Primary Maternity Services Notice 2021

This page provides information about the Primary Maternity Services Notice 2021 and related information. It also includes information about making claims when primary maternity care provision is impacted by COVID-19.

Published online: 
30 June 2021

Last updated: 21 April 2022

Primary Maternity Services Notice 2021

The Primary Maternity Services Notice 2021 (the 2021 Notice) sets out the service specifications and payment rules for remuneration of those practitioners with an authorisation to claim for the provision of community-based primary maternity services.

In 2021, the previous Primary Maternity Services Notice (the 2007 Notice), was updated so it could better deliver funding allocated in Budget 2020 for additional primary maternity care to women with complex needs, and to women living in rural areas.

The changes came into effect when the 2021 Notice was implemented on 29 November 2021. 

Services provided on or after 29 November 2021 should be provided in accordance with the new 2021 Notice. 

The 2007 Notice, and associated claim payments, will continue to apply to any care provided up to and including 28 November 2021.

The 2021 Notice was published in the New Zealand Gazette on 30 June 2021.

Primary Maternity Services Notice 2021 Guide

The Primary Maternity Services Notice 2021 Guide is designed to help providers of primary maternity services understand the 2021 Notice and what has changed from the Notice issued in 2007.

Published 29 November 2021

Maternity Facility Access Agreement

The Maternity Facility Access Agreement (Access Agreement) is a contract setting out the obligations of facilities and LMCs when they access these facilities to provide care to women (antenatally, during labour and birth, postnatally). The Access Agreement was included as Schedule 3 in the 2007 Notice. It has been removed from the 2021 Notice and is now hosted on the Ministry’s website as an associated document to the 2021 Notice. 

The Access Agreement will be reviewed and updated as needed.

Published 29 November 2021

Maternity Ultrasound Clinical Indication Codes

Primary maternity ultrasound scans will continue to be funded under the 2021 Notice. Authorised providers may claim a fee for a maternity ultrasound scan from the 2021 Notice if the following criteria are met: 

  • an appropriate referral has been received; and
  • a code corresponding to a relevant clinical indication is stated on the referral form and on the claim.

The clinical indication codes are being reviewed by the Maternity Ultrasound Advisory Group and will be updated as necessary in the near future.

Published 29 November 2021

Transfer Support Module

Where an authorised provider accompanies a woman or baby in an air or road ambulance from their home or elsewhere in the community or from a primary maternity facility to a secondary or tertiary maternity facility, the provider may claim a 'Transfer support' module. The purpose of this payment is to contribute to the cost of the provider returning to their home or vehicle.

Download further information to see the fee structure, a spoke and hub table and the list of codes to be entered when making a claim for this module:

Published 29 November 2021

Rural Practice and Travel Supplements

The 'Rural practice and travel supplements' (RPaTS) are the modules available for claiming by LMCs for travel, and for the provision of care to women who live in rural areas. There is an RPaTS attached to each of the antenatal trimester modules, the labour and birth modules, and the postnatal module. 

For explanation of the Urban Accessibility (UA) classification and to see the applicable fees when making a claim for this module, go to Rural practice and travel supplements (RPaTS) for Lead Maternity Carers.

To look up the RPaTS regional classification for a particular region, please download the RPaTS Regional Classification Look Up Tool (Excel, 3.3 MB).

Additional Care Supplements

The 'Additional care supplements' (ACS) are the modules available for claiming by LMCs for the provision of any additional care required by a woman due to their social or clinical complexity. The modules also remunerate provision of care to women who belong to those populations most at-risk of adverse outcomes. There is an ACS attached to antenatal care, labour and birth care and postnatal care.

The criteria for each ACS differ and each criterion is weighted: low, moderate or high. Each weighting has a different fee associated with it and the total amount payable for the applicable ACS is the total of the fees for the criteria which have been met. For each ACS, there is a maximum fee payable.

Criteria weighted as “low”: $25
Criteria weighted as “moderate”: $50
Criteria weighted as “high”: $90

Antenatal ACS maximum: $350
Labour and birth ACS maximum: $100
Postnatal ACS maximum: $250

Published 29 November 2021

Applying for a discretionary payment

Discretionary approval for payment of modules in the Primary Maternity Services Notice 2021: Home birth planning and supplies – partial and Antenatal additional care supplement - partial

The Primary Maternity Services Notice 2021 (the 2021 Notice) partial modules for Home birth planning and supplies (Schedule 1, payment 3.8) and Antenatal additional care supplement (Schedule 1, payment 2.16) both require discretionary approval by the Ministry of Health (the Ministry) for payment for that partial module.

