Capitation rates

Capitation rates from 1 July 2021. 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 $682.2708 $456.4248
M $682.2708 $480.5508
05–14 F $437.4552 $144.4728
M $437.4552 $135.2280
15–24 F $421.4028 $133.3116
M $421.4028 $73.3704
25–44 F $421.4028 $117.1464
M $421.4028 $75.7248
45–64 F $461.5368 $160.4532
M $461.5368 $119.8404
65+ F $494.9820 $276.5088
M $494.9820 $238.4580

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 $682.2708 $445.4208
M $682.2708 $473.9904
05–14 F $437.4552 $114.6780
M $437.4552 $108.6852
15–24 F $421.4028 $133.3116
M $421.4028 $73.3704
25–44 F $421.4028 $117.1464
M $421.4028 $75.7248
45–64 F $461.5368 $160.4532
M $461.5368 $119.8404
65+ F $494.9820 $276.5088
M $494.9820 $238.4580

3. Health promotion services

Health Promotion Non High Use Health Card Holders
Māori/Pacific Non Māori/Non Pacific
Deprivation deciles 1–8 $2.9364 $2.4468
Deprivation deciles 9–10 $3.4260 $2.9364

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 $84.5808 $169.1628 $0.00 $84.5808
M $89.0508 $178.1064 $0.00 $89.0508
05–14 F $26.7720 $53.5452 $0.00 $26.7720
M $25.0596 $50.1204 $0.00 $25.0596
15–24 F $24.7032 $49.4076 $0.00 $24.7032
M $13.5960 $27.1944 $0.00 $13.5960
25–44 F $21.7080 $49.4076 $0.00 $24.7032
M $14.0316 $28.0668 $0.00 $14.0316
45–64 F $29.7324 $59.4684 $0.00 $29.7324
M $22.2084 $44.4156 $0.00 $22.2084
65+ F $51.2412 $102.4824 $0.00 $51.2412
M $44.1900 $88.3788 $0.00 $44.1900

5. Care Plus services

$275.4096

6. Fees for administering vaccine episodes

Childhood immunisation  $23.20
Influenza immunisation $23.20

7. Rural workforce retention

Rural ranking score Rate per capita
35–40 $8.10
45–50 $12.17
55–65 $16.22
70+ $20.26

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 $17.4612 per person up to 20,000 and $1.0068 per person from 20,001 to 40,000.
  2. Otherwise, if the number of Enrolled Persons in the PHO is between 40,001 and 75,000, the rate will be $12.4248 per person up to 20,000 and $6.0420 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 $580,806 plus $6.7848 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 $100.3980
M $105.7044
5–14 F $77.3856
M $77.2044
15–24 F $68.4840
M $41.6244
25–44 F $95.2716
M $104.9304
45–64 F $189.7260
M $194.8548
65+ F $250.4796
M $267.7008

9.2 Very Low Cost Access  Non Community Services Card

Age Group Gender Rates per capita
0–4 F $100.3980
M $105.7044
5–14 F $72.3480
M $72.1464
15–24 F $37.8396
M $20.8272
25–44 F $33.2508
M $21.4944
45–64 F $45.5436
M $34.0164
65+ F $78.4848
M $67.6848

9.3 Very Low Cost Access and CSC scheme – Practice fee 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 $100.3980
M $105.7044
05–14 F $3.1224
M $2.9232

11. Zero Fees for Under-14s 

Age Bands Gender Annual rate
00–04 F $100.3980
M $105.7044
05–14 F $72.3480
M $72.1464

12. Community Services Card Funding Rates (non-VLCA CSC holders)

Age Bands Gender Annual rate
00–04 F $0.0000
M $0.0000
05–14 F $5.0376
M $5.0568
15–24 F $68.4840
M $41.6244
25–44 F $95.2716
M $104.9304
45–64 F $189.7260
M $194.8548
65+ F $250.4796
M $267.7008
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