POAC Claiming Schedule
Auckland | Waitemata | Counties Manukau
POAC Funding Rates effective 1 July 2026:
| Item | Details | Rate (incl GST) |
|---|---|---|
| Abscess: Incision and Drainage (per site) | Fixed fee | $ 205.32 |
| After Hours Fee | Applied to fixed fees only. Consultation fees are charged at clinic rate. | $ 20.53 |
| Anti-D Administration in Pregnancy | Fixed fee | $ 66.73 |
| Catheterisation (Male) | Fixed fee | $ 107.79 |
| Catheterisation (Female) | Fixed fee | $ 82.13 |
| Cellulitis - high risk initial proactive review | Fixed fee, for high dose oral treatment of cellulitis. See clinical criteria | $ 46.04 |
| Cellulitis - in person follow up | Fixed fee, for high dose oral treatment of cellulitis. See clinical criteria | $ 112.16 |
| Clexane Delayed-Scan Injection | Clexane administration only, drug can be claimed under consumables | $ 25.67 |
| Clexane Post Ultrasound (one off) | Clexane single dose post scan, drug can be claimed under consumables | $ 61.60 |
| Consultation - ACC Surcharge | At normal patient charging rate (St John/Hospital referral only) | Clinic rate |
| Consultation - GP/NP/EPC | At clinic normal patient charging rate. Conditions apply, see below | Clinic rate |
| Consultation - Phone Review / Brief Follow Up | Review/result post radiology, or next day post treatment, where indicated. | $ 20.53 |
| Consumables | Cost price, non MPSO consumables | Cost Price |
| ECG Acute | Acute ECG fixed fee, includes nurse time | $ 66.73 |
| Ferinject Infusion | Fixed Fee, single dose 1000mg per episode | $ 189.92 |
| Fluids IV 1 Litre | Fixed fee, for moderate dehydration, max 2 litres per day | $ 184.79 |
| Fluids IV 2 Litres | Fixed fee, for moderate dehydration, max 2 litres per day | $ 246.38 |
| Nurse / Observation Time | Per minute rate, where not related to a fixed fee only | $ 1.54 |
| Point of Care Testing (POCT) Blood Draw | For Low Risk Chest Pain or as per Rural Alliance Guidelines | $ 47.22 |
| Pyelonephritis – Single Dose IV with Fluids | Fixed Fee, refer HealthPathway | $ 225.85 |
| Pyelonephritis – Single Dose IM Ceftriaxone | Fixed Fee, refer HealthPathway | $ 46.20 |
| Troponin Phlebotomy Fee | Fixed Fee, in practice for low risk chest pain only | $ 20.53 |
| Wound Care (simple) post abscess I&D | Consumables can be claimed in addition. Max 7 days from I&D | $ 30.80 |
| Wound Care (complex) post abscess I&D | Consumables can be claimed in addition. Max 7 days from I&D | $ 46.20 |
| Opioid Substitution Therapy | Quarterly fee, automatically processed by POAC | $ 99.58 |
| Zoledronate Infusion | Fully funded from 1 July across Auckland region | $ 189.92 |
| AUB: Mirena Insertion | Under AUB Pathway only | $ 177.09 |
| AUB: Mirena Removal | Under AUB Pathway only | $ 59.03 |
| AUB: Pipelle Biopsy (Device & Procedure) | Under AUB Pathway only | $ 212.51 |
| AUB: Unsuccessful Mirena insertion | Under AUB Pathway only | $ 59.03 |
| GAHT: Follow up appointment without hormone therapy | Max four follow up visits funded | $ 57.50 |
| GAHT: Follow up appointment with hormone therapy | Max four follow up visits funded | $ 57.50 |
| GAHT: Initial appointment with hormone therapy initiated | $ 115.00 | |
| GAHT: Initial appointment without hormone therapy | $ 115.00 | |
| Hepatitis C Testing and Treatment | See Hep C web page for information | |
| LARC Consult - Enrolled CSC Holder | $ 22.43 | |
| LARC Consult - Enrolled Non CSC Holder | $ 47.22 | |
| LARC Consult - Non Enrolled Patient | $ 71.86 | |
| LARC Disposable long handled scissors | $ 23.61 | |
| LARC IUCD Insertion Only | $ 177.09 | |
| LARC IUCD removal, no insertion | $ 88.54 | |
| LARC IUCD string check/shortening | $ 59.03 | |
| LARC Jadelle Insertion Only | $ 177.09 | |
| LARC Jadelle removal, no insertion | $ 177.09 | |
| LARC Removal & replacement (same type) | $ 265.63 | |
| LARC Removal IUCD & replace Jadelle | $ 265.63 | |
| LARC Removal Jadelle & replace IUCD | $ 328.51 | |
| LARC Unsuccessful insertion or removal | $ 59.03 | |
| LARC Sedation (Pre-approved) | Contact POAC to discuss | Variable - discuss with POAC |
| Radiology | XR/CT/US required within 48 hrs only. Invoiced direct to POAC | Variable - invoiced by radiology provider |
| Ring Pessary: Fitting of ring pessary | $ 177.09 | |
| Ring Pessary: Insertion of new pessary | $ 88.54 | |
| Ring Pessary: Consumables | Charge at cost price | Cost Price |
| Ring Pessary: Review post insertion | $ 88.54 | |
| Ring Pessary: Ongoing 6 month review | $ 88.54 |
Important Claiming Notes
The below outlines important details regarding submission of POAC claims.
Please direct any queries or claiming education requests to claims@poac.co.nz
Claiming of Consultations:
The initial in person consult is payable by the patient unless referred by St John, a hospital, or another clinic — in which case the initial assessment can be claimed under POAC.
A same day consultation may be claimed post radiology where hospital admission/discussion, or additional acute management is required.
A next-day in person consult may be claimed where clinically indicated only (e.g. dehydration with ongoing symptoms).
This fee must not be claimed in addition to Fixed Fees for treatment provided.
Phone or brief review relates to a review undertaken by a clinical team member following a POAC-funded radiology investigation, or the following day (where clinically indicated) post treatment.
General Claiming Conditions
POAC terms and conditions apply to all referrals and claims.
Where a 'Fixed Fee' is indicated, this covers all costs, including consumables (unless otherwise stated), for treatment following the initial patient assessment.
Submit the POAC referral at the time of the clinical decision to ensure eligibility.
No co-payment should be charged to any patient enrolled under POAC.
Observation between ECG/Troponin repeat tests is not claimable — if close monitoring is required, admission may be more appropriate.
GP review following initial treatment (e.g. initial IV fluids, asthma management) is not claimable prior to commencing further treatment on the same day.
The After Hours Fee is claimable only with Fixed Fees
No outcome/final diagnosis is required if no other claim is made for the referral. For most referrals, a claim would be expected for services provided.
Consumables
Consumables apply only to non-fixed fee services that are not supplied under MPSO (Medical Practice Service Order) and should be charged at the actual cost of each individual item.
Consumables are not claimable for services that are included under a Fixed Fee, unless specifically indicated in the claiming schedule.
Additional Claiming Requirements
Clinical Documentation: All claims must be supported with relevant clinical documentation.
Claim Submission Timeline:
Initial referrals should be submitted within 24 hours of commencing POAC management
Ensure the patient has consented to referral to POAC
Claims should be submitted by the 20th of the month following treatment.
Due to current clinic capacity issues, claims extension may be given to a maximum of 6 months