Tier 2 Non-Admitted Services Classification
The Tier 2 Non-Admitted Services Classification (Tier 2) is the current activity based funding classification for non-admitted care. Tier 2 categorises a hospital’s non-admitted services into classes which are generally based on the nature of the service provided and the type of clinician providing the service.
Tier 2 is built around the concept of clinics. Clinics are classified to one of the groups below based on the predominant nature of the service provided:
- procedures (10 series)
- medical consultation services (20 series)
- diagnostic services (30 series)
- allied health or clinical nurse specialist intervention services (40 series).
Procedures (10 series) +
The 10 series is used to capture clinics where healthcare professionals provide procedural based health services.
Medical consultation services (20 series) +
The 20 series is used to capture clinics where the nature of the medical consultation means it is typically provided by a medical practitioner, a nurse practitioner or an endorsed midwife practitioner. In medical clinics, it is assumed that there may also be input from allied health personnel and/or clinical nurse specialists.
Diagnostic services (30 series) +
The 30 series is used to capture clinics that provide diagnostic services as inputs to the healthcare services of other non-admitted clinics
Allied health and/or clinical nurse specialist intervention services (40 series) +
The 40 series is used to capture clinics where there are allied health personnel and/or clinical nurse specialists providing the majority of services in a clinic.
Patient episodes are then allocated to classes based on the predominant specialisation, which may be formed around the clinician, patient condition, patient population group or type of care.
For example, a hospital outpatient clinic which performs endoscopies will be classified to a class in the procedures category (10 series). A clinic which performs computerised tomography scans will be classified to a class in the stand-alone diagnostic services category (30 series). A clinic run by a doctor who sees patients for consultations will be classified to a class in the medical consultation services category (20 series).
The next level of the classification is the type of clinician providing the service. This could be based on the speciality or profession of the clinician. For example, a clinic run by a cardiothoracic surgeon who sees patients for consultations before and after cardiac surgery is classified to the cardiothoracic class. A clinic run by an obstetrician who sees women for consultations before they give birth is classified to the obstetrics class. A clinic run by a physiotherapist who sees patients for consultations and treatments is classified to the physiotherapy class.
There are also a number of classes for specialist clinics which treat patients with specific conditions. For example, there are classes for specialist burns clinics, transplant clinics and cystic fibrosis clinics.
Classification rules exist to guide the decision making regarding which Tier 2 class a clinic should be classified to. The Independent Health and Aged Care Pricing Authority (IHACPA) has developed a suite of reference documents to assist the consistent allocation of non-admitted services to a Tier 2 class.
Rules for coding and reporting COVID-19 episodes of care
IHACPA has issued classification advice that specifies the rules for reporting of COVID-19 in Australian hospitals, including for non-admitted care. The advice can be found in the Rules for coding and reporting COVID-19 episodes of care.
For more information about COVID-19 classification refer to the How to classify COVID-19 webpage.