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Read the 7th Community Pharmacy Agreement on the Department of Health website.
What prescriptions are eligible
You can be paid the $0.15 fee for electronic:
- Pharmaceutical Benefits Scheme prescriptions
- Repatriation Pharmaceutical Benefits Scheme prescriptions
- under co-payment prescriptions
- repeat authorisations or deferred supply, if the original prescription was electronic.
Private prescriptions are not eligible for the fee.
To be eligible for the electronic prescription fee, prescriptions must be:
- uploaded by a prescriber to a Prescription Exchange Service (PES) or uploaded by a prescriber using e-Prescribing
- downloaded by an approved supplier from the PES with an Electronic Prescription Flag, also known as Script Qualifying Flag
- supplied by the approved supplier, with the dispensing records being uploaded to the PES for each item supplied, or supplied by the approved supplier using e-Prescribing.
You need to include these for each prescription you download.
Make sure you keep all prescriptions and claim-related paperwork for 2 years for audits and verifications. You can keep records in electronic or paper form.
Read more about compliance requirements when you make a claim through PBS online.
How to claim the fee
To get the fee the prescription must be claimed via PBS Online and not as a manual claim.
If your pharmacy’s dispensing software doesn’t have a prescription exchange service, you can talk to your software developer.
How we confirm your fee payments
Fee payments will appear in your PBS claims reports and reconciliation statements when we’ve paid you. We’ll include identifiers for fees and incentive payments for each prescription.
When we won't pay you the fee
You’ll get a rejection or warning reason code if we don’t pay you the fee. The following reason codes relate to claims for the electronic prescription fee.
615 Reject - The electronic prescription flag is not valid
This is when the electronic prescription flag you've sent isn't valid and that we'll only accept Y, N or U.
616 Warning - The prescription exchange service identifier (PES ID) is not provided.
This is when you’ve sent an electronic prescription Y flag but no prescription exchange service ID. We’ll still assess the prescription but not the electronic prescription fee when this happens.
618 Reject - The prescription exchange service identifier (PES ID) provided is not valid
This is when you’ve sent us your electronic Y prescription flag but didn’t use the correct PES ID format. The PES ID must have the 3 valid alphabetic characters.
Speak to your software developer if you get any of these warning or reason codes. You can also contact PBS general enquiries if you need more information.
Read more about understanding reason and rejection codes.