Primary Care and Digital Health Support - November 2025

Changes to bulk billing incentives from 1 November 2025 will expand the eligibility of bulk billing incentives to all Australians with a Medicare card.

Currently, general practitioners (GPs) only receive Medicare bulk billing incentives if they bulk bill children under 16 years old and Commonwealth concession card holders.

Additionally, from 1 November 2025, practices can choose to register and participate in the Bulk Billing Practice Incentive Program (BBPIP) and will equally share in the additional incentive payment of 12.5% of MBS billings for eligible services.

A new calculator has been released for general practice owners, managers and individual general practitioners to estimate annual earnings from Medicare bulk billing incentives (BBIs) and the new Bulk Billing Practice Incentive Program (BBPIP), starting 1 November 2025. Access the Bulk Billing Incentives Calculator.

A Bulk Billing Incentives Calculator User Guide is also available explaining how to use the calculator.

The calculator uses MBS information about BBPIP MBS eligible services only. It uses data to build an average annual provider and practice payment estimate for BBPIP MBS eligible services for your practice type and location. The payment model can be used as a baseline to estimate if you will benefit from joining BBPIP.

To get the most accurate estimate, have these details handy before you commence using the calculator:

• Select your role as a general practitioner (GP) or a practice manager (or equivalent)
• Practice location by Modified Monash Model (MMM) classification
• Percentage of billings paid to the practice
• Billing type - bulk billing only, mixed billing or private billing
• Numberof BBPIP MBS eligible services provided per year
• Percentage of BBPIP MBS eligible services provided to concession card holders or children under 16 years old
• Your bulk billing rates, average privately billed fees and annual proportion of BBPIP MBS eligible service types, including:
  • Short (level A)
  • Standard (level B)
  • Long (level C)
  • Extended/Prolonged (level D/E)
  • Management plans and reviews
  • Other BBPIP MBS eligible services

These details can be found in your practice management system. Please refer to the User Guide for step-by-step instructions to support use of the calculator. 

Additional resources including fact sheets and videos are available at Strengthening Medicare with more bulk billing resources page on the Australian Government Department of Health, Disability and Ageing website.

An Expression of Interest (EOI) form is available for providers that intend to join the Bulk Billing Practice Incentive Program. Practices that complete the EOI form will be mailed communications material for their practice to display from 1 November when they register for BBPIP.

Further details and instructions on how to register in BBPIP will be provided later this year, and registration for BBPIP will be available from 1 November 2025.

To participate in BBBPIP, practices will need to be registered for MyMedicare. Instructions on how to register for MyMedicare are available on the Services Australia Health Professional Education Resources website.

Participation in BBPIP is voluntary for practices. If a practice chooses to participate, all general practitioners at that practice must bulk bill all eligible services. For practices continuing to operate a mixed billing model, the RACGP has materials for practices to help them plan and communicate their billing arrangements to patients:

• RACGP - Optimising your billing strategy
• RACGP - Guide to introducing mixed billing in your practice

For practice support please contact [email protected].

From 1 November 2025, changes will be made to the Better Access to Psychiatrists, Psychologists and General Practitioners Initiative through the Medicare Benefits Schedule, subject to the passage of legislation.

Consistent with recommendations in the Better Access Evaluation published in 2022, the changes will:

• Improve the Better Access initiative to better meet the needs of individuals and improve equity of access to mental health supports and services.
• Support the holistic relationship between a patient and their healthcare provider, leading to improved patient outcomes.
• Reduce the administrative burden and complexity for GPs and PMPs by providing greater flexibility by using time-tiered professional (general) attendance MBS items to review a Mental Health Treatment Plan (MHTP), refer a patient for mental health treatment and undertake general mental health consultations.

Overview of the changes:

From 1 November 2025:

• A Medicare benefit will be payable for MHTP preparation, referrals for treatment services and reviews of a MHTP when a patient has seen:
  • a GP or PMP at the general practice in which the patient is enrolled in MyMedicare, or
  • regardless of whether the patient is enrolled in MyMedicare, by the patient’s usual medical practitioner.
• These requirements do not affect patients who have been referred via a Psychiatrist Assessment and Management Plan or by a direct referral from an eligible psychiatrist or eligible paediatrician.
• GP and PMP MHTP review items (2712, 92114, 92126, 277, 92120, and 92132) and GP and PMP ongoing mental health consultation items (2713, 92115, 92127, 279, 92121 and 92133) will be removed from the MBS.
• Further details can be viewed at the MBS Online website.

