The CTG PBS Co-payment program was established in July 2010 to improve access to affordable PBS medicines for Aboriginal and Torres Strait Islander people living with, or at risk of, chronic disease, and who in their doctor’s opinion would experience setbacks in the prevention or ongoing management of chronic disease if they did not take the prescribed medicine and would be unlikely to adhere to their medicines regimen without assistance through the program.

From 1 July 2021:

  • A new centralised patient registration database for the program, managed by Services Australia, went live.
  • Any PBS prescriber or AHPRA registered Aboriginal and Torres Strait Islander Health Practitioner registered with Medicare as a provider can register eligible Aboriginal and Torres Strait Islander people for the program
  • Eligible Aboriginal and Torres Strait Islander people can be registered for the program no matter where they live, and regardless of their chronic disease status.
  • Registration of eligible Aboriginal and Torres Strait Islander people will be via the Health Professional Online Services (HPOS).
  • 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. However, annotation of a PBS script will help community and Section 94 Approved Private Hospital pharmacists, when dispensing the medicines, know that the patient is registered for the program.
  • Any PBS prescriber can issue PBS General Schedule medicine prescriptions for Aboriginal and Torres Strait Islander people that are registered for the program.
  • PBS prescriptions issued by PBS prescribers within public hospitals will now be eligible to be dispensed by any community pharmacy or Section 94 Approved Private Hospital pharmacy.
  • If Aboriginal and Torres Strait Islander people are registered for the program the PBS Online claiming system will verify this in real time. If the “Closing The Gap’ field in the dispensing system has been completed, this will trigger the correct pricing. If that field has not been completed, a claim will be rejected and will need to be resubmitted.
  • Section 94 Approved Private Hospital pharmacies can still dispense PBS prescriptions covered under the program.
  • Section 94 Public Hospital pharmacies will still not be able to dispense PBS prescriptions covered under the program.
Reason code 810 will appear if the patient is not registered on this database. From 12/7/2021, the Reason code 810 changed from a Rejection to a Warning. This will continue until 30/9/2021, after which time it will become a Rejection code again.

The effect of the warning will mean that the prescription will be processed with the reduced copayment (as though the patient was registered) and would give the patient until 30 September 2021 to consult with their prescriber regarding their registration.

Where brand premiums apply to a PBS medicine covered under this program, Aboriginal and Torres Strait Islander people will need to pay the brand premium at the time of dispensing.

New reason codes will be provided for PBS claiming which will also indicate to a pharmacist whether or not Aboriginal and Torres Strait Islander people are registered for the program whilst dispensing a PBS General Schedule prescription.

Dispensing Close the Gap Prescriptions:

There is no longer a requirement to enter a CTG serial number into the dispensing software. This change is being addressed in Merlin. In the meantime, in the absence of a CTG Serial Number, the default code CTG00B should be entered as the Serial number.