Introduction of mandatory arrangements for Pharmaceutical Benefits Scheme (PBS) Efficient Funding of Chemotherapy (EFC) claims
Page last updated: 5 September 2017
From 1 December 2017, Approved Suppliers will be required to enter a Compounder ID when submitting claims for eligible PBS EFC items through PBS Online. Claims submitted without a compounder ID will not be paid.
Currently Approved Suppliers have the option to select the ‘ZZZ001’ compounder ID code where the compounder ID is unknown. From 1 December 2017, this code will no longer be available. Approved Suppliers will need to ensure they know their compounder ID prior to submitting a claim.
New payment arrangements to TGA-licensed compounders will commence on 1 December 2017. The $20 component of the compounding fee will be paid based on the compounder ID included within each eligible PBS EFC infusible item.
Under the new arrangements, payments will be based on PBS line-by-line data generated from PBS EFC claims. This change is expected to reduce the administrative burden for TGA-licensed compounders who will no longer be required to submit claims data to the Chemotherapy Compounding Payment Scheme (CCPS) Administration Agency.
TGA-licensed compounders will have until 14 December 2017 to submit claims to the CCPS Administration Agency for supplies made up to and including 30 November 2017.
For items supplied on and after 1 December 2017, payments to TGA-licensed compounders will be managed through the new payment arrangements.
Further information on the CCPS, including how to obtain a compounder ID, is available on the Chemotherapy Compounding Payment Scheme (CCPS) page.