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Patient—Closing the Gap co-payment eligibility indicator, code AAA[NNA]

Identifying and definitional attributes

Metadata item type:Help on this termData Element
Short name:Help on this termClosing the Gap co-payment eligibility indicator
Synonymous names:Help on this termCTG co-payment eligibility indicator
METeOR identifier:Help on this term603679
Registration status:Help on this termCommonwealth Department of Health, Standard 17/12/2015
Definition:Help on this termAn indicator of whether the patient is eligible for a Closing the Gap (CTG) co-payment, as represented by a code.
Context:Help on this termThe CTG co-payment was established to reduce the cost of Pharmaceutical Benefits Scheme (PBS) medicines for eligible Aboriginal and Torres Strait Islander people either living with or at risk of chronic disease.
Data Element Concept:Patient—Closing the Gap co-payment eligibility indicator

Value domain attributes

Representational attributes

Representation class:Help on this termCode
Data type:Help on this termString
Format:Help on this termAAA[NNA]
Maximum character length:Help on this term6
Supplementary values:Help on this term
ValueMeaning
6 spacesNot applicable, i.e. ineligible for Closing the Gap co-payment relief

Collection and usage attributes

Guide for use:Help on this term

The first three characters of the code should be 'CTG', followed by a two-digit number incremented within the practice of the prescriber each time an eligible prescription is written. The sixth character is an alphabetic check digit.

After the numeric component of the codes used by the practice reaches '99', it resets to '01', i.e. the next code allocated by the practice would begin with 'CTG01'.

It is possible for a practice to allocate the same six-digit code more than once on the same day, i.e. if 100 or more eligible prescriptions are written. However, the date of prescription forms part of the check digit calculation algorithm, so while eligible prescriptions written within a practice may share a common first five characters, the check digit should change from day to day.

Source and reference attributes

Submitting organisation:Help on this termDepartment of Health

Data element attributes

Collection and usage attributes

Guide for use:Help on this term

A non-blank response is indicative of the patient's eligibility for the Closing the Gap co-payment.

An eligible patient is an Aboriginal and Torres Strait Islander person of any age who presents with an existing chronic disease or is at risk of chronic disease, and who, in the opinion of the prescriber:

  • would experience setbacks in the prevention or ongoing management of chronic disease if they did not take the prescribed medicine, and
  • is unlikely to adhere to their medicines regimen without assistance through the measure.

Eligible patients can be registered at either:

  • general practices participating in the Indigenous Health Incentive under the Practice Incentives Programme, or
  • Indigenous Health Services in urban and rural settings.

The following prescribers are eligible to provide their patients with a Closing the Gap annotated script:

  • any medical practitioner working in a practice that is participating in the Indigenous Health Incentive under the Practice Incentives Programme,
  • any medical practitioner working in an Indigenous Health Service in rural or urban settings, or
  • any medical specialist in any practice location, provided the patient is eligible under the Closing the Gap - PBS Co-payment Measure, and has been referred by a medical practitioner working in a practice that is participating in the Indigenous Health Incentive PBS Co-payment Measure under the Practice Incentives Programme.
Comments:Help on this term

The Closing the Gap (CTG) co-payment measure within the Pharmaceutical Benefits Scheme (PBS) is intended to improve access to PBS medicinal products for eligible Aboriginal and Torres Strait Islander patients who are living with, or at risk of, chronic disease.

Closing the Gap prescriptions attract a lower or nil patient co-payment for PBS medicinal products. General (non-concessional) patients who present a Closing the Gap prescription should be charged the current concessional rate for each PBS item on that prescription. Similarly, concessional patients who present a Closing the Gap prescription do not need to pay a patient co-payment each PBS item on that prescription.

Care should be taken when using this data element. While a non-blank response may be indicative of the Indigenous status of the patient for whom the prescription is written, it should not be regarded as a definitive alternative to an actual Indigenous status data element.

Source and reference attributes

Submitting organisation:Help on this termDepartment of Health
Reference documents:Help on this termDepartment of Human Services, 2015. Closing The Gap - PBS Co-payment Measure. Department of Human Services, Canberra. Viewed 25 June 2015,
http://www.humanservices.gov.au/health-professionals/services/
pbs-closing-the-gap-co-payment-measure/

Relational attributes

Related metadata references:Help on this term

See also Person—Indigenous status, code N Housing assistance, Superseded 30/08/2017, Health, Superseded 19/11/2015, Early Childhood, Superseded 24/07/2018, Homelessness, Superseded 10/08/2018, Tasmanian Health, Archived 01/09/2016, WA Health, Endorsed 04/03/2014, Independent Hospital Pricing Authority, Standard 01/11/2012, Indigenous, Archived 16/10/2017, Commonwealth Department of Health, Candidate 16/07/2015, Disability, Superseded 29/02/2016, Children and Families, Standard 22/11/2016, Community Services (retired), Standard 25/08/2005

See also Pharmaceutical Benefits Scheme (PBS) prescription—PBS claim type, code A Commonwealth Department of Health, Standard 17/12/2015

Implementation in Data Set Specifications:Help on this term

Pharmaceutical Benefits Scheme (PBS) state/territory data extract 2013-14 Commonwealth Department of Health, Standard 17/12/2015

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