Possible claims

  • Postnatal First Partial module (inpatient or non-inpatient)
  • Postnatal Full module (inpatient or non-inpatient)
  • Postnatal Last Partial Last partial module (inpatient or non-inpatient)

Relevant clause is Section 88 - DA29

1) The fees for inpatient postnatal care may be claimed only if the woman receives inpatient postnatal care.

(2) The fees for no inpatient postnatal care may be claimed only if the woman does not receive inpatient postnatal care.

(5) A maternity provider may claim only the first partial fee if the woman was registered with the maternity provider, but changed maternity provider during the first, second or third week following birth.

(6) A maternity provider may claim only the last partial fee if the woman first registered with the maternity provider during the fourth, fifth or sixth week following birth.

(7) If subclauses (5) and (6) do not apply, the maternity provider may claim the full fee.

Although medically, the postnatal period begins immediately after the delivery of the baby, the Ministry considers the postnatal module to begin two hours after the delivery of the placenta (Section 88 p. 1043). This module is in place to compensate the care that took place following the delivery of the baby(s). Only one payment for services following birth will be paid per woman, per pregnancy except where the mother and baby have different residential address which described in further detail under Baby uplifts/Adoptions/Whangai.

The Ministry has two types of postnatal module which can be claimed, depending on how long the woman was in hospital for following the birth - inpatient and no-inpatient care.

A first partial can be claimed if care took place between the 1st, 2nd or 3rd week post-delivery

Example of this:

  • A maternity provider registers a woman one week postnatally and leaves her care on day 19, regardless of how many visits were done.

A last partial can be claimed if care took place between the 4th, 5th and 6th week post-delivery

Example of this:

  • A maternity provider registers a woman on day 22 because she just moved to a new house and discharged her woman on day 42.

A full module can be claimed if care took place from week 1 to 22+ days (Section 88 p. 1071 part 7).

Example of this:

  • A maternity provider cares for a woman throughout her whole pregnancy, provides postnatal care, the woman is low needs so the maternity provider discharges her from her care at day 28.

A few points to note in relation to the postnatal module are that a maternity provider may claim up to two weeks of postnatal care following a miscarriage or termination (Section 88 p. 1039 part b subclause iv). Another point is that if a woman transfers from one hospital directly to another following the birth, the woman is considered to still be an inpatient. Or if the woman births at home (unplanned home birth) and transfers to hospital shortly after delivery, stays longer than 12 hours after the delivery of the placenta, this is also inpatient care.

During the services following birth module, a minimum of 7 visits should be made to the woman and her baby, 5 of which must be in the woman’s home. It is important to remember that a phone call does not count as a visit.