The department has reviewed and considered stakeholder feedback and concerns on changes to the format for Prescribed List billing code.
Taking the feedback into consideration, we have finalised the billing code format, which will be effective from the March 2025 Prescribed List:
AXNNN
Where:
- X represents an alpha or numeric character
- AX remains as the sponsor-specific prefix
In this way, the AA sponsor-specific prefix will continue to be used until the NNN combinations are exhausted for a particular sponsor.
The AXNNN format:
- represents a low-complexity system change
- is compatible with HCP and Eclipse systems
- allows sponsors to keep using their AA sponsor-specific prefixes until combinations are exhausted
- accommodates the preference for sponsor-specific codes prefixes
- provides 260 sponsor-specific prefix combinations that will last 8-10 years based on the current rate of allocation
Stakeholders are required to update their systems to be ready to consume the Prescribed List from 1 March 2025.
More information on the implementation of this format and a test XML file can be downloaded from Consultation Hub.
Any issues must be emailed to prescribedlist.reforms@health.gov.au by 2 December 2024. After this date, compatibility with stakeholder business systems will be assumed as no further changes will be accommodated.