MyMedicare began as an optional patient registration model and has become, in less than two years, a load-bearing piece of your practice's revenue infrastructure. Chronic Condition Management items flow through it. Telehealth access has been restructured around it. The Bulk Billing Practice Incentive Program uses it to define eligible patients. And from 31 December 2026, the accreditation exemption that allowed unaccredited practices to register expires. If your practice is registered with MyMedicare, you now carry a set of compliance obligations that did not exist three years ago. This guide sets them out clearly.
What is MyMedicare?
MyMedicare is a voluntary patient registration model administered by the Department of Health and Services Australia that formalises the relationship between a patient and their usual general practice. When a patient registers with your practice through MyMedicare, they are declaring you as their nominated primary care provider. That single act of registration then unlocks a set of Medicare items and incentive programs that are only available to registered patients, and it triggers compliance obligations on the practice side that the patient does not see.
The model launched in October 2023 and has been progressively expanded. From 1 July 2025, the Chronic Condition Management items were linked to MyMedicare registration. From 1 November 2025, telehealth access changed so that MyMedicare-registered patients can consult their practice via telehealth without the previous 12-month in-person visit requirement. From the same date, MyMedicare-registered patients became an eligible patient category under the Bulk Billing Practice Incentive Program. The direction of policy is clear: MyMedicare is becoming the default structure for primary care funding.
The accreditation requirement and the December 2026 deadline
Registering your practice with MyMedicare requires your practice to be accredited against the RACGP Standards for general practices. An exemption currently allows unaccredited practices to register if they can demonstrate they are working toward accreditation. That exemption expires on 31 December 2026. From 1 January 2027, practices that are not accredited will lose their MyMedicare registration and therefore lose access to the patient registrations, chronic condition items, telehealth rules, and BBPIP eligibility that flow through it.
For practices that have been drifting toward accreditation without a concrete plan, this deadline is the one that matters most. RACGP accreditation is a structured, multi-month process involving document preparation, a site visit, and evidence of clinical governance. It is not something you can start in November 2026 and complete in time. If you have not begun the accreditation journey, our guide to getting started with RACGP accreditation walks through the steps and timelines, and our guide to common accreditation failures covers the pitfalls to avoid.
The seven-day enrolment obligation
Once a patient submits a MyMedicare registration form nominating your practice, you have a seven-day window to complete the enrolment in the Services Australia provider portal. This is not optional. If you do not complete the enrolment within seven days, the patient's registration lapses and they must submit the form again. Repeated failures to enrol patients within the window can trigger a compliance review.
This obligation sits with the practice, not the patient. Most practices handle it through a designated staff member who monitors incoming MyMedicare forms (paper or digital), verifies patient details against the practice's existing records, and completes the enrolment in the portal. If your workflow depends on a single staff member and that person is on leave, you can accumulate a backlog of expired registrations within a fortnight.
Chronic Condition Management item linkage
From 1 July 2025, the Chronic Condition Management items (which replaced the older GP Management Plan and Team Care Arrangement items) can only be claimed for patients registered with your practice through MyMedicare. This was one of the most significant changes to GP billing in years. A practice that is not registered with MyMedicare cannot bill CCM items at all. A practice that is registered can only bill CCM items for its MyMedicare-registered patient list.
The practical implication is that chronic disease patients who are not yet registered need to be. Many practices have moved to a proactive registration workflow, identifying chronic disease patients at their next visit and walking them through the MyMedicare registration form at the front desk. Without that workflow, you are leaving CCM items on the table for patients who would otherwise be eligible.
Telehealth access changes from November 2025
From 1 November 2025, MyMedicare-registered patients can access telehealth consultations with their nominated practice without needing to have had a face-to-face visit in the previous 12 months. For non-registered patients, the 12-month in-person rule continues to apply. This is a significant shift that favours MyMedicare-registered practices and patients, and it has compliance implications.
If your reception or nursing team is booking a telehealth appointment for a patient, the eligibility rules now depend on the patient's MyMedicare registration status. Booking a telehealth consultation for a non-registered patient who has not had a face-to-face visit in 12 months will result in a non-compliant claim. Medicare has been actively auditing telehealth billing, including sending awareness letters to providers who appear to be claiming telehealth for ineligible patients.
