Paying for patient treatment

If you’re treating a patient for an injury we cover, we’ll contribute to the cost of treatment. Find out what treatment services we’ll pay for and how much.

On this page

    When we’ll pay for your services

    We'll pay you for treating a patient’s injury as long as it’s:

    • the most suitable option for their condition
    • of acceptable quality
    • given at the right time and place, with only the necessary number of treatments needed
    • given by a provider with appropriate qualifications and a current annual practicing certificate
    • clearly documented
    • pre-approved by us (if needed).

    When we decide what we’ll pay for, we also look at:

    • the type of injury and its severity
    • if it's a generally accepted form of treatment in New Zealand
    • other options available in New Zealand to treat the injury
    • the cost and benefit to the client of each treatment option.

    If we need more information about the injury or treatment

    We may ask you for more information before we can pay you for your services, eg, your clinical records.

    How we’ll pay for your services

    You can work with us in three different ways. How and how much we’ll pay for your services depends on how you work with us.

    If you work under the Cost of Treatment Regulations

    The Cost of Treatment Regulations set out:

    • who we'll pay
    • how much we'll contribute to the cost of treatment
    • the types of treatment we'll pay for.

    Liability to Pay or Contribute to Cost of Treatment Regulations 2003

    If you work under contract

    Your contract will set out the:

    • service we're purchasing
    • amount we'll pay for the service.

    If we ask for your services by purchase order

    We may ask you to provide a service that's not included in Regulations or a contract. In this case, we'll send you a purchase order that includes the:

    • purchase order number
    • type of service and the service item code
    • date range we’ll need the service
    • amount of the service we need.

    How much we’ll pay under the Cost of Treatment Regulations

    How much we can pay towards your treatment services depends on:

    • the type of services you provide
    • if it includes procedures 
    • the type of provider you are.

    General practitioners, nurses and nurse practitioners

    If you're a general practitioner, nurse or nurse practitioner, we can contribute to two parts of your treatment services:

    1. A consultation rate – including joint consultations 

    We pay a higher rate for clients under 13 to compensate you for providing them with free visits.

    Sometimes both a nurse and a general or nurse practitioner treat a patient during the same visit. If they make relevant patient notes, we'll contribute to both of these through a joint consultation rate.

    2. Specific treatments or procedures a patient might get during a visit

    We'll only contribute to the cost of the treatment or procedures set out in the Regulations.

    ACC1520 General practitioners', nurse practitioners' and nurses' costs

    Medical specialists

    If you're a medical practitioner who practices in one or more of the recognised branches of medicine, we'll pay the amount set out in the Regulations.

    Registered specialist costs

    Specified treatment providers

    Specified treatment providers include:

    • acupuncturists
    • chiropractors
    • occupational therapists
    • osteopaths
    • physiotherapists
    • podiatrists
    • speech-language therapists.

    As a specified treatment provider, you can choose to be paid per hour or per treatment.

    ACC1523 Specified treatment provider costs

    Paid per hour

    If you're invoicing us for per hour of treatment, we'll pay for the time you spend face to face with the client.

    Minutes Rate (excluding GST) Rate (including GST)
    5 $4.84 $5.57
    10 $9.67 $11.12
    15 $14.51 $16.69
    20 $19.34 $22.24
    25 $24.18 $27.81
    30 $29.01 $33.36
    35 $33.85 $38.93
    40 $38.68 $44.48
    45 $43.52 $50.05
    50 $48.35 $55.60
    55 $53.19 $61.17
    60 $58.02 $66.72

    Paid per treatment

    This is a fixed rate per treatment. If you're treating a patient with more than one injury, you can't combine the number of treatments of the different injuries. You can only provide the number of treatments for the highest individual trigger number for the injury.

    If the client needs more treatment for those injuries, you'll need to get pre-approval from us first.

    Getting pre-approval for patient treatment


    If you're a counsellor or a counsellor who's a medical practitioner, we'll pay you a fixed hourly rate set out in the Regulations.

    Counsellor costs


    If you're a radiologist, we'll pay at a fixed rate for imaging services and treatments or procedures. How much we pay is set out in the Regulations.

    High-tech imaging services are only paid under contract.

    Radiologist costs


    If you provide dental services, we can pay for a client's consultation and treatment. How much we pay is set out in the Regulations.

    ACC1522 Dentist costs

    Treatment provider handbook

    For more information on what we'll pay for, download the treatment provider handbook.

    Treatment provider handbook

    Contact us

    If you have a problem with your invoicing or we haven’t paid you, contact us.

    Phone 0800 222 070 (Monday to Friday 7am – 7pm)

    Last reviewed: 3 July 2017