Use the correct Medicare Provider Number when claiming GPACI-eligible services

Country SA PHN Newsletter April 2025

Some General Practice in Aged Care Incentive (GPACI) registered practices and their GPs may not have received a payment that they expected because the incorrect Medicare Provider Number (MPN) was used when claiming GPACI-eligible services.

The Organisation Register recognises Organisation Sites (that is, practice locations), not the overall Organisation entity. GPs who practice out of more than one location (site) have a different MPN for each location.

Therefore, GPs (or practice staff on their behalf) must ensure that the MPN used for claiming services for each individual patient is the MPN for the same Organisation Site in which:

• the patient is registered for MyMedicare and GPACI, and
• the GP has been added as the Responsible Provider for that patient.

It is important to remember that for a service to be considered eligible:

• it must be on the list of GPACI-eligible MBS/DVA service items
• the patient must have the GPACI Indicator selected, and a Responsible Provider nominated on their MyMedicare profile
• the Responsible Provider must deliver at least one of the two regular services (which must be delivered in separate calendar months) to the patient during the quarter, on or after the day they were nominated as the Responsible Provider in the Organisation Register, and
• the MPN used to claim the services must be for the same practice location as the Organisation Site where the patient who received the services is registered for MyMedicare and GPACI.

For further information, visit the Services Australia MyMedicare resources webpage.

Published on: April 9, 2025