $60.2112
  Male $64.2528 $60.0444
15-24 Female $57.7668 $31.9188
  Male $35.1108 $17.5680
25-44  Female $80.3628 $28.0476
  Male $88.5096 $18.1308
45-64 Female $160.0356 $38.4156
  Male $164.3616 $28.6932
65+ Female $211.2816 $66.2028
  Male $225.8076 $57.0924

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 $4.1928
  Male $4.2084
15-24 Female $57.7668
  Male $35.1108
25-44  Female $80.3628
  Male $88.5096
45-64 Female $160.0356
  Male $164.3616
65+ Female $211.2816
  Male $225.8076

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 $83.4312
M $87.8412
05–14 F $2.5992
M $2.4324

11. Zero Fees for Under-14s

Age Bands Gender Annual rate
00–04 F $83.4312
M $87.8412
05–14 F $60.2112
M $60.0444
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