How MyMedicare links to BBPIP
MyMedicare-registered patients are an eligible patient category under the Bulk Billing Practice Incentive Program. This means that if your practice is claiming BBPIP, you must bulk bill every eligible service for every MyMedicare-registered patient. You cannot selectively charge an out-of-pocket fee to a registered patient and expect to receive the quarterly BBPIP incentive. For the full detail on BBPIP rules, see our BBPIP compliance guide.
This tight interlock is why MyMedicare compliance now sits at the centre of your practice's Medicare revenue. Registration unlocks the revenue. Non-compliance with registration obligations blocks it.
What registered practices should be tracking
There are five things your practice should be tracking continuously once you are registered with MyMedicare. The first is your MyMedicare patient list and its accuracy against the Services Australia register. The second is incoming registration forms and their enrolment within the seven-day window. The third is your accreditation status and the timeline to your next RACGP assessment, especially with the 31 December 2026 deadline approaching. The fourth is chronic disease patient registration coverage, so that you are not losing CCM item revenue through unregistered patients. The fifth is telehealth eligibility at the point of booking, so you avoid claiming telehealth items for patients who do not meet the rules.
A structured compliance tool that monitors accreditation milestones, enrolment backlog, and patient eligibility in one place replaces the spreadsheet-and-memory approach that most practices are still relying on. With three years of interlocking obligations stacking on top of MyMedicare, that approach is no longer safe.
Frequently Asked Questions
What is MyMedicare and is it mandatory?
MyMedicare is a voluntary patient registration model that formalises the relationship between a patient and their usual general practice. It is not mandatory for patients or practices, but it is now a prerequisite for claiming Chronic Condition Management items, for accessing the expanded telehealth rules from November 2025, and for having patients count as eligible under the Bulk Billing Practice Incentive Program. For most general practices, registration has effectively become necessary to access standard GP revenue streams.
Does my practice need to be accredited to register with MyMedicare?
Yes. Registering with MyMedicare requires your practice to be accredited against the RACGP Standards for general practices. An exemption currently allows unaccredited practices to register if they are working toward accreditation, but this exemption expires on 31 December 2026. From 1 January 2027, only accredited practices will retain MyMedicare registration.
What is the seven-day enrolment rule?
When a patient submits a MyMedicare registration form nominating your practice, you must complete the enrolment in the Services Australia provider portal within seven days. If you do not enrol the patient within this window, their registration lapses and they must submit a new form. Repeated failures can trigger a compliance review.
Can I claim Chronic Condition Management items without MyMedicare?
No. From 1 July 2025, Chronic Condition Management items can only be claimed for patients who are registered with your practice through MyMedicare. A practice that is not registered with MyMedicare cannot bill CCM items, and a registered practice can only bill CCM items for its MyMedicare-registered patient list.
How did the telehealth rules change for MyMedicare patients?
From 1 November 2025, MyMedicare-registered patients can access telehealth consultations with their nominated practice without needing a face-to-face visit in the previous 12 months. For non-registered patients, the 12-month in-person rule continues to apply. Booking a telehealth consultation for a non-registered patient who has not had a face-to-face visit in 12 months will result in a non-compliant Medicare claim.
How does MyMedicare connect to BBPIP?
MyMedicare-registered patients are an eligible patient category under the Bulk Billing Practice Incentive Program. If your practice claims BBPIP, you must bulk bill every eligible service for every MyMedicare-registered patient. Charging an out-of-pocket fee to a registered patient for an eligible service forfeits the quarterly BBPIP incentive.
What happens if my practice is not accredited by 31 December 2026?
From 1 January 2027, practices that are not accredited will lose their MyMedicare registration. They will no longer be able to claim Chronic Condition Management items, they will lose the expanded telehealth rules for previously registered patients, and their MyMedicare-registered patients will no longer count as eligible under BBPIP. RACGP accreditation is a multi-month process and cannot be completed in weeks, so practices not yet on an accreditation path need to start now.
Track MyMedicare obligations with ClinicComply
ClinicComply gives Australian general practices a single place to track accreditation milestones, MyMedicare enrolment backlogs, chronic condition registration coverage, and the six-year records that underpin Medicare compliance. Your practice gets visibility into the compliance gaps that cost you Medicare revenue before they become clawback letters. Start your free 30-day trial at cliniccomply.com.au.