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
- MyMedicare Program Guidelines
- 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, Disability and Ageing.
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.
Access the MyMedicare Program Guidelines here.
The guidelines contain detailed information and guidance for practices, general practitioners and patients who wish to voluntarily register with the MyMedicare Program.
We encourage general practices to familiarise themselves with these guidelines which provide further information regarding:
- The Service Australia Organisation Register - a streamlined practice registration tool connecting a general practice, GPs, patients, MBS claiming and incentives in one central system. The guidelines describe how the Organisation Register supports MyMedicare and new, existing and future health programs.
- Aboriginal Community Controlled Servies or Aboriginal Medical Services can register their organisation sites under a 'Hub and Spoke' model. Practices operating under this model are considered as a singular organisation for the purposes of MyMedicare registration.
- General Practice registration requirements and exemptions - note that accreditation exemptions for non-traditional practices are in effect until 31 December 2026.
- 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.
Please note* the program guidelines were last published 6 January 2025.
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 Department 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 Department website for more information.
COORDINARE - South Eastern NSW PHN has developed a MyMedicare workflow to help manage patient registrations. Download the MyMedicare workflow here.
Consent and record keeping requirements:
- Patients aged 14 years and over must provide consent when registering in MyMedicare.
- Consent for MyMedicare for patients under 14 is required by a parent or guardian.
- Under current MyMedicare policy, staff at aged care facilities or treating doctors are not permitted to complete and sign the MyMedicare registration form on behalf of the patient.
- If a patient is incapable of providing consent, a signed consent form from a responsible person is required to ensure compliance with audit and privacy standards. A responsible person refers to an adult who is accompanying the patient or responsible for their care. This may include a parent, guardian, a person with POA or guardianship authority, authorised representative or the patient’s next of kin.
To register a patient with MyMedicare a practice must declare that the individual providing consent has signed and completed an authorised Patient Registration form, and the practice will retain a copy of this form for compliance of record keeping obligations in accordance with federal, state and territory legislation applicable to their practice.
A practice also declares that the information provided is true and correct, and they understand that giving false or misleading information is a serious offence.
Only the authorised MyMedicare Registration form available online at the Department’s website can be used to register a patient in MyMedicare.
Access COORDINARE's:
- Quality Improvement Toolkit for Strengthening Medicare – MyMedicare in Primary Care
- Self-paced long audit
Visit the Department website for the latest:
Quality Improvement Toolkit – Strengthening Medicare – MyMedicare in Primary Care
Maintaining MyMedicare accreditation details - information for practices on how to update these details is available on slide 9 of the HPE resource.
General Practice in Aged Care Incentive: key processes and resources.
- About
- How to participate
- Eligibility
- MBS user guide
- Tips on managing GPACI
- 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.
The Department of Health, Disability and Ageing 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?
GPACI Q4 Service and Payment requirements - last updated May 2025.
The 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 requirements, to ensure they meet Q4 eligibility. Read the requirements here.
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. |
Download the GPACI Quality Improvement toolkit here.
Visit the Department 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
- Backdating Patient Registration (note available until 31 March 2025)
- e-learning module - how to access detailed payment information in HPOS
- services Australia e-learning modules
- incentive forecasting function e-learning module
- Infographic for practices - how to search for and view payment information
- 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 Department website for the latest resources including:
Chronic Condition Management: key resources and improvement activities.
- About
- New CCM framework from 1 July 2025
- Activity 1 - New year CCM resolutions
- Activity 2 - Planning with your practice team
- Activity 3 - Practice Team discussion
- Fact Sheets – Upcoming Changes
- Resources for GPs and healthcare providers
Chronic disease is a growing problem and a leading cause of illness, disability and mortality. Chronic Conditions Management (CCM) MBS item changes recommended by the MBS Review Taskforce are scheduled to come into effect on 1 July 2025.
The changes aim to simplify, streamline, and modernise the arrangements for health care professionals and patients, promote continuity of care, encourage the regular review of CCM plans, support communication between a patient’s multidisciplinary care team and ensure existing patients can continue to access the care they need.
