GO7943: General Practice in Aged Care Incentive

The objective of the GPACI is to improve access to quality, proactive general practice care for older people who live in aged care homes by incentivising proactive visits, regular, planned reviews and coordinated care planning.

Primary care providers and practices registered in MyMedicare will receive incentive payments for providing their MyMedicare registered patients who permanently live in residential aged care homes with care planning services and regular visits.

The GPACI also forms part of the Australian Government's Strengthening Medicare Reforms.

These reforms respond to the recommendations of the Taskforce and aim to meet the healthcare needs of today while building a stronger Medicare system for future generations.

The Practice is considered the applicant.

Responsible Providers must be linked in the Organisation Register to the same registered practice as the patient, be declared as the Responsible Provider for eligible services, and be linked to eligible patients registered in GPACI.

Patients must permanently live in an aged care home (not respite), be registered in MyMedicare with the eligible practice, have the GPACI indicator selected on their MyMedicare profile, and have a Responsible Provider identified.

For payment, providers/practices must deliver at least 10 eligible services over a 12-month period: 2 eligible care planning services (both delivered by the Responsible Provider) and 8 eligible regular services including at least 2 eligible regular services per quarter (each in separate calendar months) with at least one of the regular visits in each quarter provided by the Responsible Provider.

Eligible services must be claimed using the Medicare Provider Number linked to the same registered practice.

Practices in MMM regions 4-7 can deliver up to 4 of the 8 regular services per 12-month period by eligible telehealth items.

Eligible MBS and DVA items and further delivery and legislative requirements are specified in Appendix 17.2 and relevant legislation.

Practices must notify Services Australia of organisational changes within 7 days.