End of Life care

Pinnacle practices in the Te Whatu Ora Lakes area who do not receive Health Care Home funding can claim for this service

GPs and nurse practitioners can claim for this service provided they are set up for payments with Pinnacle.

Once a patient is assessed as being within their expected last year of life you may claim payments for a combination of 15 home or practice visits per patient provided by either the nominated general medical/nurse practitioner or registered nurse (an extension to these 15 visits may be granted if need is evidenced in the claim form).

The 15 visits may include:

• a visit on the patient’s death to sign the death certificate

In addition, an allowance for kilometres travelled may be claimed to see patients living more than a 20 km round trip from the general practice.

Should a patient require transfer to a rest home facility or be a resident in a rest home where the rest home does not provide funded general practice visits, the rest home visits may be claimed under this agreement.

You are required to:

• identify the lead general medical/nurse practitioner for each patient
• deliver all care required yourself or in conjunction with an after-hours care provider
• ensure the lead general medical/nurse practitioner is able to be contacted 24/7 by the patient and any nominated after-hours care provider and provide:
  • contact details for the after-hours provider to the patient; and
  • the patient’s contact details and clinical information to the after-hours care provider
  • a deputising service for leave cover and that service is provided with the relevant health information
• health practitioners providing the service must participate in ongoing professional education region when provided by us, hospice or other training providers.

Patients who are all of the following:

• receiving palliative care
• assessed as being within their expected last year of life
• eligible to receive publicly funded health services
• enrolled with a Pinnacle practice.

Rest home visits, for patients who are not entitled to subsidised care under their residency agreement, are also eligible for this service.   

Visits to hospice facilities are not included in this service.

This service can be utilised up until the signing of a death certificate.

Once the 12 home or practice visits have all been claimed, or prior to that, if they are no longer required. An extension to these 12 visits may be granted if need is evidenced in the claim form.

Claims are submitted in the electronic format provided by Pinnacle Midlands Health Network.

End of Life Care Visit Allowance Total prices (GST incl)

Funding is for 15 visits per patient in any combination of the following:

• GP/NP practice visit (maximum 2 visits):                                                                                                        $79
• GP/NP home visit Standard Rate (< 30 minutes):                                                                                          $126
• GP/NP home visit Premium Rate (for consultations > 30 minutes or between the hours of 10pm and 7am):        $160            
• Practice Nurse home visit:                                                                                                                              $79
• GP/NP visit to sign the death certificate:                                                                                                        $126
• Travel For travel > 20kms (single visit round trip):                                                                             0.95c per km

IRD mileage.

An extension to these 15 visits may be granted if need is evidenced in the claim form.

Please be aware this funding does not cover patients who are under the care of hospice.

Practices are required to provide sufficiently detailed consultation notes to determine appropriate use of funding.

It has been recommended that in addition to a good assessment and history, the full range of appropriate observations should be documented. It is important to state the time of consultations and interactions with the patient.

No co-payment can be charged to the patient.

From Pinnacle's flexible funding budget.