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ACC fee changes – effective 1 July 2023
Elective Surgery
Elective Surgery Services variation goes live on 1 July 2023.
Unless you hold an Elective Surgery Contract, changes to the pricing for surgical procedures will be notified to you via your contract holder(s).
Hospital clients using PHM will receive a separate Infosheet notification on how to add or update their ACC contract prices.
Updating Elective Surgery invoice items in SPM
Invoice items can be updated either:
- Individually, or
- For all Invoice Items in a Billing Type
GST
Invoice codes are set either GST inclusive or GST exclusive depending on the ‘Set Fees’ flag. Ensure that you enter the amounts accordingly.
You can check the GST settings (remember this is per Provider) as follows:
Setup > Provider > Config 2 > Edit
Update the price for an individual invoice item
Setup > Financial > Charges > Invoice Items > Edit
To change each amount, edit the individual invoice codes, changing the Amount for the relevant Billing Type.
Update prices for all invoice items for a Billing Type (e.g. ACC Contract)
Setup > Financial > Charges > Invoice Items > Update Prices
If you have been notified of an across-the-board percentage increase by the holder(s) of the Elective Surgery Contract, you can use the ‘Update Prices’ function to apply the change.
- Ensure you have selected the correct Billing Type.
- Enter the percentage increase to apply that you have been advised of
- Enter a rounding process to apply
(optional - you will need to obtain the rounding rules from your contract holder).
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Warning:
This process is irreversible. Please ensure you have entered percentage correctly.
If in any doubt, Cancel.
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Clinical Services
New Clinical Services contracts go live on 1 July 2023, with an increase of 6.11%
Below are some of the commonly used service items with the new pricing effective 1 July. Please refer to your contracts with ACC for the full list of codes. If you do not hold a Clinical Services Contract direct with ACC, please refer to your contract holder for the prices.
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Service Item Code
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Item description
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Flat Rate (GST inclusive)
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Flat Rate (GST Exclusive)
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CS10
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Clinical Services - Simple Assessment (Initial)
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$ 223.65
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$ 194.48
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CS1T
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Clinical Services: Simple First Assmt Telehealth
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$ 223.65
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$ 194.48
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CS20
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Clinical Services - Complex Assessment (Initial)
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$ 342.69
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$ 297.99
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CS2T
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Clinical Services: Complex First Assmt Telehealth
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$ 342.69
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$ 297.99
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CS40
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Clinical Services - Second Opinion Assessment
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$ 223.65
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$ 194.48
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CS50
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Clinical Services - Reassessment
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$ 223.65
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$ 194.48
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CS61
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Clinical Services - Subsequent Assessment: Simple
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$ 151.47
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$ 131.71
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CS61T
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Clinical Services: Simple Subseq Assmt Telehealth
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$ 151.47
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$ 131.71
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CS62
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Clinical Services - Subsequent Assessment: Complex
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$ 223.65
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$ 194.48
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CS62T
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Clinical Services: Complex Subseq Assmt Telehealth
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$ 223.65
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$ 194.48
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CS90
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Clinical Services - Second Opinion Assmt Complex
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$ 342.69
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$ 297.99
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CSD1
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Clinical Services - Echocardiogram
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$ 680.59
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$ 591.82
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CSD2
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Clinical Services - Stress Echo
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$ 1184.36
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$ 1029.88
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CSD3
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Clinical Services - Respiratory Spirometry
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$ 113.01
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$ 98.27
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CSD4
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Clinical Services - Exercise Treadmill
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$ 536.57
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$ 466.58
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ECG
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Clinical Services: Electrocardiogram
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$ 77.29
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$ 67.21
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CD10
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Clinical Services: Flow and residual test
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$ 162.52
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$ 141.32
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CD40
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Clinical Services: OCT scan - unilateral (ophthal)
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$ 280.53
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$ 243.94
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CD41
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Clinical Services: OCT scan - bilateral (ophthal)
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$ 341.39
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$ 296.86
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CD42
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Clinical Services: Visual Field Test - unilateral
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$ 99.57
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$ 86.58
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CD43
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Clinical Services: Visual Field Test - bilateral
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$ 127.56
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$ 110.92
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CD44
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Clinical Services: Orthoptic assessment - child
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$ 165.83
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$ 144.20
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CD45
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Clinical Services: Orthoptic assessment - adult
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$ 191.82
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$ 166.80
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CD46
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Clinical Services: Fluorescein angiography (eye)
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$ 652.58
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$ 567.46
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CD47
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Corneal Topography
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$ 236.38
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$ 205.55
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CSE1
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Clinical Services - Moonboots prov by Specialists
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Actual & Reasonable
up to $329.66 (ex)
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CSE2
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Clinical Services - Simple Orthotics
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Actual & Reasonable
up to $329.66 (ex)
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Changing the amounts charged for Clinical Services Contracts:
The amounts you claim from ACC for your Clinical Services Contracts can be entered in one of two places if you are bulk-billing the services by way of a schedule.
When you edit your schedule (see above), note whether the schedule is set to use Invoice Items or Schedule Items:
Schedule Items
Note, that if you are set to use Schedule Items, these codes are shared by other providers in your database. Before making any changes to the amounts, please check that all secretaries have completed claiming for services up to 30 June before you change the amounts. Do not enter any claims for services dated from 1 July until you have updated your prices.
- Setup > Financial > Charges > Schedules > Third Party Schedule Claim Item
- Change existing codes using edit, change the Amount.
Note, the rates entered here are GST inclusive.
- For new Service Items, select New.
Note, the ACC Service Code or Alias Code needs to be entered in the Item # field. This is what is transmitted to ACC.
The Code does not have to be the same as the Item #.
Invoice Items
- Setup > Financial > Charges > Invoice Items
- Change existing codes using edit, change the Amount.
Note, the rates entered here are either entered GST inclusive or GST exclusive depending on the switch against the provider.
If you are unsure, check via Setup > Provider > Config. 2 > Edit
Check List for Clinical Services
- Enter all services up to 30 June.
- Process / advance your schedule(s).
- Update all rates as applicable prior to entering any services dated on or after 1 July 2023.
Cost of Treatment Regulations (CoTR)
The Cost of Treatment Regulations Amendment was effective from 1 May 2023 and have not changed since.
If you have any queries please create a ticket at http://www.incisivesupport.com or send an email to help@incisivesupport.com
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