Clinical Programmes | West Coast Health

Programme	Fee	Eligibility
Skin Cancer Management	Punch biopsy - $111.40 Skin excision: Simple - $278.42 Skin excision: Moderate - $381.98 Multiple excisions over 45 minutes OR complex excision performed by GPSI over 45 minutes - $600 One off post op wound complication - $82 Clinical assessment following referral - $82	Suspected or confirmed Skin Cancers and one of the below: Patients holding a Community Services Card; or Māori and Pacific peoples.
National Bowel Screening Programme	$74.62 will be paid for qualifying claims.	People aged 60-74 years with no prior history of bowel cancer or current pathology. Please note FIT test is sent directly to patient by NBSP *
Mental Health Extended Consult	$60 (GST inclusive) will be paid for consultations exceeding 20-minutes above the standard 15- minute appointment.	The patient must be enrolled with PHO.
GP MRI	Paid at $128.32	Must be an ACC claim. Patient must be enrolled with the PHO; Patient is aged 17 years and older; Patient has an injury that meets the criteria outlined in the GPMRI Clinical Pathways; Patient has been assessed by a Trained GP as suitable for referral; and The date on the Injury Claim Lodgement with ACC-45 is not greater than 6 months
Extended Primary Care (EPC)	Claiming is based on time-based funding for the package of care provided. See programme PDF for further details.	General Practice services will be able to claim for providing a package of care: To patients with an acute condition, who without EPC funding support would otherwise be referred acutely to hospital or secondary services. Includes patients who are residents of ARCs. For rural practices providing prolonged clinical care and observation for patients waiting on a hospital transfer (rural stabilisation). For any person eligible for New Zealand healthcare funding, regardless of WC Health enrolment status or Practice Enrolment Status, for the packages of care as above. Please note that offering the programme to patients not enrolled at your practice is at your own discretion. There is no claw-back available and no additional allocation for practices with higher numbers of visitors to their area.
Cardiovascular Risk Assessment (CVRA)	To be eligible for payments reviews must occur under the following criteria: People <10% CVR – initial and 5 yearly = $19 People ≥15% CVR – annual = $80	Any person without known cardiovascular disease and meets the following criteria, Men 45-74 years; Women 55-74 years; For Māori, Pacific and South Asian populations risk assessment is recommended to begin in men aged 30 years and in women aged 40 years, 15 years earlier than other population groups; For people with serious mental illness (schizophrenia, major depressive disorder, bipolar disorder, schizoaffective disorder), CVRA is recommended from age 25 years. Re-screen intervals: < 3 percent = 10 years 3-9 percent = 5 years 10 - 14 percent = 2 years 15+ percent = 1 year, as part of annual management review
Community Probation Service	Full review – 30 minutes Enrolled: $80 Casual: $103 Normal consult Enrolled: $19.50 Casual: $62 Script Enrolled: $5 Casual: $5	This programme funds General Practice consultations and prescriptions for Community Probation Service (CPS) clients with valid CPS vouchers. One voucher number is valid for one Initial Consult and three Follow-Up appointments. Initial Consult – this can be either a ‘Full Consult’ or a ‘Standard Consult’ Full Consult A 30-minute appointment. It includes a functional enquiry covering all body systems and mental health, a CVD risk assessment and diabetes screen (if appropriate according to CVDRA guidelines), and other standard prevention activities e.g. HPV/ Cervical Smear, Tetanus injection. It is expected that this will be done by GP and nurse. OR an extended mental health initial assessment (> 20 minutes) Standard Consult A standard 15-minute appointment. Follow-Up Consult – this is a ‘Standard Consult’
Contraception and Sexual Health	Visit PDF for further information.	Anyone under the age of 25 years. Any women 25 years and older who: a) are enrolled in a West Coast general practice and b) live in quintile 5 areas; or c) hold a community services card; or d) are high risk of an unplanned pregnancy and poor health and social outcomes, such as: Māori, Pacific disability service users Oranga Tamariki residential or foster care users of Community Alcohol and Drug services users of Residential or Community Mental Health services high users of maternity services exceptions on a case-by-case basis.
Coast Quit	See programme PDF for further details.	All individuals aged 15 and older enrolled with PHO. Currently smoke tobacco and are wanting support to stop. Up to two enrolments per patient within a 12-month period. Minimum of eight weeks between enrolments.
Palliative Care	Payments are paid at the rate of $97 for a home visit, $19 for a surgery consultation or for a palliative care nurse consult (GST inclusive). It is expected that there will be no patient co-payment. Services may be provided for a maximum of six months and up to $500 per patient (GST inclusive), unless further approval is obtained*.	The patient must be enrolled with the PHO.
Long Term Condition Mental Health Programme	Initial Review - $120 Annual Review - $80 Follow-up Review - $40	A confirmed diagnosis of a serious long-term mental health condition e.g.: major depression (ongoing – e.g. greater than two years), schizophrenia disorder, bi-polar disorder, psychotic disorder.