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General Practice in Aged Care Incentive (GPACI) Payment Eligibility – Medicare Provider Number

Some GPACI-registered practices and their GPs may not have received a payment they expected because the incorrect Medicare Provider Number was used when claiming the GPACI-eligible services.

The Organisation Register recognises Organisation Sites (that is, practice locations), not the overall Organisation entity. GPs who practice out of more than one location (site) have a different Medicare Provider Number (MPN) for each location.

Therefore, GPs (or practice staff on their behalf) must ensure that the MPN used for claiming services for each individual patient is the MPN for the same Organisation Site in which the:

  • patient is registered for MyMedicare and GPACI, and
  • GP has been added as the Responsible Provider for that patient.

Remember for a service to be considered eligible:

  • it must be on the list of General Practice in Aged Care Incentive Eligible MBS/DVA service items,
  • the patient must have the GPACI Indicator selected, and a Responsible Provider nominated on their MyMedicare profile,
  • the Responsible Provider must deliver at least one of the two regular services (which must be delivered in separate calendar months) to the patient during the quarter, on or after the day they were nominated as the Responsible Provider in the Organisation Register, and
  • the Medicare Provider Number used to claim the services must be for the same practice location as the Organisation Site where the patient who received the services is registered for MyMedicare and GPACI.

**Tip** A new Health Professional Education resource has been released on the Services Australia MyMedicare Resource page with the above information and more tips for Practices: General Practice in Aged Care Incentive – From registration to service delivery.

For more information about MyMedicare incentives, including GPACI payment requirements please see health.gov.au/mymedicare.

If you have any questions, you can:

  • call Services Australia on 13 21 50 (select option 2) (call charges may apply), or
  • email mymedicare@servicesaustralia.gov.au (please be aware that there may be risks with sending personal information through unsecured networks or email channels).

For further general support on MyMedicare or the General Practice Aged Care Incentive (GPACI), please contact CESPHNs Practice Support Team at practicesupport@cesphn.com.au

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