Stoma Appliance Scheme
If you’re a member of an Australian stoma association you can access stoma-related products for free using the Stoma Appliance Scheme (SAS).
To access the SAS you need to:
- live in Australia or be an eligible overseas resident
- be eligible for Medicare or Department of Veterans’ Affairs benefits
- have a temporary or permanent artificial body opening which helps remove urine and products of the gastrointestinal tract
- be a member of an approved stoma association
- have a SAS entitlement card issued by an approved stoma association.
You can’t get stoma products if you’re an:
- Australian citizen living outside Australia
- Australian citizen absent from Australia for more than 12 months.
Find out more about the Stoma Appliance Scheme on the Department of Health website.
To register for the SAS you need to:
- complete part 1 of the Stoma Appliance Scheme application form (PB049)
- give the form to your medical practitioner or Stomal Therapy Nurse (STN) so they can complete part 2
- send the completed form to your nominated stoma association.
Your STN or medical practitioner will suggest suitable products for your condition.
Department of Health approves products issued to SAS members using the Stoma Appliance Scheme Schedule.
The schedule tells you more about:
- the maximum quantity you can receive each month
- the products
- any restrictions using certain products.
Items not listed on the schedule aren’t subsidised. You’ll need to pay for them.
If you need more products ask your STN or medical practitioner to help you complete:
- a medical supply certificate stating the clinical reasons you need more supplies, product types and quantities
- an Application for additional stoma supplies form (PB050).
Send the documents to your stoma association. They’ll forward it to us. The additional supply certificate is valid for 6 months.
Travelling with stoma products
If you’re travelling within Australia, you can ask the stoma association in the area you’re visiting to supply you with stoma products. You can use your SAS entitlement card at any approved stoma association.
Make sure you contact the association before you leave to check your products are in stock.
You can also request up to 2 months’ supply in advance by:
- completing an Application for additional stoma supplies form (PB050) with help from your STN or medical practitioner
- sending the completed form to your stoma association.
If you’re travelling overseas, you can get up to 6 months’ supply. You’ll need to give your association proof of travel.
Information for stoma associations
As a stoma association we’ll reimburse you for the cost of products you’ve supplied to your members. You need to complete these forms and give them to us with an electronic copy of supporting claim information:
- Claim for payment Stoma Appliance Scheme form (PB043) signed by an authorised representative of your association, see table below for details
- Supply of stoma appliances form (PB046) signed by the patient or someone that can deal with us on their behalf* when they collect the items. If you’ve sent products, you need to let us know on the form (for example note ‘certified despatched’), see table below for details.
If your form is incomplete, it may delay payment.
*Find out how patients can have someone to deal with us on their behalf.
This table provides information about resources you’ll need as a stoma association, and how to access them.
|Form name||Form number||What you need it for||Where you can get it|
|Claim for payment – Stoma Appliance Scheme||PB043||Use this form to claim reimbursement from us for items you’ve supplied.||You can request forms from
The Camerons Group by calling 02 9933 4456 then returning by fax to
02 9933 4441.Orders are sent within 2 business days.
|Supply of stoma appliances and pharmaceutical preparations||PB046||Use this form to record all items you’ve supplied to members.|
|Stoma Appliance Scheme Entitlement Card||PB044||You need to give this card to people registered for the SAS.|
|Stoma Appliance Dual Entitlement Card||PB045||You need to give this card to people registered for the SAS who have more than one stoma and need extra products.|
Note: authorised paraplegic and quadriplegic associations can use some of these forms. For more information see the Paraplegic and Quadriplegic Program.
Non-departmental forms for irrigation kits, tieman tip catheters, ace stoppers and silicone spray need special authorisation from an STN or medical practitioner before the approved stoma association can supply the items.
Understanding reason codes
If there’s an issue with an item in your claim you may get a reason code reflected on your PBS Reconciliation Statement.
This could be because the information in your claim was incorrect or incomplete.
The codes provide you with feedback to assist you with future claiming. The table below will help you understand the reasons codes.
There are 3 types of reason codes:
- R - Reject
- W - Warning
- I - Information.
You will not be paid for items allocated a reject reason code.
If you need more information contact the PBS Complex Drugs Programs enquiry line.
|Reason code||Reason type code||Reason text|
|15||I||The Ostomy item has been successfully cancelled.|
|29||W||Form type was not provided or is invalid – should be ‘1’ original for Ostomy.|
|41||R||The serial number was not provided or the serial number provided is invalid. Provided as < >.|
|42||W||Duplicate serial number.|
|50||R||Date of supply provided is invalid.|
|53||R||The item code provided is invalid.|
|55||W||The brand provided is invalid. Provided as < >.|
|56||R||The quantity was not provided or the quantity provided is invalid. Provided as < >.|
|92||R||The date of supply of the ostomy item is after the revocation date for the ostomy association.|
|93||R||The date of supply of the ostomy item is after the suspension date for the ostomy association.|
|94||R||The date of supply of the ostomy item is prior to the approval start date for the ostomy association.|
|100||W||The date of supply of the ostomy item is after the approval end date for the ostomy association.|
|101||R||The item code provided is not an ostomy item.|
|102||R||Association type is not authorised to supply this item type. Item type is < >.|
|103||W||Ostomy patient ID has not been provided.|
|105||R||The patient identifier provided is invalid. Provided as < >.|
|106||R||The supplied quantity for this item exceeds the schedule maximum quantity.|
|138||W||Item < > on the item/brand translation table.|
|141||R||The item provided was not a benefit as at the date of supply.|
|142||W||The brand provided was not found on the Stoma Schedule at the date of supply. Brand will be ignored.|
|144||W||The scheduled quantity for this item exceeds the schedule maximum quantity.|
|158||W||The supplied quantity for this item exceeds the maximum quantity amount authorised.|
|298||R||The date of supply provided is invalid. Provided as < >.|
|299||R||A date of supply was not provided.|
|346||W||The ostomy claim form was not signed by and/or dated by the patient/agent.|
|434||R||Claim paperwork is inaccurate or incomplete.|
|597||R||The date of supply is greater than 2 years old.|
Members of approved stoma associations receive stoma-related products free of charge. Stoma associations purchase products and distribute them to their members as needed.
Department of Health approves stoma associations under the Stoma Appliance Scheme (SAS).
Read about the Australian Council of Stoma Associations.
Page last updated: 12 June 2020
This information was printed 4 July 2020 from https://www.servicesaustralia.gov.au/organisations/health-professionals/services/medicare/stoma-appliance-scheme. It may not include all of the relevant information on this topic. Please consider any relevant site notices at https://www.servicesaustralia.gov.au/individuals/site-notices when using this material.