Written application for a discretionary decision on payment of these two partial modules will no longer be required from 20 April 2022 as long as all of the following applicable conditions are met by the claimant LMC:

  • The relevant conditions apply for a partial payment:
    • For the Antenatal additional care supplement – partial, as set out in clause DA35(5), where the woman experiences a first or second trimester pregnancy loss; or changes LMC; or clinical responsibility transfers to secondary maternity services during the first or second trimester of pregnancy.
    • For the Home birth planning and supplies – partial, where the LMC attends an unplanned home birth, as set out in clause DA42(3), or where an LMC attends a second trimester pregnancy loss at a woman’s home, as set out in clause DA42(4).    
  • The care provided by the claimant meets the relevant service specifications and payment rules for the module in question.
  • The claimant has read and adheres to the Antenatal additional care supplement criteria, as required for the full Antenatal additional care supplement module payment.
  • The claimant documents and retains proof that these criteria have been met and provides this proof upon request for audit purposes.

If a claimant does not meet the criteria specified above, they must continue to make written application to the Ministry for a discretionary decision on payment of a partial module. If a claimant makes a claim for one of the above stated partial modules that is processed automatically, but which is later found not meet the criteria specified, then they may be required to make repayment under clause CB2(6).

Registration Form 2021 Notice

Download the paper Registration Form for services provided under the 2021 Notice from the Maternity claim forms page.

Consultation on changes to the Notice

Implementing funding of $85 million (over four years) allocated in Budget 2020 required the 2007 Notice to be updated so it could deliver funding for additional primary maternity care to women with complex needs, and to women living in rural areas. The Ministry of Health undertook a public consultation on proposed changes to the 2007 Notice from 4 September to 13 November 2020.

Advisory to lead maternity care (LMC) midwives about funding for care of COVID-19 positive women/people

As New Zealand sees more cases of COVID-19 in our community, specific clinical guidance has continued to be developed to support the provision of safe and integrated maternity care.

The ‘Care Framework for pregnant women and people isolating in the community for COVID-19’ recognises that, depending on individual circumstances, isolating in the community may be a good option for some people. This shift in approach will see more LMC midwives becoming involved in the care of COVID-19 positive pregnant women / people.  View more: COVID-19: Maternity

LMC midwives can now claim $100 per person if the LMC provides in-person care to someone who is COVID-19 positive or a household contact of a positive case. This is in recognition of the additional work in supporting pregnant women / people, including donning and doffing PPE and providing home visits. The payment is made per case, not per visit, and is applicable for antenatal, labour and birth, or postnatal care (or a combination of all three).

In acknowledgment that many LMC midwives have already been providing care in the community to COVID-19 positive women / people, the Ministry will backdate these payments to the date that New Zealand moved into the Red Setting of the traffic light system, 23 January 2022.

To claim this fee, LMC midwives must complete the form below once per quarter. The first claim can be made from 1 April 2022 for the first quarter of 2022. Claims for the previous quarter must be submitted before the end of the next quarter.

Updated 23 March 2022

Claiming when primary maternity service provision is impacted by COVID-19

As New Zealand sees more cases of COVID-19 in our communities, specific clinical guidance has been developed to support the provision of safe and integrated maternity care. The Care Framework for pregnant women and people isolating in the community for COVID-19 recognises that, depending on individual circumstances, most people who become COVID-19 positive will isolate in the community. This shift in approach sees LMCs becoming more involved in the care of COVID-19 positive pregnant women/people.

Circumstances may arise where it becomes appropriate due to the COVID-19 status of the woman/person, to provide antenatal or postnatal maternity care via a phone or video assessment. In most cases, these circumstances are expected to only be necessary for a short period of time. If it is not clinically appropriate for an LMC to provide in-person antenatal or postnatal maternity care to their registered client and they provide phone or video assessments instead, the Ministry can still count these visits in the total of requisite visits for a module of care. The relevant clinical circumstance must be documented and made available to auditors on request (as per clause CB2 of the Primary Maternity Services Notice 2021).

During Phases 2 and 3 of the Omicron response, critical workers (such as midwives) who are identified as close contacts of a COVID-19 case will be able to continue to work, as long as they return a negative rapid antigen test (RAT) prior to working each day of their isolation period.

From 28 February 2022, LMCs will only be able to claim under the Primary Maternity Services Notice 2021 for care of pregnant/birthing/postpartum women/ people and infants with actual, probable or suspected COVID-19 infection when they have continued to provide the care themselves.

If a woman/person requires a transfer of clinical responsibility for maternity care to secondary services due to risk stratification or severity of COVID-19 disease, a three-way consultation will take place to determine the involvement of the LMC, in accordance with the Guidelines for Consultation with Obstetric and Related Medical Services (Referral Guidelines). If the LMC does not remain involved in care provision, they will not be able to claim off the Primary Maternity Services Notice 2021 for care provided after their involvement has ceased.

If a midwife/LMC tests positive for COVID-19, they may claim for any births missed over the recovery/self-isolation period. LMCs are advised to contact the New Zealand College of Midwives on 0800MIDWIFE to arrange locum cover for the period of time they are required to self-isolate. The locum is paid from the locum service contract and the LMC claims the labour and birth module.

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