Summary of Covid-Related Claims & Processes
11/03/2022
To support recent updates around claiming for Covid-related activity in general practice recently, please see the below summary of the various claiming types and processes for these. Halcyon claims should be made as activity occurs, payments are made on a monthly cycle.
Swab-based Activity Claims Claim Type PCR Testing Virtual Consultation Simple Assessment (No Swab) Asymptomatic Consult + Swab Simple Assessments (+ Swab) Full Assessments + Swab
Amount (inc. GST)
Eligibility
$69 $69 $138 $138 $287.50
For MOH Testing Guidance click here
$138
For MOH RAT Guidance click here.
Amount (inc. GST)
Eligibility
Claim Via
Halcyon For “Covid Swab Type” select “PCR”
Rapid Antigen Testing (RAT) Simple Assessment + RAT Swab
Halcyon For “Covid Swab Type” select “RAT”
Vaccination Support Claims Claim Type ‘Quick Call’ by Nurse (For Vaccine Hesitant Pts & to Encouraging uptake of eligible vaccination doses & boosters)
$23
Pre-Vaccination Consultation (Pfizer) (All consults prior to Pfizer 1st, 2nd primary dose + booster vaccine - to encourage uptake & discuss patient concerns)
Māori, Pasifika, CSC Holder (or ‘Other’ as per clinical discretion)
Claim as: ‘Pre-Vaccination Consult’ - ‘Nurse’ ‘Quick Call/Virtual’
Māori, Pasifika, CSC Holder (or ‘Other’ as per clinical discretion)
Claim as: ‘Pre-Vaccination Consult’ & Select appropriate Vaccine Dose Number & Type
Halcyon
$69
Simple Consult + Prescription: $69
3rd Primary Dose (Immunocompromised)
Complex Consult + Prescription: $138
Age 12+ severely immunocompromised patients.
(inc. Virtual/In-person consult + Prescription, Consult, no prescription/patient declined)
Patient Declines Vaccine or Deemed Not Eligible: $69
For clinical guidance document click here.
AstraZeneca Consultation All consults prior to AstraZeneca 1st, 2nd primary dose + booster vaccine. Prescription sometimes required - see clinical guide.
Post–Vaccine Consult: Adverse Event (inc. Virtual/in person limited assessment + in-person full assessment)
Temporary Vaccine Exemption Consult (inc. Standard (no exam) and Complex (with exam)
Claim Via Halcyon
All Patients
$69
AstraZeneca Clinical Guidance Document here. Prescription required only for ‘off label’ use as per clinical guidelines.
Halcyon
Claim as: ‘Pre-Vaccination Consult’ “3rd Dose” – Simple/Complex Consult + Outcome (e.g. Prescription Given)
Halcyon
Claim as: ‘Pre-Vaccination Consult’ & Select appropriate Vaccine Dose Number & Type
Halcyon
Virtual/In Person Limited Assessment: $69 In-Person Full Assessment: $138
Standard (no Pt exam): $69 Complex (Full Pt exam): $138
All patients Claim must be within 14 days of Vaccination Event
Specified exemption criteria. For Clinical Guidance (including application form) click here.
Claim as: ‘Post-Vaccine (Adverse Event)’ – Limited/Full Assessment. You can add ‘Additional Costs (such as ECG) in the form.
Halcyon Claim as: ‘Vaccine Exemption’ + Patient Examination/ No Examination’