Practice Incentives Program payments

Once you’re in the Practice Incentives Program (PIP), you’ll automatically get payments in your bank account, if you meet the eligibility requirements for each entire quarter.

We make payments every quarter, in February, May, August and November. Based on your communication preference, we’ll send payment statements to your practice by mail or online through Health Professional Online Services (HPOS) through PRODA.

Automatically calculated payments

We calculate entitlements for payments automatically based on the information we get from your practice. It’s important to let us know about any changes to your practice details.

Some PIP payments are based on a measure of the practice size, known as the Standardised Whole Patient Equivalent (SWPE) value.

The SWPE value includes Medicare Benefits Schedule (MBS) and the Department of Veterans’ Affairs (DVA) services. These services are given to patients by all general practitioners and nurse practitioners registered to your PIP practice profile during the reference period. The reference period is a 12-month rolling period. This period starts 16 months before each payment quarter.

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

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

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

We update the weighting amounts below each quarter. If a gender other than female or male is identified, we apply the higher weighting for that age group based on trends.

Request a review

You can ask us to review our decision about:

• practice payments
• practice status including if your practice is closed or withdrawn
• other reviews for the PIP or Workforce Incentive Program - Practice Stream.

To do this, use the Practice incentives review of decision form.