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. Please refer to the accreditation exemption for non-traditional practices

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

  • $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.  

  • The practice and provider must deliver at least 2 regular services to the patient, each in a separate calendar month.  
  • The Responsible Provider must deliver at least one of the regular services. The other regular service can be delivered by either the Responsible Provider or an Alternate Provider.

In each 12-month annual care period:  

  • 2 care planning services must be delivered by the Responsible Provider.  
  • 8 regular services must be delivered. For the annual assessment, these services do not have to be delivered:  
  1. In separate months or quarters.  
  2. By the Responsible Provider. They need to be delivered by an eligible provider linked to the same practice as the patient receiving the services. 

If the Responsible Provider does not deliver the 2 care planning services by the end of the 12-month care period:  

  • the practice and the Responsible Provider will not get the Q4 payment.  
  • the Responsible Provider must deliver at least 1 care planning service in Q1 of the following 12-month care period.  

If the requirements are not met, the practice and provider will be ineligible for the Incentive payments for that patient for the remainder of the patient’s new 12-month care period.  

HPOS sends notifications to the practice and Responsible Provider:  

  • if they did not meet the annual servicing requirements for a patient by the end of Q4, to notify them of the requirements to maintain eligibility.  
  • if they fail to meet this requirement in Q1 of the following 12-month care period, to notify them that the practice and Responsible Provider are not eligible for assessment for that patient for the remainder of the patient’s new 12-month care period.  

Additional information regarding servicing requirements, including for Q4, can be found in the GPACI program guidelines here.

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

Payment Requirements

The General Practice in Aged Care Incentive (GPACI) Quarter 4 (Q4) payment requirements are different to the requirements for Q1, Q2 and Q3.  

Patients who had the GPACI added to their MyMedicare profile in the July-September 2024 quarter are now in Q4 of their 12-month care period.  

Practices and providers must familiarise themselves with the below requirements, to ensure they meet Q4 eligibility.  

If you would like further information to the below, or have any questions, please REGISTER HERE for the ‘Ask Me Anything… GPACI Q4 Payments’ webinar on 20 May 2025, 12:30pm AEST hosted by the Australian Association of Practice Managers (AAPM) in collaboration with Services Australia.  

Patients who had the GPACI added to their MyMedicare profile in the July-September 2024 quarter are now in Q4 of their 12-month care period.  

To receive Incentive payments for GPACI patients in Q4, practices and providers must deliver the GPACI quarterly servicing requirements AND the GPACI annual servicing requirements.  

Individual providers may have some patients in Q4 while other patients may be in Q1, Q2 or Q3. This is dependent on when the patient had GPACI added to their MyMedicare profile; not when the practice registered for GPACI or when the practice linked the provider to the patient as the Responsible Provider.  

It is the responsibility of the practice and the Responsible Provider to make sure they track which quarter each individual patient is in, and that all servicing requirements are met.  

It is recommended that practices and providers run an Eligibility Forecast in HPOS, particularly for patients in Q4. This will identify any servicing requirements that have not been met.  

For more information, refer to Quarterly and Annual servicing requirements or download the GPACI program guidelines here

Payments for the MyMedicare General Practice in Aged Care Incentive quarterly assessment for January – March 2025 have been processed and notifications have been sent via Health Professional Online Services (HPOS) mailboxes. The time taken to receive funds is dependent on individual financial institutions. 

  • Remember to check your HPOS notifications for any requiring action, e.g. failed payments due to missing or incorrect bank account details. 
  • *IMPORTANT MESSAGE FOR RESPONSIBLE PROVIDERS:  Add bank account details to HPOS for the MyMedicare program or GPACI payments won’t be able to be received. There are a number of providers who have not yet done this. 
  •  *REASSESSMENTS: There has been a delay in reassessing previous quarterly payments and therefore a delay in adjustments, including additional payments that practices and providers may be expecting. When reassessments have been processed, you will be notified of any adjustments to previous payments via your HPOS mailbox. 

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.

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

For GPACI, the relationship between the 3 participants is critical (the practice, the patient, and the Responsible Provider). The assessment process looks for this relationship, and anything that can potentially break or remove any of those relationships will impact GPACI payments for eligible services. If there is a change in the relationship (e.g. new responsible provider) it is important that the previous relationship is maintained in the patient’s MyMedicare profile. Removing or deleting relationships will impact past payments.   

*Note that the Responsible Provider may not be the same practitioner as the patient’s nominated Preferred GP (e.g. a registrar may be engaged to deliver RACH services).  

Below are tips on managing GPACI correctly and some cautions on what not to do (also attached as infographics). *IMPORTANT: Using actions incorrectly can impact payments, including reassessment of past payments.  

For the Incentive Period: 

  • DO select Set period and add a Start Date to add the Incentive to a patient’s MyMedicare profile.  
  • DO NOT add an End Date to the Incentive period. When a patient is withdrawn from the MyMedicare program, the system will automatically end the Incentive period. 
  • DO NOT Amend the Start Date for the Incentive period, unless it was incorrect and you understand the impact to payments.  
  • DO NOT Amend the Incentive period at the start of every new quarter.  
  • DO NOT Delete the Incentive unless it was added to the patient’s MyMedicare profile in error.    

For the Responsible Provider: 

  • DO Add the Responsible Provider and add a Start Date. 
  • DO NOT add an End Date for the Responsible Provider. If a new Responsible Provider is added, the system will automatically end the previous Responsible Provider. 
  • DO NOT Amend the Start Date for the Responsible Provider, unless it was incorrect and you understand the impact to payments.  
  • DO NOT Remove the Responsible Provider unless they were added in error.  

For the Patient: 

  • DO Register the patient for the MyMedicare program as soon as possible and no later than 28 days after receiving the consent form (or they can register themselves online). 
  • DO Add GPACI to the patient’s MyMedicare profile (as above). 
  • DO Add a new Responsible Provider if required (only add a Start Date, do not add an End Date). Adding a new Responsible Provider will automatically end the previous one. 
  • DO Add an Incentive period End Date if the Patient asks to no longer be part of GPACI (Note, this is very unlikely). 
  • DO Withdraw the patient if they ask to no longer be part of the MyMedicare program or are deceased. This will automatically end the Incentive. 
  • DO NOT Remove a Responsible Provider. It is important that previous relationships are maintained, even if the patient has a new Responsible Provider added, no longer wants to be involved in GPACI or MyMedicare, or is withdrawn from MyMedicare. Removing responsible providers will impact reassessment of past payments. 
  • DO NOT Move a patient to a new Organisation Site unless you understand the impact to payments. Moving a patient resets their MyMedicare registration date and restarts them in Quarter 1 for GPACI. 
  • DO NOT Delete GPACI from a patient’s MyMedicare profile unless the Incentive was added in error. If the patient is deceased, withdraw them from MyMedicare but do not delete the Incentive. 

We know you receive a lot of correspondence via your individual and/or organisation Health Professional Online Services (HPOS) mailboxes:  

  • While some of these may be statements or everyday notifications, some of these are important and require action. 
  • Turn on notifications to receive alerts for new messages, to save you having to check regularly for new mail. 
  • Now that the first MyMedicare Incentive is in place, please make sure you action any notifications as required, e.g. failed payments 

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 13 May 2025.