MyMedicare and the General Practice in Aged Care Incentive

The General Practice in Aged Care Incentive offers incentive payments to primary health care providers for delivering regular visits and care planning to people in residential aged care homes.

The General Practice in Aged Care Incentive (GP ACI) began on 1 July 2024, offering incentive payments to general practices and practitioners for conducting regular visits and care planning for permanent residents living in residential aged care homes (RACHs). MyMedicare registration is voluntary for patients, practices and providers. Practices can register for MyMedicare and start enrolling patients today.

About the General Practice in Aged Care Incentive

The General Practice in Aged Care Incentive aims to strengthen and formalise relationships between residents and their primary care provider, or general practice. To participate in this incentive, practices need to be registered in the Organisation Register, and providers need to be linked to their MyMedicare registered practice.

Learn more by watching the short video series (2 – 5 minute) produced by South East Melbourne PHN featuring Dr Billy Stoupas who provides a short overview of MyMedicare and the General Practice in Aged Care Incentive from a GP perspective:

Practice Registration Process

To register for the General Practice in Aged Care Incentive, please refer to the following steps:

  1. Log into your PRODA to access your organisation’s HPOS account
  2. Go to the Organisation Site Record and select the MyMedicare Program Registration tab
  3. Add or verify bank account details under “Details” then “Add Banking Details” (you may need to wait 24 hours to proceed)
  4. Navigate to “Program Registration,” choose “New Program,” then select “MyMedicare GP ACI” and click “Add program”
  5. Review the information on the view-only screen, check the declaration and click “Save”

Business Modelling and Service Delivery

Eligible GPs and practices will receive an incentive payment quarterly if they are registered with MyMedicare, and meet the General Practice in Aged Care Incentive eligibility and servicing requirements. 

Patients must be a permanent resident of an aged care home, registered with MyMedicare and identified by the responsible GP and practice to participate in the incentive as outlined in the General Practice in Aged Care Incentive Program Guidelines

Payments Structure:  

  • $300 per patient, per year, paid to the responsible GP, and 
  • $130 per patient, per year, paid to the practice. 

The payments will be quarterly, in addition to existing Medicare Benefits Scheme (MBS) and Department of Veterans’ Affairs (DVA) rebates for services delivered. Incentive service requirements:

  • Two eligible care planning service per year 
  • Eight eligible regular visits per year (at least two eligible regular services per quarter)

GPACI Incentive Payment Structure. Image sourced from the Department of Health and Aged Care.

Service Delivery and Financial Modelling

The latest version of the General Practice in Aged Care (GP ACI) User Guide includes after-hours MBS item numbers and an example of triple bulk-billing benefits.

This resource provides a quick reference guide for general practices with examples of how to use MBS items to meet quarterly and annual service delivery requirements for GP ACI.

How to use the guide 

To use the guide in your practice, simply select the Sample Schedule and Example Annual Cycle billing scenario that best suits your practice team and setting. 

There are three main general practice Sample schedules (pages 3-8) reflected in this user guide: 

  1. Responsible provider only: where a single GP delivers all care to the resident
  2. Responsible provider and alternative provider: where other members of the practice team also deliver care to the resident including other GPs, Prescribed medical practitioners and Nurse practitioners
  3. Responsible provider and other care team members: where other members of the practice team also include visits delivered by practice nurses or Aboriginal Health Workers, in addition to other GPs, Prescribed medical practitioners and Nurse practitioners. 

The guide incorporates a variation of sample schedules that describes how telehealth items could be billed for practices in MMM 4 – 7. The guide also includes Example Annual Cycle including estimated billings (pages 11 -14) to support your practice to deliver the proactive and regular planned care required to meet the General Practice in Aged Care Incentive. On page 15 there is an example of triple bulk billing incentives. 

There are a range of ways your practice could use the guide including: 

  1. Identify the Sample Schedule and Example Annual Cycle billing scenario that best suits your practice team and setting. Print these or share them with your practice team to inform care planning for the General Practice in Aged Care Incentive. 
  2. Review your historical billing practices for Residential Aged Care Home patients and use the guide to develop a quick PDSA (Plan – Do – Study – Act) to identify any improvements you could make to billing and care practices. 
  3. Plan care for your residential aged care patients 3 – 6 months ahead by booking appointments for residential aged care visits each month using the Example Annual Cycle as a guide. Consider how you can group visits to a residential aged care home in your practice booking system to maximise efficiency of clinician time. 
  4. Meet with your practice team to reflect on the guide, and identify opportunities for practice nurses, Aboriginal health workers and other doctors to support or deliver care. For example, could practice nurses work alongside doctors at aged care visits to work up care planning and make the visit more efficient for your practice, residential aged care homes, and patients you care for that are residents of aged care homes?   

Please also refer to the forecast payments and eligibility for GP ACI for providers and practices to check the GP ACI incentive requirements.

