CODE GE General consumer General consumers must hold a Medicare card, and pay the full patient contribution for PBS prescription items unless they reach the applicable general Safety Net threshold in a given calendar year. Under the Reciprocal Health Care Agreements, visitors from participating countries are treated as general consumers. To receive a pharmaceutical benefit, visitors must present either an interim Medicare card (blue), a Reciprocal Health Care Medicare card (pale green) or their passport. CODE CO Concession card holder The first level of reduced patient contribution for PBS items. Concessional consumers must hold a Medicare card and at least one of the following cards from either Centrelink, the Department of Veterans' Affairs (DVA) or the Department of Human Services (DHS). - Pensioner Concession card (Centrelink or DVA)
- Commonwealth Seniors Health card (Centrelink or DVA)
- Health Care card
- Safety Net concession card (general consumers who reach or exceed the applicable general Safety Net threshold in a given calendar year pay the same patient contribution as concession card holders for the remainder of that calendar year).
CODE PE Pensioner The second level of reduced patient contribution for PBS items. This code is only applicable to concession card holders (see Code 'CO' above) who reach or exceed the concessional Safety Net threshold in a given calendar year. PBS items for consumers in this category are supplied free of charge for the remainder of the calendar year, with the consumer continuing to pay any applicable special patient contributions, brand premiums or therapeutic group premiums. Safety Net consumers must hold a Safety Net Entitlement card ('SN' prefix on the number) issued by the Department of Human Services (DHS). CODE RE Repatriation (Department of Veterans' Affairs) Veterans' Affairs claims. Repatriation consumers must hold one of the following cards from the Department of Veterans' Affairs (DVA). - Repatriation Health Card For All Conditions (gold) - concessional patients under the Repatriation Pharmaceutical Benefits Scheme (RPBS)
- Repatriation Health Card For Specific Conditions (white) – only regarded as concessional patients for RPBS prescriptions unless they hold a separate entitlement from Centrelink, otherwise they are general patients
- Repatriation Pharmaceutical Benefits Card (orange) - concessional patients under the RPBS
- Safety Net Concession Card or Safety Net Entitlement Card - issued by the Department of Human Services.
CODE DB Prescriber Bag Also known as Doctor's Bag, particularly in the context of historical data. Items supplied on Prescriber Bag order forms. Consumers currently pay no contribution. CODE OC Stoma This code applies to those patients who are likely to claim benefits related to the provision of stoma-related aids and appliances. Assistance in relation to stoma-related products is provided via the Stoma Appliance Scheme (SAS). The SAS provides assistance to Medicare-eligible Australian residents who have a temporary or permanent artificial body opening, whether created surgically or otherwise, which facilitates the removal of urine and products of the gastrointestinal tract where the person does not have normal gastrointestinal tract or bladder functions. To receive subsidised stoma-related products a patient must be a member of a stoma association in Australia and hold an SAS entitlement card issued by Medicare through one of the associations. CODE OP Paraplegic and quadriplegic This code applies to those patients who claim PBS benefits related to the provision of paraplegic- or quadriplegic-related products. Assistance in relation to paraplegic- or quadriplegic-related products is provided via the provisions of the National Health (Paraplegic and Quadriplegic Program) Special Arrangement 2010. The program provides assistance to Medicare-eligible Australian residents who have paraplegia or quadriplegia. To receive subsidised paraplegic- or quadriplegic-related products a patient must be a member of an authorised paraplegic or quadriplegic association in Australia and hold an entitlement card issued by Medicare through one of the associations. |