Calculation of payments

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

The SWPE value is calculated using Medicare Benefits Schedule (MBS) claims by patients attending the practice during an historical 12-month period, known as the reference period. The reference period is a rolling 12-month period that begins 16 months before the payment quarter.

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

Data will be excluded if any of the practitioners in a practice refuse consent to the use of their data for the purposes of calculating the practice's payment when completing the Practice Incentives Individual general practitioner or nurse practitioner details form. If practitioners would like their data to be included at a later stage, they must advise us in writing.

Page last updated: 22 February 2019

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