Resources for general practices

Resources for providers

Patient Registration Process

If your practice is planning to participate in the General Practice in Aged Care Incentive, you may be considering the practicalities of how to sign up your patients living in an aged care home for MyMedicare.

There are several approaches to how your practice can do this and we’ve provided a few options for you to consider and adapt to suit your practice setting below. The first step is to make sure your practice is signed up to MyMedicare beforehand. Services Australia has created valuable resources about how to sign up your practice.

This option allows your practice to start patient registration for MyMedicare through HPOS. Registration can be finalised by a patient (or an appropriate carer or family member) through their Medicare Online Account or Express Plus Medicare Mobile app.

This option will only work for patients who have a Medicare Online Account set up to receive digital notifications. If they don’t have an online account, you will receive an error message in HPOS. If this occurs, you can contact them to encourage them to set up an online account or use the approach outlined in option two or three.

  • Step 1 – start the registration process for MyMedicare via HPOS through the ‘My Programs’ tab by selecting the MyMedicare tile
  • Step 2 – search for a known patient and start their registration with your practice. This will send the patient (or their carer or family member) a notification in their Medicare Online Account or Express Plus Medicare Mobile app
  • Step 3 – the patient (or their carer or family) uses their online account or app to finalise their MyMedicare registration with your practice
  • Details of how to complete these steps are available through the Services Australia e-learning package (see pages 15 – 18)

This option allows your practice to partially complete a MyMedicare registration form with patient details from your practice software for patients, carers or guardians to sign to consent to MyMedicare registration with your practice.

Most general practice software has a function that will pre-populate a MyMedicare registration template for individual patients or mail merge a list of patients onto the MyMedicare Registration forms. You can use this functionality to complete a form for each residential aged care patient, print and have patients or their guardian sign them.

It is essential for MyMedicare GPs to obtain consent from residential aged care patients or their representatives for MyMedicare voluntary patient registration, ensuring it is securely stored in the patient’s medical records to comply with legal and care standards. You can read more about the requirements for health service providers under the Privacy Act 1988 by visiting the Australian Government’s Office of the Australian Information Commissioner’s Guide to health privacy

You can contact our Virtual Support team at support@wentwest.com.au to request a mail merge MyMedicare registration form in Microsoft Word format. 

Patients can register themselves, or their family or carer can also support them in completing a MyMedicare registration form or registering online through Medicare Online Account or the Express Plus Medicare Mobile app

  • Step 1 – develop a list of your residential aged care home patients using your clinical software. You may already have a list or you can search your practice software for addresses of residential aged care homes you deliver care to, or for MBS items that are exclusive to residential aged care homes (e.g. 90020, 90035, 90043)
  • Step 2 – decide on how you wish to communicate to encourage patients to register to MyMedicare, such as:
    • Sending an SMS, email or letter to the patient or their guardian
    • Engaging with residential aged care homes to encourage residents and their guardians to register
    • Discussing MyMedicare registration with patients and their guardians next time you visit the residential aged care home and providing a brochure or information to help them complete their registration
  • Step 3 – you may need to accept the registration in HPOS (see pages 5-14 of the Managing Patient Registrations e-learning package) 

Once your patients are registered, you can add them to the General Practice in Aged Care Incentive patient incentive indicator (see page 27 of Managing patient registrations).

How Can We Support Your Practice with GP ACI?

Our Primary Care Delivery team can support by: 

  • Providing an in-depth overview of the benefits and features of GP ACI
  • Providing resources to support and increase awareness about GP ACI amongst staff and RACH patients/carers and providers
  • Assisting with the MyMedicare registration process at a time that is convenient to your practice schedule
  • Identifying RACH patients who would benefit from MyMedicare and GP ACI
  • Helping your practice select billing guides, optimise billing practices, schedule aged care visits and foster team collaboration to streamline care delivery

Practices and providers are encouraged to contact our team if they need further information on eligibility or registration. You can contact your Practice Development Coordinator/Facilitator directly or email support@wentwest.com.au

Resources and More Information

Additional support

For more information and support, please contact the following teams. Details are in Australian Eastern Standard Time (AEST).

ContactDetails
Provider Digital Access (PRODA)Phone: 1800 700 199 and select option 1
Available Monday to Friday, 8am to 5pm
Services Australia – Health Professional Online Services (HPOS)Phone: 132 150 and select option 6
Available Monday to Friday, 10am to 7pm
Services Australia – MyMedicare Provider Enquiry LinePhone: 132 150 and select option 2
Available Monday to Friday, 8:30am to 5:00pm
Services Australia – Incentive programsPhone: 1800 222 032
Available Monday to Friday, 9:00am to 5:30pm
Virtual Support team – Western Sydney Primary Health Network Phone: 02 8811 7100 and select option 2
Email: support@wentwest.com.au
Available Monday to Friday, 9am to 5pm

Information is correct as of 9:30am, 20 September 2024.