ICPSA Claim Processing Changes

Health New Zealand updated the ICPSA claim processing system on Tuesday, 7 October 2025. While the new system has been tested to ensure compatibility with Toniq Dispensary and alignment with ICPSA requirements, please be vigilant about any unexpected issues that may arise from the transition.

What’s Changing

• Error messages will be updated with clearer descriptions and standardised 4-digit codes.
  • You can find a copy of the new codes on the Health New Zealand website under Publications, Claiming Guidelines.
  • See also the attachment ICPSA Error Messages - Old and New in Error Codes for Electronic Claiming.
• Special Authority NHI Check: The new system will validate that the NHI matches the Special Authority record.
• Post-claim documentation will now be delivered via email rather than by post and will feature updated formatting and terminology. For further details regarding this, contact Health NZ directly.
• Note from Health New Zealand:

Extensive comparison testing revealed minor payment differences between the old and new systems. For context, this impacts some claim items by up to one cent and approximately 0.018% of total claims paid. Please contact the Health NZ Contact Centre (0800 855 066 or via email [e-mail]) if you have any queries about this or require more information.

What’s Staying the Same

• Claim submission via Toniq Dispensary remains unchanged.
• Payment schedules are unaffected.
• Pharmac rules and other regulations are not impacted.
• Late claim items (older than 3 months) still require Portfolio Manager approval.