Key points:

• Removal of the 12 review and mental health consultation items provides GPs and PMPs greater flexibility to use the most appropriate time-tiered professional (general) attendance item, reflecting the time spent with patients. This includes items for longer consultations and, where applicable, the triple bulk billing incentive to review MHTPs and deliver mental health care and support to patients.
• Any MHTP referral dated prior to 1 November 2025 will remain valid until all treatment services specified in the referral (within the maximum session limit for the course of treatment) have been delivered to the patient.
• The MyMedicare and usual medical practitioner requirements will also apply to GP/PMP telehealth items for MHTPs, with these services no longer exempt from the established clinical relationship rule. Further information on the GP MBS telehealth (video and phone) established clinical relationship criteria and exemptions will be available from 1 November 2025 in explanatory note AN.1.1 on MBS Online.
• These changes to do not affect focussed psychological strategies which can continue to be available to any patient from any eligible GP and eligible PMP who has the appropriate training recognised by the General Practice Mental Health Standards Collaboration.
• Treatment services referred to under the Better Access Initiative are for patients who require at least a moderate level of mental health support. Information on other free or low-cost Commonwealth funded mental health treatment services can be found on the Medicare Mental Health website or contact your PHN for referral options in your region or to learn more about the Stepped Care Model.

If you need support, please contact us [email protected]. You can find more information about MyMedicare on the Australian Government Department of Health, Disability and Ageing website.

For further information on the Better Access Mental Health Program changes see the MBS Online website.

Australians will soon benefit from improved and more timely access to their key health information through My Health Record, supporting safer and more connected care.

What’s changing?
Upcoming reforms will require healthcare providers to upload written pathology and diagnostic imaging reports to My Health Record. This will make important health information more consistently available to both consumers and healthcare professionals helping reduce duplicate tests, support better clinical decisions, and improve coordination of care across different settings.

Faster access to results
From October 2025, most pathology results will be visible to consumers as soon as they are uploaded. Some types of tests such as anatomical pathology, cytopathology and genetic testing will be available after a shorter 5-day delay (previously 7 days).

By February 2026, imaging results for arms and legs will also be viewable immediately, with a 5-day delay for other scans including CT, MRI, PET, ultrasound, and x-rays of the head, chest, abdomen, and pelvis.

These changes mean people can see their results sooner, encouraging them to take a more active role in their health. Healthcare providers will still have instant access to all reports as soon as they are uploaded.

How to get ready

• Consumers: Make sure your My Health Record is linked to your myGov account and download the my health app for easy access on the go.
• Healthcare providers: Familiarise yourself with the new Sharing by Default requirements, check My Health Record before ordering new tests, and talk with patients about how they can view their results.

Useful links

• Share by Default requirements 
• Implement My Health Record in your healthcare organisation
• Consumer fact sheet 

Download the Better and Faster access guide:

• Guide for requesting providers
• Guide for pathology and diagnostic imaging services

For more information, visit digitalhealth.gov.au or email [email protected].

The Primary Care and Digital Health team continue visiting practices in numerous regions including Adelaide Hills, Murray Bridge and Gawler.  Support and information have been provided on the following activities:

• CDM plus - digital resources
• Goshare 
• Health Pathways  
• Shine SA scholarship
• Bowel and Cervical Cancer Screening roadshow 
• My Medicare links - digital resources 
• QPR - digital resources 
• Carefinder - digital resources 
• General Practice Aged Care Inventive
• Aboriginal Cultural & community awareness online course - digital resources 

Practice visits are scheduled for Eyre Peninsula in late November 2025.

Since July 2025, eight general practices have participated in GoShare activities supporting community wellness and providing Quality Improvement activities to enhance the Practice Incentive Payment (PIP) initiative. Information and recall messages have been provided to local communities including:

• Influenza recall
• Pneumococcal recall
• Shingles 
• 75+ Health checks
• 45-49 Health checks
• Diabetes

Ferrers Medical Clinic in Mount Gambier participated in an influenza recall/reminder campaign using GoShare to recall 1018 patients aged 65+ who had not received a flu vaccine. Achieving 64.0% vaccine coverage in 8 weeks to 82 eligible patients is a positive outcome with the community less likely to be hospitalised with influenza. This compares favorably to the National average of 60.5% for this age group.

Ferrers Medical Clinic Practice Manager Tiffany Kenny provided an overview of the campaign.

Ferrers Medical Clinic is in the Limestone Coast, Mount Gambier, we provide a service to approximately 12,000 registered patients, with a large portion of our demographic being over the age of 60. Each year, we run dedicated flu clinics at the beginning of the influenza season, typically over a period of 6–7 weeks.

This year, with the support of Country PHN and the Go Share platform, we participated in an influenza recall campaign. Given the rise in winter coughs and colds across Mount Gambier, we saw this as an ideal opportunity to enhance our outreach and boost vaccine uptake among our patient population.

The Go Share recall program proved to be simple, effective, and user-friendly. We found it to be a highly efficient way to reach our patients with timely information about their eligibility and how to access the flu vaccine.

We received a strong response from patients. Many were grateful for the reminder, some had forgotten to return for their vaccination, others were unaware they were eligible for a free vaccine at age 65. Additionally, some patients informed us they had already received their vaccination at a local pharmacy, allowing us to update their records accordingly.

At Ferrers, we pride ourselves on maintaining strong relationships with our patients, which has consistently contributed to a high rate of vaccine uptake. The use of the PHN Go Share recall campaign supported and enhanced this commitment, and we would gladly recommend the program to other clinics aiming to improve preventative healthcare engagement.

Breast Cancer Awareness month takes place every October. In recognition the Primary Care and Digital Health team wore pink at the October Practice Nurse Network meeting.

The next scheduled meeting will be a Practice Manager Network meeting Thursday 20 November.

Primary Care and Digital Support Officer Venessa Blinman recently attended the R U OK? Workplace Roadshow Breakfast, where she heard inspiring stories and explored practical ways to create supportive, mentally healthy workplace cultures. The event highlighted the importance of checking in with colleagues and fostering open conversations, providing useful tools and strategies to make a meaningful difference in the workplace.

The Living and Ageing Well Expo held at the Nautilus Theatre in Port Lincoln was a great success, bringing together 28 organisations that showcased their services and activities to support healthy ageing in the community.

The event featured nine informative presentations covering essential topics such as:

• Falls prevention
• Staying safe at home
• Avoiding scams
• Aged rights and financial advocacy services

With over 100 community members in attendance, the expo provided a valuable opportunity for individuals to seek advice, gather resources, and connect with service providers dedicated to enhancing wellbeing and independence as people age.

The Bowel and Cervical Screening roadshow continues to attract good numbers attending the events. Four events have now been presented in Pt Lincoln, Victor Harbor, Jamestown and Nuriootpa with the Stirling Adelaide Hills event scheduled for Wednesday 12 November. This event will be presented by gastrologist Dr Justin Baker.

Register your interest

From 1 July 2025, Chronic Disease Management referrals and care requirements were replaced by new GP Chronic Conditions Management Plans (GPCCMPs). Allied health providers and Aboriginal Health Workers, and Aboriginal and Torres Strait Islander health practitioners may notice some changes to referrals from general practices.

These changes provide greater flexibility for patients to choose which services they access. There are no changes to individual allied health items for treating chronic conditions, but referral requirements have been simplified:

• The number of allied health services under a GPCCMP does not need to be specified by the referring GP (GPs may still specify this on referral letters).
• The allied health provider does not need to be named.
• Team care arrangements are no longer needed.

Allied health tips to plan service delivery with patients referred for Chronic Conditions Management:

• If the patient has private health cover, explore options to claim through their private health insurer rather than Medicare. This will allow the patient to use their Medicare GPCCMP referrals with other allied health services if they wish to do so.
• Discuss the patients’ priorities and explore how many of their 5 MBS allied health services a patient would like to use with your allied health service.
• Contact their general practice to confirm which individual allied health services for chronic conditions are included in the patient’s management plan. Explore how your service can coordinate with the primary care team, including:
  • Case conferencing, and
  • Group allied health services for people with type 2 diabetes.
• Have the patient use their MyGov app to review and confirm their claims history for allied health MBS services to check the number of allied health MBS items claimed in the calendar year.
• Check MBS item eligibility and history for your patient using Health Professional Online Services (HPOS) and Medicare Benefits Schedule (MBS) Online.
• Use My Health Record to view the patient’s medical history, services, and identify other members of their care team to coordinate with. You can access My Health Record through the National Provider Portal or using your practice software if it is a Conformant Clinical Information System (CIS).

If you need support to navigate these changes, using My Health Record or Provider Connect Australia, contact us via [email protected].

More detailed information about allied health referrals and care requirements related to Chronic Conditions Management is available using the links below.

Helpful links

MBS Online notes and information:

• AN.15.3 – Overview of MBS items to support management of chronic conditions in primary care
• AN.15.4 – Allied health services for chronic condition management
• AN.15.5 – GP chronic condition management plans – transition arrangements for existing patients with a GP management plan and/or team care arrangement
• AN.15.6 – Referral requirements for allied health services
• AN.0.47 – GP chronic condition management plans
• MN.3.1 – Individual allied health services for treating chronic conditions
• MN.11.1 – Individual allied health services for people of Aboriginal and Torres Strait Islander descent with a chronic condition or identified through a health assessment
• MN.9.1 – Assessing suitability for group allied health services for patients with type 2 diabetes
• MN.9.2 – Group allied health services for patients with type 2 diabetes

Department of Health, Disability and Ageing information:

• Upcoming changes to MBS Chronic Disease Management Arrangements