Practice Nurse Incentive Programme (PNIP)

The Practice Nurse Incentive Program provides incentive payments to practices to support an expanded role for nurses working in general practice.

The Practice Nurse Incentive Programme (PNIP) simplifies funding arrangements under the previous Practice Incentives Programme (PIP) Practice Nurse Incentive and 6 of the Medicare Benefits Schedule practice nurse items. We manage the PNIP on behalf of the Department of Health and the Department of Veterans' Affairs

The PNIP also includes:

  • support for accredited practices to employ an Aboriginal Health Worker instead of, or in addition to, a practice nurse (Registered Nurse or Enrolled Nurse)
  • support for practices in urban areas of workforce shortage, Aboriginal Medical Services and Aboriginal Community Controlled Health Services to employ an allied health professional, such as a physiotherapist, dietician or occupational therapist, instead of, or in addition to, a practice nurse or Aboriginal Health Worker
  • a rural loading of up to 50% based on the Australian Standard Geographical Classification - Remoteness Areas
  • a loading for Aboriginal Medical Services and Aboriginal Community Controlled Health Services
  • a once-only $5,000 incentive to support eligible non-accredited practices to become accredited

Eligibility

Eligibility for PNIP

General practices across Australia, including those in urban areas, Aboriginal Medical Services and Aboriginal Community Controlled Health Services, may be eligible for an incentive to offset the costs of employing a practice nurse.

Payments will be made to eligible general practices that apply for the PNIP. More information on the PNIP can be found in the Practice Nurse Incentive Programme guidelines [rtf 467kb].

Practices must meet the eligibility requirements outlined in the Practice Nurse Incentive Programme guidelines

To be eligible to participate in the PNIP, a practice must do all of the following:

  • meet the Royal Australian College of General Practitioner (RACGP) definition of a general practice as defined in the current Standards for general practices
  • be accredited or registered for accreditation against the RACGP Standards for general practice
    • practices registered for accreditation must obtain full accreditation within 12 months of joining the PNIP
  • maintain full accreditation
  • maintain current public liability insurance
  • ensure that all general practitioners (GPs), practice nurses, Aboriginal Health Workers and allied health professionals have current and appropriate professional indemnity cover as required by the Australian Health Practitioner Regulation Agency or the professional’s registration board
  • employ or otherwise retain the services of eligible practice nurses and Aboriginal Health Workers, and
  • employ or otherwise retain the services of a GP. This can include less than 1 full-time GP (for example, a GP who works part time)

All practices eligible under the above criteria can apply for incentives through the PNIP to support the employment or retention of:

  • Registered Nurses
  • Enrolled Nurses, and
  • Aboriginal Health Workers

Practice acceditation

Accreditation is available through 2 approved organisations: the Australian General Practice Accreditation Ltd (AGPAL), and the Quality Practice Accreditation Pty Ltd through the General Practice Australia (GPA) Accreditation plus program.

Accreditation involves:

  • self-assessment against agreed standards
  • peer review surveys (practice visits) of the practice's organisation and facilities, and
  • a continuous quality improvement cycle 

A practice is accredited on successful completion of the peer review survey. The practice is responsible for notifying us when they have been fully accredited.

Practices registered for accreditation must achieve full accreditation within 1 year of the date they join the PNIP and maintain accreditation to remain eligible for the PNIP.

Applying

Applying for the PNIP

Practices can apply for the PNIP:

  • through Health Professionals Online Services using a Medicare Public Key Infrastructure (PKI) Individual Certificate, or
  • by completing the PNIP application and faxing it to us with the required supporting documentation

Incomplete application forms may delay the application process.

Applying online

A user guide is available to help practices complete the PNIP application online. Please view the Practice Nurse Incentive Programme Online guide [pdf 2.1mb] for further information.

You need to register for HPOS to access PNIP services online. To register for HPOS, you must have a PKI Individual Certificate linked to your practice. If you haven’t got a PKI Individual Certificate, you can apply for one and register for HPOS by filling in the registration form.

If you already have a PKI Individual Certificate, make sure you tell us what your 10 digit Registered Authority (RA) number is. Practice owners or authorised practice contacts must send the RA number by mail initially. When we get your RA number, you can add other practitioners RA numbers to your practice’s profile through HPOS. You can send the RA number to us for the first time on your practice’s letterhead.

Practices with multiple locations

Practices with multiple locations can apply to join the PNIP as a single practice, provided they meet the eligibility requirements. Practices need to nominate their main practice location when applying for the PNIP, which should be the location that provides the highest number of Medicare Benefits Schedule services each year. Additional practice locations are known as practice branches.

Practices with multiple practice branches will only be regarded as a single practice where 1 or more of the doctors practising at the main location also practises at 1 or more of the other locations. More information on practices with multiple locations is in the Practice Nurse Incentives Programme guidelines [rtf 467kb]

Consent for the PNIP

To reduce red tape, any practice participating in the PIP can consent to us using your practice information for the purposes of the PNIP.

PIP Practice details

When a PIP-registered practice provides consent for the PNIP, they are consenting to the use of the following information:

  • practice name and main address
  • eligibility details, such as accreditation, public liability insurance and indemnity insurance
  • bank account details
  • contact details
  • location details
  • ownership details
  • GP details
  • associated documents
  • comments
  • SWPE (for the PNIP calculations)

Giving consent allows us to use the following PIP information for a purpose other than that for which it was collected:

  • the practice's SWPE that is already in use for the PIP, and
  •  the practice details provided for the PIP

The PNIP Online application process will auto-fill these details, including current practitioners. PNIP Online is access through the Health Professional Online Services (HPOS)

Payments

Incentive payment

The amount of incentive payment a general practice will be entitled to will depend on the practice’s SWPE value and the hours worked by practice nurses at the practice.

