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Hospital Substitute Treatment (HST) claims for Medicare 011-43010080

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This page contains the process for claims for Hospital Substitute Treatment (HST) presented either over the counter, or by mail.

Processing claims for HST presented over the counter or via mail

This table describes the process for actioning claims for HST presented either over the counter or by mail.

Expand table

Step

Action

1

Determine if account endorsed by private health insurer

Is the account endorsed by private health insurer?

  • Yes, process claim as an in-patient service adding 'H' to item number and pay at 75%
  • No, go to Step 2

2

Determine if account lodged with private health insurer

Has the claimant (contact if received via mail) lodge the account with their private health insurer?

  • Yes, process the claim as an inpatient service adding 'H' to the item number and pay at 75%
  • No, return the account to the claimant informing them to lodge with their private health insurer first