Written answers
Wednesday, 11 March 2015
Department of Health
General Medical Services Scheme Payments
Michael McGrath (Cork South Central, Fianna Fail)
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99. To ask the Minister for Health if he will provide in tabular form the current capitation fees paid to general practitioners in respect of medical card holders under the general medical services scheme by category of medical card holder; and if he will make a statement on the matter. [10648/15]
Kathleen Lynch (Cork North Central, Labour)
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Under the General Medical Services (GMS) contract, GPs are reimbursed by the HSE's Primary Care Reimbursement Service for a range of services they provide to medical card and GP visit card holders. The current fee and allowance rates are set out in S.I. 277/2013 - Health Professionals (Reduction of Payments to General Practitioners) Regulations 2013, which are available on line at: .
The payments include an annual capitation payment in respect of each patient on the GP’s GMS list, irrespective of how many times they visit their doctor during the year. The capitation payment is based on the age and gender of the patient and if the patient is aged 70 years or more, whether they are residing in the community or in residential care.
The Capitation rates, which are listed at Schedule 1 of S.I. 277/2013 are set out in the following table:
SCHEDULE 1
Services rendered under the General Medical Services Scheme - Capitation Agreement - general practitioner capitation rates (all amounts inclusive of the former practice maintenance, equipment and development and former payments in respect of discretionary medical cards)
| Reference Number (1) | Description (2) | Amount(3) |
|---|---|---|
| 1 | Male patient aged under 5 years | € 74.59 |
| 2 | Male patient aged 5 years or more and less than 16 years | € 43.29 |
| 3 | Male patient aged 16 years or more and less than 45 years | € 55.26 |
| 4 | Male patient aged 45 years or more and less than 65 years | € 110.38 |
| 5 | Male patient aged 65 years or more and less than 70 years | € 116.00 |
| 6 | Patient aged 70 years or more residing in the community | € 271.62 |
| 7 | Patient aged 70 years or more residing in a private nursing home (approved by the HSE) for continuous periods in excess of 5 weeks | € 434.15 |
| 8 | Female patient aged under 5 years | € 72.76 |
| 9 | Female patient aged 5 years or more and less than 16 years | € 43.79 |
| 10 | Female patient aged 16 years or more and less than 45 years | € 90.37 |
| 11 | Female patient aged 45 years or more and less than 65 years | € 121.29 |
| 12 | Female patient aged 65 years or more and less than 70 years | € 129.72 |
| 13 | Supplementary out-of-hours fee | € 3.64 |
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