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Changes to ACC  - effective 1 July 2021
Posted by Jane Hughes on 30 June 2021 08:06 AM

Elective Surgery

Elective Surgery Services variation goes live on 1 July 2021, increasing prices by 3.86%, except for HIT50A, HIT60A and HIT70A which have been repriced. (KNE27 has also been removed as this was actually retired as at 30 June 2020).

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 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


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 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 all prices 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 e. 3.86
  • Enter a rounding process to apply
    (Optional - you will need to obtain this from your contract holder).


This process is irreversible.  Please ensure you have entered percentage correctly.

If in any doubt, cancel.


Check List for Elective Surgery

  • Invoice for all services up to 30 June.
  • Update all rates as applicable prior to entering any services dated on or after 1 July 2021.

Clinical Services

New Clinical Services contracts go-live on 1 July 2021 with new contract numbers.  Prices have increased by 1.63%.  New codes are included for telehealth assessments, subsequent pain diagnosis and treatment procedures, medial branch blocks, radiofrequency neurotomy and 'add-on' items for urology procedures.

CT13 has been retired and CSP6 and CSP8 are now priced to include a consultation fee.

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.

Service Item Code (Alias Code)

Item description

 Flat Rate (GST inclusive)

 Flat Rate (GST Exclusive)


Clinical Services - Simple Assessment (Initial)

 $            206.84

 $                  179.86


Clinical Services: Simple First Assmt Telehealth

 $            206.84

 $                  179.86


Clinical Services - Complex Assessment (Initial)

 $            316.93

 $                  275.59


Clinical Services: Complex First Assmt Telehealth

 $            316.93

 $                  275.59


Clinical Services - Second Opinion Assessment

 $            206.84

 $                  179.86


Clinical Services - Reassessment

 $            206.84

 $                  179.86


Clinical Services - Subsequent Assessment: Simple

 $            140.09

 $                  121.82


Clinical Services: Simple Subseq Assmt Telehealth

 $            140.09

 $                  121.82


Clinical Services - Subsequent Assessment: Complex

 $            206.84

 $                  179.86


Clinical Services: Complex Subseq Assmt Telehealth

 $            206.84

 $                  179.86


Clinical Services - Second Opinion Assmt Complex

 $            316.93

 $                  275.59


Clinical Services - Echocardiogram

 $            629.44

 $                  547.34


Clinical Services - Stress Echo

 $        1,095.35

 $                  952.48


Clinical Services - Respiratory Spirometry

 $            104.51

 $                    90.88


Clinical Services - Exercise Treadmill

 $            496.24

 $                  431.51


Clinical Services: Electrocardiogram

 $              71.48

 $                    62.16


Clinical Services: Flow and residual test

 $            150.31

 $                  130.70


Clinical Services: OCT scan - unilateral (ophthal)

 $            259.44

 $                  225.60


Clinical Services: OCT scan - bilateral  (ophthal)

 $            315.73

 $                  274.55


Clinical Services: Visual Field Test - unilateral

 $              92.08

 $                    80.07


Clinical Services: Visual Field Test - bilateral

 $            117.97

 $                  102.58


Clinical Services: Orthoptic assessment - child

 $            153.38

 $                  133.37


Clinical Services: Orthoptic assessment - adult

 $            177.41

 $                  154.27


Clinical Services: Fluorescein angiography (eye)

 $            603.53

 $                  524.81


Corneal Topography

 $            218.62

 $                  190.10


Clinical Services - Moonboots prov by Specialists

 Actual & Reasonable up to $304.89


Clinical Services - Simple Orthotics

 Actual & Reasonable up to $304.89

What the new Clinical Services contract numbers will mean

All services up to and including 30 June 2021 will need to be entered and your claims processed before you can change your contract details in Incisive (and the prices).

We recommend that you amend the contract details as follows:


  • Setup – Contacts – Third Party Schedules – select relevant entry – Edit.

Amend the Contract Number.


  • Setup – Contacts – Invoicing / Reports – select the relevant entry – Edit.

Amend the contract number.


If you decide to add a new Schedule entry, then you need to be aware of the following:

The ACC procurement system cannot handle duplicated schedule numbers.  If you create a new third party schedule entry, the first transaction entered for the new schedule will be prompt for a starting number.  The default starting number is 1.   You will need to ensure that you jump the numbering to follow on from your current schedule numbering so there is no overlap of numbers. Once the number is set there is no option for you to subsequently amend this.


For this reason, this option is not recommended for claims via schedules.


If you are billing by way of a Third Party Invoice, the numbering is sequential and the next available number is automatically allocated.


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 Items
  • 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).
  • Amend the Contract number.
  • Update all rates as applicable prior to entering any services dated on or after 1 July 2021.

Cost of Treatment Regulations (CoTR)

The Cost of Treatment Regulations Amendment was effective from 1 May 2021 so your prices should have been updated by now.

Any change in prices to the Regulations can be made as follows:

Setup – Financial – Charges – Schedules – ACC (or ACC Regulations).

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