Stoma Appliance Scheme information for stoma associations

You can claim a reimbursement for products you supply to your members under the Stoma Appliance Scheme (SAS).

Read about the Stoma Appliance Scheme on the Department of Health and Aged Care website.

Before you claim a SAS reimbursement

Your members need to apply to be eligible to get stoma products under the SAS. Their medical practitioner or stomal therapy nurse can help them apply. They need to:

If your members need additional stoma products or an advance supply, their medical practitioner or stomal therapy nurse can help them complete the Stoma Appliance Scheme application for additional supplies for clinical and other reasons form (PB050).

Claim a SAS reimbursement

You can claim a reimbursement for products you’ve supplied to your members under the SAS.

To claim a reimbursement, upload your electronic claim file through Health Professional Online Services (HPOS).

You'll need a PRODA account to access HPOS. If you don’t have one, register for an Individual account. You’ll also need to register your association as an organisation in PRODA and then link the account to HPOS.

You no longer need to send us copies of the claim paperwork or patient forms PB049 and PB050. Please keep them on record for 2 years.

Reason codes

After we’ve processed your claim, you’ll receive a Reconciliation Statement. The statement will include reason codes to assist you to correct claiming issues and explain the amount you’ve been paid. There are 3 types of reason codes:

  • R – Reject
  • W – Warning
  • X – Time based warning, returning as a warning (W) for a set time period of 90 days. After this time the reason code will be returned as a reject.

Use this filter to search for reason codes.

Reason code Reason type Reason text
029 W Form type was not provided or is invalid - should be '1' original for ostomy.
041 R The serial number was not provided or the serial number provided is invalid - provided as <>.
042 R Duplicate serial number.
050 R Date of supply provided is invalid.
053 R The item code provided is invalid.
055 R The brand provided is invalid - provided as <>.
056 R The quantity was not provided or the quantity provided is invalid - provided as <>.
092 R The date of supply of the ostomy item is after the revocation date for the Ostomy Association.
093 R The date of supply of the ostomy item is after the suspension date for the Ostomy Association.
094 R The date of supply of the ostomy item is prior to the approval start date for the Ostomy Association.
100 R 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.
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 supplied quantity for this item exceeds the schedule maximum quantity.
158 R The supplied quantity for this item exceeds the maximum quantity amount authorised.
205 X The Medicare number provided is invalid - provided as <>.
206 X The DVA number provided contains invalid characters - provided as <>.
207 R The passport number provided contains invalid characters - provided as <>.
212 R The patient’s date of birth is an invalid date - provided as <>.
213 R The Norfolk Island additional supply indicator should be Y or N.
214 R The Norfolk Island additional supply amount is invalid.
215 R The remote patient additional supply indicator should be Y or N.
216 R The remote patient additional supply amount is invalid.
217 R The remote patient additional supply end date is invalid.
218 R The holiday additional supply indicator should be Y or N.
219 R The holiday additional supply amount is invalid.
220 R The holiday additional supply end date is invalid.
221 R The clinical additional supply indicator should be Y or N.
222 R The clinical additional supply amount is invalid.
223 R The clinical additional supply Department of Health indicator should be Y or N.
224 R The clinical additional supply end date is invalid.
229 W Item identified as a possible duplicate based on Medicare number, item, supply date and quantity.
230 W Item identified as a possible duplicate based on Medicare number, item and supply date.
231 R The Norfolk Island additional supply indicator and data provided do not correspond.
232 R The remotely located additional supply indicator and data provided do not correspond.
233 R The holiday additional supply indicator and data provided do not correspond.
234 R The clinical additional supply indicator and data provided do not correspond.
235 R The clinical additional supply factor provided must be supported with approval from the Department of Health.
240 R The date of supply is after the remotely located additional supply end date.
241 R The number of months supplied for the Norfolk Island additional supply exceeds the maximum permitted.
242 R The number of months supplied for the remotely located additional supply exceeds the maximum permitted.
243 R The number of months supplied for the holiday additional supply exceeds the maximum permitted.
247 R The date of supply and months requested in the holiday additional supply exceeds the approval end date.
248 X The Medicare number provided is invalid.
252 X The Medicare number provided is not current at date of supply.
253 X The patient Medicare reference number provided in the claim was invalid.
254 X Check patient reference and card issue numbers, names matched on the first 9 digits of Medicare number.
255 X The Medicare number provided does not exist.
256 X The Medicare number provided matched on surname only.
257 X The Medicare number provided matched on first name only.
258 X The Medicare number could not be matched with either the patient first name or surname provided.
260 X The Medicare number provided has been reported stolen and has been cancelled.
261 X The Medicare number provided has been reported lost and has been cancelled.
262 R Medicare eligibility cannot be determined.
263 X Medicare eligibility cannot be determined.
264 X The DVA repatriation health card number provided is invalid.
265 X The DVA repatriation health card number provided does not exist.
267 R The patient's Medicare number, DVA number or passport number was not provided. One of these identifiers are mandatory.
268 R The Medicare number is valid, but no further checks applied as first name and surname not provided.
269 R The Medicare number could not be confirmed, as first name and surname was not provided
298 R The date of supply provided is invalid - provided as <>.
299 R A date of supply was not provided.
597 R The date of supply is greater than 2 years old.

For more information about SAS

To ask about a SAS claim, contact the PBS Complex Drugs Programs enquiry line.

Read about the Stoma Appliance Scheme on the Department of Health and Aged Care website.

Page last updated: 7 July 2022.
QC 23371

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