To help your practice prepare to transition to CCM with small manageable changes, COORDINARE invites your practice to participate in our CCM activities to implement new CCM items, strengthening the connections that patients have with your practice through MyMedicare.
- Activity 1 aims to engage patients returning to your practice for CCM Plans and team care arrangements in MyMedicare.
- Activity 2 aims to raise awareness among your practice team of MyMedicare, CCM changes, and support your team to explore their roles in both MyMedicare and CCM.
New framework for chronic disease management - from 1 July 2025.
Please note* transition arrangements will be in place for 2 years to ensure current patients do not lose access to services.
From 1 July 2025 the following items will cease and be replaced with a new streamlined GP chronic condition management plan (see table below for item numbers):
-
GP management plans (229, 721, 92024, 92055)
-
Team care arrangements (230, 723, 92025, 92056)
-
Reviews (233, 732, 92028, 92059) will cease and be replaced with a new streamlined GP chronic condition management plan.
The updated framework will be known as chronic condition management (CCM).
Table 1: Chronic Condition Management Items commencing 1 July 2025*
| Name of item | GP item number | Prescribed medical practitioner item number |
| Prepare a GP CCM plan - face-to-face | 965 | 392 |
| Prepare a GP CCM plan - video | 92029 | 92060 |
| Review a GP CCM plan - face-to-face | 967 | 393 |
| Review a GP CCM plan - video | 92030 | 92061 |
Please note* These changes do not affect multidisciplinary care plan items (231, 232, 729, 731, 92026, 92027, 92057, 92058).
For more information, please view the MBS Online Factsheets here.
For support on MyMedicare and upcoming CCM Changes, please contact your local COORDINARE Health Coordination Consultant or contact us directly here.
Many patients and practices time Chronic Condition Management (CCM) plans with the start of a calendar year, when allied health items are available through team care renew (items 10950 to 10970 and 81100 to 81125).
The new year provides an opportunity to complete the first steps in preparing for the upcoming CCM changes and not double up on work. Two of the major changes include MyMedicare Registration, and more regular reviews for patients with chronic conditions.
There are a range of ideas outlined below for you to tailor and develop your own plan. You can document your plan using our Plan-Do-Study-Act Template (pdf/word doc).
Activity outcomes:
- Register all returning CCM Patients for MyMedicare with your practice prior to, or at their next CCM appointment.
- Develop a process for booking future review appointments for any patient you put onto a CCM Plan.
- Develop a clear communication plan for why review appointments are important to attend for your practice team and patients (including if there are out of pocket costs for the patient).
- Develop a process to manage missed or cancelled patient review appointments.
This activity aims to raise awareness among your practice team of MyMedicare, Chronic Conditions Management (CCM) changes, supporting your team to explore their roles in these areas.
This process will help ease your team through change and provide a shared document that can help your team to identify and discuss anything that isn’t quite working, explore changes and update the document to keep everyone on the same page.
There are a range of ideas outlined below for you to tailor and develop your own plan. You can document your plan using our Plan-Do-Study-Act Template (pdf/word doc).
Activity outcomes:
- Your practice team has a better understanding of MyMedicare (Voluntary Patient Registration).
- Your practice team has a better understanding of the proposed CCM changes.
- Your practice team roles in MyMedicare and CCM are well defined, and each team member has a clear role and responsibilities.
The purpose of this activity is to:
-
Understand how MyMedicare is evolving, and the current and future benefits.
-
Develop a shared practice team perspective of how MyMedicare aligns with your practice’s approach to patient care.
-
Develop key messages, benefits and talking points that your practice team can use to consistently communicate to patients about Chronic Conditions Management and MyMedicare.
-
Develop a plan for targeting patient populations using different communication mediums and channels to increase MyMedicare registration for regular patients of your practice.
Access COORDINARE's:
- Quality Improvement Toolkit for Strengthening Medicare – Chronic Condition Management.
- Self-paced learning mini audit.
Additional resources:
- (Template) Practice roles and responsibilities for MyMedicare and CCM (word/pdf)
- Summary of CCM changes
Page last updated: May 2025.