October payment update

Practices may have noticed that the 1 July – 30 September 2025 quarter payment due by the end of October was delayed. The Australian Department of Disability, Health and Ageing has advised that payments are expected to be made in mid-November.

The delay relates to the recent removal of the 12-month exclusion period from the program’s guidelines, which is detailed below.

Updated GPACI guidelines

In response to stakeholder feedback, the Department has updated the GPACI guidelines to remove barriers to participating in the program, changing the guidelines’ appearance and making 2 eligibility changes.

There are no other policy changes in the new guidelines.

Eligibility – Bulk Billing Practice Incentive Program (BBPIP) accreditation exclusion

Practices that receive a BBPI accreditation exemption are not  eligible to participate in the GPACI program. 

Practices that wish to participate in the GPACI program are required to meet MyMedicare accreditation requirements set out in the MyMedicare Guidelines. This includes being covered by one of the MyMedicare accreditation exemptions for non-accredited practices who deliver general practice services entirely through mobile and outreach models.

12-month exclusion period removed

The Department has removed the exclusion period for responsible providers who did not meet the 12-month care plan eligibility requirements.

If a patient did not receive 2 eligible care planning services by the end of their 12-month period and a care planning service was not subsequently provided in the next quarter, the practice and provider would be ineligible for GPACI payments for that patient for the remainder of the patient’s new 12-month period. This requirement has been removed, and the exclusion period will no longer be enacted.

The delay to the October payments is to enable system changes to be implemented to ensure payments will be made as usual if the patient received their 2 regular services in their firth quarter, and to stop correspondence relating to the patient exclusion requirement.

Participating practices are required to continue providing the 10 eligible services comprising 2 care planning items and 8 regular visits each year (2 regular visits must be made in separate calendar months each quarter) to receive their quarterly GPACI payments, in addition to the Medicare Benefit Services and Department of Veterans Affairs rebates for their patients.

Download the new GPACI guidelines.

Accreditation reminder

Many practices registered for MyMedicare and the GPACI are currently ineligible due to lapsed accreditation. Practices must record and regularly update their accreditation status in the Organisation Register.

At the end of an accreditation period, practices must be re-accredited. If the practice participating in MyMedicare has not obtained accreditation or re-accreditation at the end of their accreditation period, the practice will be ineligible for MyMedicare and GPACI. Any GPACI services performed after accreditation has lapsed will not be eligible for payment.

New GPACI resource

The Department has also released a new education resource for health professionals: ‘Hints and tips to ensure you get paid correctly’. The resource emphasises the relationship between practice, patient and responsible provider. The GPACI assessment and reassessment process looks for this relationship. Anything that changes the relationship will impact current and past GPACI payments.

If patient details change, practices are advised to follow the steps outlined in the new resource and to make sure they do not delete previous responsible providers.

Download the ‘Hints and tips to ensure you get paid correctly’ resource.

For support on GPACI and MyMedicare, including if you need assistance in updating your accreditation record, please contact your Provider Support Officer or visit SEMPHN's dedicated MyMedicare page.