Scripts dispensed under the Closing the Gap (CTG) PBS Co-payment Program are verified by PBS Online 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.

Please refer to the below table for an explanation of PBS Online reason codes related to the CTG PBS Co-payment program.

CTG PBS Online reason codes

Reason codeDescriptionDispenser action required
R810The patient is not registered for CTG with Services Australia The prescriber must register the patientas CTG so that the patient can access CTG prescriptions.

 

If the patient is not eligible for CTG:

  1. Dispenser should manually uncheck the CTG patient flag in the patient's profile.
  2. Edit the script and remove the value from the CTG field, then resubmit as a non-CTG script.
R811Patient is CTG eligible
  1. Edit the rejected script and check the CTG checkbox, then resubmit as a CTG script.
Note: Minfos will automatically check the CTG checkbox in the patient’s profile.
R812Supplier type ineligible for CTG

  1. Dispenser should edit the rejected script and remove the value from the CTG field.

  2. Resubmit script as non-CTG.*
R813Payment category ineligible for CTG
  1. Dispenser should edit the rejected script and remove the value from the CTG field.
  2. Resubmit script as non-CTG.*
R814Program code ineligible for CTG
  1. Dispenser should edit the rejected script and remove the value from the CTG field.
  2. Resubmit script as non-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, check or uncheck the CTG checkbox in the Customer Editing window.

When the CTG checkbox is checked in the patient’s profile, and the selected item is eligible to be claimed under the CTG program, Minfos will automatically select the CTG checkbox on the Dispense Form. When the status of the CTG checkbox is changed the price to customer will update accordingly.

Note
From 1 July 2024 the CTG PBS Co-Payment Program also applies to Section 100 PBS medicines when dispensed by a community pharmacy, approved medical practitioner or private hospital.

When a customer has the CTG flag ticked in their profile and an S100 item drug is selected, the dispenser must tick the CTG flag in the dispense form manually.

Minfos version 8.1.1 (expected to be released in July) contains an enhancement to automate this process. After you update to Minfos version 8.1.1, when a S100 drug is selected for a customer that has CTG ticked in their profile, Minfos will automatically tick the CTG flag in the dispense form. 

Refer to Changes to the CTG PBS Co-Payment Program from 1 July 2024 for further details.

The dispenser can choose to manually change the status of the CTG checkbox. Either check or uncheck the CTG checkbox or press [Alt + \].

Items that are not eligible to be claimed under the CTG program are: 


  • Doctor's Bag 

If a patient’s profile has the CTG checkbox checked and is dispensed one of these items Minfos will not automatically check the CTG checkbox on the Dispense Form.

Further information

For further information please refer to the resources below: