MyMedicare timeline
MyMedicare is a new voluntary patient registration model. It aims to formalise the relationship between patients, their general practice, general practitioner (GP) and primary care teams.
MyMedicare: key processes and resources
- About
- Eligibility
- How to register General Practices
- Linking an organisation in PRODA
- Managing patient registration
- Resources for GPs and health care providers
MyMedicare is a voluntary patient registration model. It aims to strengthen the relationship between patients, their general practice, general practitioner (GP) and primary care teams.
Video provided by the Australian Department of Health and Aged Care.
Eligibility for general practices
To be eligible for MyMedicare, general practices must:
- provide Medicare-funded services
- be registered in Provider Digital Access (PRODA)
- be registered with Health Professional Online Services (HPOS)
- be registered on the Organisation Register in HPOS
- have at least one eligible provider linked to the practice in the Organisation Register - eligible providers can be a vocationally registered general practitioner (GP), non-vocationally registered GP or a GP registrar
- be accredited against the National General Practice Accreditation Scheme - non-accredited practices will have 12 months to register with an accreditation agency and gain accreditation.
Read more about National General Practice Accreditation Scheme on the Australian Commission on Safety and Quality in Healthcare website.
For more information and support on accreditation processes, visit the Australian Commission on Safety and Quality in Health Care.
Eligibility for health care providers
To be eligible for MyMedicare, providers must:
- work at a MyMedicare eligible practice
- be linked to the practice on the Organisation Register
- have a valid provider number and be eligible to deliver Medicare Benefits Schedule (MBS) or Department of Veterans’ Affairs (DVA) equivalent services.
The provider must be an eligible GP or nurse practitioner.
Eligibility for patients
Patients can register for MyMedicare.
Patients must have a Medicare or DVA Veteran card to register in MyMedicare. There will be options for patients to register online and or in-person at their registered practice.
Read about patient eligibility on the Department of Health and Aged Care website.
To register in MyMedicare as a general practice, you must:
- make sure your practice is eligible
- link an organisation in PRODA to Health Professional Online Services (HPOS) (further details copied in the below tab)
- access the Organisation Register in HPOS to:
- register your practice
- link your eligible GPs providers
- add the MyMedicare program to your practice registration.
If your practice is already registered and all participating providers are linked in the organisation register, you do not need to complete a second registration process.
Visit the DOHAC website for further information.
Choose the steps below that apply to where you are up to in the registration process. You do not need to complete a step if you have done so previously. Most practices will only need to follow the instructions for step 6.
Tip* if you are unsure, follow the instruction for step 6 'Organisation Registration for MyMedicare' to see if you have access to the "green tile" (Organisation Register) before looking at the other steps.
Note* for large or complex business structures - please contact our Digital Health Team for individualised advice.
- Step 1 - PRODA individual account registration
- Step 2 - PRODA organisation account registration
- Step 3 - Adding members to PRODA organisation
- Step 4 - Managing member delegation in PRODA organisation
- Step 5 - Linking an organisation in PRODA to HPOS
- Step 6 - Organisation registration for MyMedicare
Visit the DOHAC website for more information.
COORDINARE - South Eastern NSW PHN has developed a MyMedicare workflow to help manage patient registrations.
Download the MyMedicare workflow here.
Visit the DOHAC website for the latest:
General Practice in Aged Care Incentive: key processes and resources.
- About
- How to participate
- Eligibility
- MBS user guide
- Resources for GPs and practices
- Resources for residential aged care
The General Practice in Aged Care Incentive supports older people living in residential aged care. This will help them receive quality primary care services from their regular provider and practice.
From 1 July 2024, eligible general practitioners (GPs) and practices registered with both MyMedicare and General Practice in Aged Care Incentive will be able to receive incentive payments. These incentive payments are for providing regular visits and care planning to older people living in aged care.
Practices and providers participating in MyMedicare can receive financial incentives for delivering enhanced care. The incentive payments will be quarterly, on top of existing Medicare Benefits Scheme (MBS) and Department of Veterans’ Affairs (DVA) rebates for services delivered.
Payments are:
- $300 per patient, per year to responsible providers.
