Staged Supply services can be requested when the prescriber determines that a Patient may be at risk if they were to obtain a full PBS supply of the nominated medicine. The service is of particular value to Patients with a mental illness, drug dependency, or who are unable to manage their medicines safely (e.g. people living in accommodation where there is the possibility of theft or a lack of refrigeration for the medication).
The frequency of Staged Supply dosing instalments should be determined by the prescriber in consultation with the Pharmacy and the Patient and/or their carer. The Staged Supply Program specifically excludes medicines supplied under the Section 100 Opioid Dependence Treatment Program.
Staged Supply Service Providers must also collect health outcomes data for up to four patients at Initial Patient Registration and at Six-Monthly Follow-Ups. This data must be provided to the Pharmacy Programs Administrator to assist with assessing the effectiveness of the Program.
To be eligible to become an Approved Staged Supply Service Provider and participate in the Staged Supply Program, a Pharmacy must:
To be eligible for a Staged Supply Service, a Patient must:
A Patient is not eligible for a Staged Supply Service if they are currently an in-patient at a public hospital, private hospital, day hospital facility or transition care facility, or a resident of an Aged Care Facility or a correctional facility.
Staged Supply Services funded under this Program are not available to Patients receiving Staged Supply Services funded under other federal, state or territory government programs.
Patients who are not eligible for funded services under the Staged Supply Program may receive medicines in staged supply at their own cost. A lack of eligibility for funding under this Program does not invalidate a request by the patient or their carer to provide medicines in a manner equivalent to staged supply.
To become an Approved Staged Supply Service Provider and participate in the Staged Supply Program, eligible Pharmacies must first register via the Pharmaceutical Programs Administrator Portal. Once approved, Service Providers may claim payments for the provision of Staged Supply Services for up to 15 eligible Patients.
Service Providers must submit claims for eligible Staged Supply services via the Pharmacy Programs Administrator Portal. Claims must be submitted by the end of the next calendar month (e.g. services provided in May must be claimed by 30 June). Claims submitted outside this timeframe will not be paid and cannot be resubmitted.
Claims for Follow Up Services can only be made after six months have passed from the Initial Patient Registration claim, unless the patient has exited the program in which case the patient must have been receiving Staged Supply Services for at least four months.
Approved Service Providers can claim the following payments under the Program:
|Provision of first Staged Supply Service each week (first day)||$8.01|
|Each additional provision of a Staged Supply Service during the week (subsequent days)||$4.06|
|Collection of data at Initial Patient Registration||$31.90|
|Collection of data at Follow Up Service||$31.90|
No additional patient charges may be levied for participating patients who are funded through the Staged Supply Program.
Service Providers participating in the Staged Supply Program must keep all relevant records for seven years after the provision of the funded services. These records may be electronic or hard copy and must include all claim forms, program evaluations, notes and records of Patient interviews, and any other records generated in the provision of the services.
Staged Supply Service Providers may be subject to audits by the Australian Government Department of Health to ensure the services are provided in accordance with the Pharmacy Programs Administrator General Terms and Conditions and the Staged Supply Program Rules.
Please refer to the Portal User Guide – Staged Supply that is available from the Downloads section of this page.
Please see the Program Rules available from the Downloads section of this page.
No, eligible Patients must hold a current, government-issued concession card.
No, you may only claim one medication per patient.
You can claim up to 15 patients per month.
You can collect health outcome data for up to four Patients. This data includes an Initial Patient Registration data set and another for the same patient at a Follow-Up Service six months after the initial registration.
Yes, if a Patient exits the Staged Supply program you can register another Patient for health outcome data collection.
The Staged Supply payment is based on the number of Staged Supply Services each Patient receives each week. For the first service each week, the Pharmacy is paid $8.01 per Patient. For any subsequent services that week, the Pharmacy is paid $4.06 per service.
For the collection of health outcome data at both Patient Registration and Follow-Up Service, the Pharmacy is $31.90 for each successfully completed data set supplied to the Pharmacy Programs Administrator.
No, claims cannot be submitted until the start of the following calendar month.
Claims are due at the end of the calendar month after the Staged Supply Services were performed, e.g. Staged Supply Services performed in March would need to be submitted by the end of April.
Yes, this information must be provided in the Portal during Program registration.
Yes, patients who are not eligible for the program can be charged by the Pharmacy for provision of a staged supply service. Patients eligible for the staged supply program should not be charged for the service.
The number of doses dispatched column is intended to count the number of days you have seen the patient. If you see a patient more than once in a day count all of those times as just once.
Yes, if a patient’s data has already been entered during a previous month, the Portal will auto populate all relevant fields after the patient’s Medicare/DVA number has been entered into a new claim.