Topic: MyMedicare

MyMedicare accreditation exemption date extended to 31 December 2026

The accreditation exemption for non-traditional practices choosing to participate in MyMedicare has been extended from 30 June 2025 until 31 December 2026.

The accreditation exemption is available to non-accredited practices (including sole providers) who deliver general practice services through mobile and outreach models in rural settings, residential aged care and disability residential settings, as well as to First Nations Australians and people experiencing homelessness.

The extension is in recognition of the new definition of general practice for the purpose of accreditation, which may allow some non-accredited practices to now become accredited. It aims to support non-accredited practices in considering their accreditation options under the National General Practice Accreditation Scheme.

Practices currently using this MyMedicare exemption will not need to take any action to update the new end date.

Turn on your HPOS mailbox notifications

Health professionals receive a lot of correspondence via their individual and/or organisation Health Professional Online Services (HPOS) mailboxes. While some of these may be statements or everyday notifications, others are important and require action.

Make sure you turn on notifications to receive alerts for new messages and save you having to check for new mail.

Now the first MyMedicare incentive is in place make sure you action any notifications as required, such as failed payments.

Payments for January to March 2025 quarter and reassessments

Payments for the MyMedicare General Practice in Aged Care Incentive quarterly assessment for January to 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, for example failed payments due to missing or incorrect bank account details

• Reassessments: There has been a delay in reassessing previous quarterly payments and therefore a delay in adjustments, including additional payments which 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

Tips on managing GPACI

For GPACI, the relationship between the three participants (practice, patient and responsible provider) is critical. The assessment process looks for this relationship, and anything which can potentially break or remove any of those relationships will impact GPACI payments for eligible services.

If there is a change in the relationship (for example, new responsible provider) it is important the previous relationship is maintained in the patient’s MyMedicare profile. Removing or deleting relationships will impact past payments.

The responsible provider may not be the same practitioner as the patient’s nominated preferred GP. For example, a registrar may be engaged to deliver Residential Aged Care Home services.

Here are some tips on managing GPACI correctly and some precautions on what not to do as 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
• 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 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

For support on MyMedicare contact your Practice Advancement Officer or Practice Support Officer.

MyMedicare Program Guidelines published on 6 January 2025 contain detailed information and guidance for practices, GPs and patients who wish to voluntarily register with the MyMedicare Program. The guidelines also set out the program’s requirements, benefits and dispute processes.

The MyMedicare Program Guidelines provide further information regarding:

• The Services Australia Organisation Register; a streamlined practice registration tool connecting a general practice, GPs, patients, MBS claiming and incentives in the one central system. The guidelines describe how the Organisation Register supports MyMedicare and new, existing and future health programs.
• Aboriginal Community Controlled Services or Aboriginal Medical Services can register their organisation sites under a ‘hub and spoke’ model, whereby practices operating under this model are considered as a singular organisation for the purposes of MyMedicare Registration.
• General practice accreditation requirements and exemptions. Note that accreditation exemptions for non-traditional practices are in effect until 30 June 2025.
• Provider registration requirements outlining which providers are eligible
• Patient registration requirements including patient eligibility, exemptions to MBS service requirements, and more on patient registration
• Patient consent of MyMedicare
• Withdrawing from MyMedicare
• MBS items linked to MyMedicare
• Incentive programs Linked to MyMedicare
• My Health Record and MyMedicare

For support on MyMedicare and the General Practice Aged Care Incentive, please contact your Practice Advancement Officer.