- $130 per patient, per year to registered practices.
To register and access the incentive your practice must be eligible and registered for MyMedicare. Your patients that are aged care home residents will also need to be registered for MyMedicare with your practice.
Once your practice is registered for the General Practice in Aged Care Incentive, you will need to:
- Link your providers and your MyMedicare patients to your practice.
- Select the General Practice in Aged Care Incentive indicator on your patients’ MyMedicare profiles.
- Link patients to responsible providers in your practice.
- Access a step-by-step guide here.
Alert* New error causing issues in PRODA
Many General Practices have been experiencing a new error message that is causing issues in PRODA when attempting to link the provider to a GPACI patient in HPOS. An image of this error is copied below as an example of this error.
DoHAC has received confirmation from Services Australia that this is a new error. It has come to their attention through the help desk as well as through PHNs, they are working with the systems team to fix this error, which is expected to go live in December.
In the interim, the explanation is:
- The 0831 warning displays when a provider is not eligible for the full period that the incentive indicator is assigned to the patient. Please note, this is not an error and does not restrict the ability for a practice to add an incentive indicator or assign a responsible provider.
- As this is only a warning message, the user can continue by selecting ‘confirm’ again after the message appears to proceed with linking/adding the responsible provider.
- Operators may also have to select ‘save’ twice.
- Updated wording for the 0831 warning message will be updated soon to help alleviate any confusion or concern.
Any further advice from Services Australia will be circulated once received.
GP eligibility
GPs must be:
- an eligible primary care provider as outlined in the Program Guidelines
- linked to their eligible practice
- declared as the responsible GP of eligible services to the registered patient, including coordinating services provided by the care team or practice.
Patient eligibility
Patients can be registered by their GP or general practice for the General Practice in Aged Care Incentive from 1 July 2024.
Patients must:
- permanently live in a residential aged care home, not including respite care
- register with MyMedicare and link to an eligible practice and responsible GP
- have the General Practice in Aged Care Incentive indicator selected on their MyMedicare profile by their practice.
GPs or practices must:
- link GPs and their MyMedicare patients to their practice
- select the General Practice in Aged Care Incentive indicator on their patients’ MyMedicare profiles
- link patients to responsible providers in their practice.
Video provided by PHN Cooperative - Detailed video on GPACI, service and eligibility requirements.
About the guide
The General Practice in Aged Care (GPACI) User Guide includes after-hours MBS item numbers and an example of triple bulk-billing benefits. PHNs across the country have collaborated to design this user guide and continue to work as a connected network to support local change management for MyMedicare.
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 GPACI and is available here.
How to use this 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:
- Responsible provider only – where a single GP delivers all care to the resident.
- 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.
- 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:
- 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.
- Review your historical billing practices for Residential Aged Care Home patients and use the guide to develop a quality improvement activity to identify any improvements you could make to billing and care practices.
- 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 maximize efficiency of clinician time.
- 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 to 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?
Visit the DOHAC website for the latest resources including:
- fact sheet
- frequently asked questions for GPs and practices
- GPACI GP and practice information kit
- GPACI patient journeys
- GPACI roles and contributions
- GAPCI person-centred care
- New resource* e-learning module - how to access detailed payment information in HPOS
- services Australia e-learning modules
- incentive forecasting function e-learning module
- New resource* Infographic for practices - how to search for and view payment information
- New resource* Infographic for providers - how to search for and view payment information
- Care plan and contribution template
- Patient front sheet template
- Patient monitoring and tracking tool
Visit the DOHAC website for the latest resources including:
Chronic disease management: more information coming soon.
- About
Chronic Disease Management and MBS deferred to 1 July 2025
On 25 September 2024 the Department of Health and Ageing announced the commencement date for Chronic Conditions Management MBS item changes have been deferred to 1 July 2025.
The additional time will support all practices and providers, including GPs and allied health providers, to be ready for the changes to these important services. Previously, these changes were due to come into effect from 1 November 2024.
More information will be available soon. If you need any additional support, or have any questions, please contact your local Health Coordination Consultants.
Page last updated: September 2024.