From 1 July 2021, there are changes to the Closing the Gap (CTG) PBS Co-payment Program.
PBS prescribers will no longer be legally required to write or electronically print ‘CTG’ on eligible PBS prescriptions for registered Aboriginal and Torres Strait Islander people. Instead, when a claim is made PBS Online will verify the CTG status of the patient in real-time.
If the script has been claimed as CTG, i.e. a CTG value was entered in CTG field on the dispense form, the patient is registered for the program and the script is eligible to be claimed as CTG, the claim will be processed and the PBS response will be Accepted.
If the script has not been claimed as CTG, but the patient is registered for the program and the script is eligible to be claimed as CTG, the claim will be rejected and will need to be resubmitted. In this case, the PBS response will be Rejected.
New PBS Online reason codes have been added to support the enhancement to the Closing the Gap (CTG) PBS Co-payment Program. Please refer to the below table for an explanation of each new reason code.
New CTG PBS Online reason codes
|Reason code||Description||Dispenser action required|
|W810||The patient is not registered for CTG with Services Australia||This warning will become a rejection on the 1st of October 2021. This warning does not affect the claim, but the prescriber must register the patient as CTG before 30 September 2021 so that the patient can continue to access CTG prescriptions.|
If the patient is not eligible for CTG:
|R811||Patient is CTG eligible|
|R812||Supplier type ineligible for CTG|
|R813||Payment category ineligible for CTG|
|R814||Program code ineligible or CTG|
* Note: The patient is registered in the program. However, the script is not eligible for claiming under the CTG program - refer to rejection code.
Edit a patient's CTG status in Minfos
To change a patient's CTG status in Minfos ongoing, select or unselect the CTG checkbox in the Customer Editing screen.
Edit the CTG status of a selected script by entering or removing the CTG value 'H' in the Minfos Dispense Form.
For further information please refer to the below resources.