Changes to the Closing the Gap PBS Co-Payment

From 1 July 2021, changes to the Closing the Gap (CTG) PBS Co-payment have taken effect. These changes will allow patients eligible for the co-payment relief to benefit from cheaper medicines, or free medicines if they have a concession or health care card, under the Pharmaceutical Benefits Scheme.

Previously, only Aboriginal or Torres Strait Islanders living with, or at risk of, chronic diseases were eligible for the CTG PBS Co-payment program. After 1 July, however, patients will be eligible if they meet the following criteria:

  • Self-identify as an Aboriginal or Torres Strait Islander Australian
  • Will have setbacks in preventing or managing their condition if they don’t take the medicine
  • Are unlikely to keep up their treatment without help with the cost
  • Are enrolled with Medicare

To support these changes and make the registration process easier, Services Australia has introduced a national registration database where patients must be registered to receive these co-payment benefits. Patients who were previously registered will have their registrations transferred to the new database, and nothing further will be required from them.

Only PBS prescribers and Aboriginal or Torres Strait Islander Health practitioners (who are registered with both AHPRA & Medicare) will be able to add new registrations to the national database via the Health Professional Online Service (HPOS) once they have received consent from eligible patients.

For Bp Premier users, there will be no changes to workflows within the system. Eligible patients will still need to have their ethnicity recorded, and the ‘Registered for CTG PBS Co-payment Relief’ checkbox must be ticked in the patient’s demographic window.

PBS Co-payment article ethnicity field screenshot

For prescribers using Bp Premier, prescriptions created in Bp Premier will have the relevant alpha numeric code included, such as ‘CTG00B’, on both paper and electronic prescriptions. For handwritten prescriptions, prescribers can include the letters ‘CTG’ along with their initials or signature. While annotation is not a legal requirement, it will help pharmacists in dispensing the medicine.

Further information on changes to the Closing the Gap PBS Co-payment can be found on Services Australia’s website.

Authored by:

Jessica White Author Blog Picture

Jessica White
Manager of Commercial and Customer Enablement at Best Practice Software