The PNIP will provide incentive payments to eligible practices of:

  • $25,000 per year per 1,000 SWPE where a Registered Nurse works at least 12 hours and 40 minutes per week, and
  • $12,500 per year per 1,000 SWPE where an Enrolled Nurse works at least 12 hours and 40 minutes per week

Incentives will be capped at 5 per practice, meaning that practices will be eligible to receive up to $125,000 per year to support their practice nurse workforce. More information on payment calculation can be found in the Practice Nurse Incentive Programme guidelines [rtf 467kb].

Accreditation assistance payment

To be eligible for the once-only accreditation assistance payment, a practice must be registered for accreditation against the Royal Australian College of General Practitioners Standards for general practice and meet the other eligibility requirements as detailed in the Practice Nurse Incentive Programme guidelines [rtf 467kb]. In addition, the practice must join the PNIP, provide proof of registration for accreditation and become accredited within 12 months of joining the PNIP. Practices must maintain their accreditation.

Department of Veterans’ Affairs loading

Practices that are eligible for the PNIP and provide GP services to Department of Veterans’ Affairs Gold Card holders will be eligible for a yearly payment per veteran. These practices will be identified by us and paid in August each year.

The Department of Veterans’ Affairs loading will be calculated by determining the number of Gold Card holders who receive an ‘in rooms’ consultation in an eligible practice during each year. An amount will be paid for each Department of Veterans’ Affairs Gold Card holder, regardless of the practice location, nursing qualifications or the number of nurses per practice. There are no limits on the number of Department of Veterans’ Affairs loadings paid per practice.

Where a Gold Card holder chooses to use more than 1 practice each year, the Department of Veterans’ Affairs loading will be divided across the practices based on the percentage of total consultation fees paid.

When payments are made

Payments will be calculated and paid retrospectively on a quarterly basis.

Payments are made by electronic funds transfer to the account nominated by the practice in the PNIP application form, and do not attract Goods and Services Tax.

To qualify for payments, practices must have their application approved for the PNIP by the 'point-in-time' date. The point-in-time date corresponds to the last day of the month before the next PNIP quarterly payment. Practices must submit their application at least 7 days before the point-in-time to ensure their application can be approved by this date. The quarterly payment months, point-in-time dates and payment periods are provided below.

Practices are eligible from the date of approval, not from the date of lodgement.

Quarterly payment monthPoint-in-time assessment of eligibilityPayment period
February31 January1 November to 31 January
May30 April1 February to 30 April
August31 July1 May to 31 July
November31 October1 August to 31 October

How the PNIP payments are made

We will provide quarterly confirmation statements to all practices receiving PNIP payments. Practices are required to confirm their details on the quarterly confirmation statement before the payment can be released to the practice.

Practices will receive their quarterly confirmation statement via PNIP Online. If a practice does not have access to PNIP Online, we will mail the practice's confirmation statement.

If a practice does not complete and return the quarterly confirmation statement by the point-in-time date for eligibility assessment, the practice's payment will be held.

Payment calculations

Payments are calculated using Medicare and Department of Veterans’ Affairs data. The data are is linked to the provider numbers specified on the practice's application form, and any subsequent amendments. If, for example, a practice does not provide us with details of new practitioners you will not receive payments associated with the services provided by those new practitioners.

If a practice tells us that it has changed its circumstances, either as a result of the quarterly confirmation statement or separately by the practice within 7 calendar days of the change in circumstances, its payment will be calculated based on the updated details.

Data will be excluded if any of the practitioners in a practice do not consent to the use of their data for the purposes of calculating the practice's payment. If practitioners would like their data to be included at a later stage, they must advise us in writing.

Calculating the SWPE value

PNIP payments are based on a measure of the practice size, known as the SWPE value. The SWPE value of a practice is the sum of the fractions of care provided to practice patients, weighted for the age and sex of each patient. As a guide, the average full-time GP has a SWPE value of around 1,000 each year.

If your practice is an existing PIP practice, and you have provided consent for us to access your PIP information, the existing PIP SWPE value will be used in determining the SWPE value for the PNIP. Refer to PIP for more information on how SWPEs are calculated.

New practices, practices that are not participating in the PIP, and PIP practices that do not give us consent to access their PIP information will be given an initial SWPE value of 1,000.

It takes approximately 6 payment quarters (18 months) from the time of joining the PNIP to establish a full SWPE value. From then, the calculated SWPE value will be used, even if it is lower than 1,000. If the practice's SWPE value is more than 1,000 during the initial 18-month period, the actual SWPE value will be used to calculate payments.

Aboriginal Medical Services and Aboriginal Community Controlled Health Services

The SWPE values for Aboriginal Medical Services and Aboriginal Community Controlled Health Services will be increased by 50%.

Resources

PNIP Incentive Payment Ready Reckoner

We have developed a ready reckoner that can be used to estimate the incentive amount a practice may be entitled to:

Review of decision process

The PNIP has a review of decision process. To request a review of decision, your practice's authorised contact person or the practice owner must write to us within 28 calendar days of the date of the notice of the decision it would like reviewed.

The request must include the following details:

  • the name and address of the person requesting the review
  • the name and identification number of the practice
  • the decision to be reviewed, and
  • the grounds for requesting the review 

We will reconsider our decision following the PNIP eligibility criteria and payment criteria used to make the original decision, and advise the practice in writing of the outcome of the review.

If a practice is not satisfied with the reviewed decision, the practice may request the decision to be considered by a formal review committee. We will make these decisions on a case-by-case basis.

Contact us for more information about review of decision processes.