MyMedicare General Practice in Aged Care Incentive FAQ

The article provides information about the General Practice in Aged Care Incentive, which is set to replace the existing Aged Care Access Incentive on 1 July 2024.

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What is the General Practice in Aged Care Incentive?

The General Practice in Aged Care Incentive aims to promote continuous, high-quality care. Created as a result of the:

From 1 July 2024, providers and practices registered with MyMedicare will have the opportunity to receive incentive payments if they meet the eligibility requirements. The incentive payments are intended to support regular visits and care planning for older individuals living in residential aged care homes.

Where can I find information about the Incentive payments and eligibility?

Providers and practices registered with MyMedicare, who meet the General Practice in Aged Care Incentive eligibility and servicing requirements, will receive an incentive payment each quarter.

Eligible providers will receive payments for reviewing their patients in a Residential Aged Care Home (RACH), as opposed to their usual practice setting.

Eligible practices will receive funding to manage the care for registered patients living in a Residential Aged Care Home (RACH).

For information on Incentive payments and eligibility, visit the Department of Health and Aged Care General Practice in Aged Care Incentive website.

What are the eligibility requirements?

Practice eligibility

General practices must be an eligible practice and registered in the:

  • Organisation Register
  • MyMedicare program (with banking details added)
  • General Practice in Aged Care Incentive program.

Practices will be able to register for the General Practice in Aged Care Incentive through the MyMedicare program from 1 July 2024.

Provider eligibility

Providers must be:

  • an eligible provider
  • linked to their eligible practice
  • declared as the responsible provider of eligible services to the registered patient, including coordinating services provided by the care team.

Providers will be able to participate in the General Practice in Aged Care Incentive from 1 July 2024.

Patient eligibility

Patients must:

  • permanently live in a Residential Aged Care Home (RACH), not including respite care
  • register with the MyMedicare program and link to an eligible practice and responsible provider
  • have the General Practice in Aged Care Incentive indicator selected on their MyMedicare profile by their practice.

Patients can be registered by their practice for the General Practice in Aged Care Incentive from 1 July 2024.

IMPORTANT   It is the responsibility of providers and practices to ensure a patient is eligible for MyMedicare.

The provider and/or practice must declare their patient meets the eligibility criteria for General Practice in Aged Care Incentive as part of the patient registration process. Practices will need to:

  • link providers 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.

For information on eligibility requirements, visit the Department of Health and Aged Care General Practice in Aged Care Incentive website.

What servicing requirements must we meet to be eligible for the incentive?

Providers and practices must meet the servicing requirements to be eligible for incentive payments. These requirements include delivering:

To learn more about Servicing requirements, refer to the General Practice in Aged Care Incentive factsheet provided by the Department of Health and Aged Care.

Care planning services

The responsible provider must deliver at least two eligible care planning services within a 12-month period.

Eligible care planning includes a range of Medicare Benefits Schedule (MBS) and Department of Veterans’ Affairs (DVA) items in the following categories:

  • comprehensive medical assessment
  • contribution to, or review of, multidisciplinary care plan
  • multidisciplinary care conference(GP arranged or participated)
  • Residential Medication Management Review.

To learn more about Servicing requirements, refer to the General Practice in Aged Care Incentive factsheet provided by the Department of Health and Aged Care.

Regular visits per quarter

The responsible provider and their care team must deliver at least two eligible regular visits per quarter, delivered in separate calendar months, with a minimum of eight regular visits per 12-month period.

Eligible regular visits include a range of MBS items in the following categories:

  • attendance at a RACH (Level B-E consultations or equivalent)
  • after hours services
  • nurse practitioner services
  • practice nurse and Aboriginal and
  • Torres Strait Islander health practitioner and health worker services.

To learn more about Servicing requirements, refer to the General Practice in Aged Care Incentive factsheet provided by the Department of Health and Aged Care.

Quarterly visits

Services must be delivered under the responsibility and direction of the responsible provider.

Providers and practices will be required to meet:

  • all servicing requirements outlined in the Program Guidelines
  • individual servicing requirements for each assessment quarter to be eligible for payment.

At least one of the regular visits must be provided by the responsible provider.

A second visit can be delivered by the responsible provider or another member of the patient’s care team. This includes:

  • an alternate provider within the same practice
  • GP registrar
  • nurse practitioner

To learn more about Servicing requirements, refer to the General Practice in Aged Care Incentive factsheet provided by the Department of Health and Aged Care.

Telehealth for Modified Monash Model areas MMM 4 to MMM 7

Practices located in Modified Monash Model (MMM) areas MMM 4 - 7 will be able to provide 4 four regular visits per 12- month period using eligible telehealth MBS items when they are unable to attend a face-to-face service.

To learn more about Servicing requirements, refer to the General Practice in Aged Care Incentive factsheet provided by the Department of Health and Aged Care.

 

Last updated: 27 June 2024.