Calculating a payment

Calculating the SWPE value

The SWPE value is a calculation of practice size. It’s based on Medicare Benefits Schedule (MBS) services that all general practitioners and nurse practitioners provide in the practice.

The SWPE value includes both Medicare and the Department of Veterans’ Affairs services provided to patients during the reference period. This is a rolling, historical, 12 month period. It starts 16 months before the payment quarter.

We calculate your practice’s SWPE value based on information your practice gives to us. It’s important to let us know of any changes.

To work out the SWPE values, we calculate the fraction of care given to each patient. This is known as the Whole Patient Equivalent, which equals 1.0.

For example, in a 12 month period, a patient gets $100 in MBS benefits at Practice A and $400 at Practice B, a total of $500:

• Practice A is assigned with $100 ÷ $500 or 0.2 of the patient’s care
• Practice B is assigned with $400 ÷ $500 or 0.8 of the patient’s care.

This is weighted for the age and gender of each patient. The weighting recognises people have different care needs at different stages of life.

The weighting amounts below are revised each quarter.