Everything a practice owner, practice manager or GP needs to run the Practice Incentives Program Quality Improvement Incentive correctly: the two eligibility components, the 10 quality improvement measures in detail, the quarterly data submission, the patient consent position, and how PIP QI links to CPD hours and to the RACGP standards.
Last reviewed: July 2026. Editorial and review process: about this site. Sources cited at the end.
The Practice Incentives Program Quality Improvement (PIP QI) Incentive is a quarterly payment to eligible general practices that participate in continuous quality improvement in partnership with their local Primary Health Network (PHN). It commenced on 1 August 2019 and replaced four quality-stream elements of the previous Practice Incentives Program (PIP): the Asthma Incentive, the Cervical Screening Incentive, the Diabetes Incentive and the Quality Prescribing Incentive, together with the Service Incentive Payments (SIPs) attached to them.
The payment is calculated at $5.00 per Standardised Whole Patient Equivalent (SWPE) per year, capped at a maximum of $12,500 per quarter per practice. The payment goes to the practice, not to individual GPs. The SWPE is the same patient-weighting measure used elsewhere in the PIP and reflects the practice’s active patient population adjusted for age and sex.
The payment is a direct revenue line. A practice of around 5,000 SWPE receives about $6,250 per quarter, or $25,000 per year. The $12,500 per quarter / $50,000 per year cap is reached at 10,000 SWPE.
Some practices choose to split their practices over different sites to maximise the payment and so avoid being capped out.
To receive a PIP QI payment, a practice must satisfy two components at each quarterly payment point.
Component 1: participate in continuous quality improvement in partnership with the local PHN. The practice commits to ongoing QI activity, informed by its own clinical information system data, addressing the needs of its patient population. There is no prescribed format, no prescribed target, and no prescribed number of activities. The activity must be continuous, partnership-based with the PHN, and responsive to data.
Component 2: submit the PIP Eligible Data Set to the local PHN each quarter. The data set is the de-identified practice data the practice extracts from its clinical information system against the 10 quality improvement measures. The submission is via a compliant data extraction tool, most commonly PenCS Cat4 or POLAR, and is delivered to the PHN through the data exchange platform the PHN operates.
A practice that satisfies both components for a quarter receives the quarterly payment. A practice that misses the data submission for a quarter does not receive the payment for that quarter, even if it satisfied the QI commitment. Reinstatement requires the next successful quarterly submission.
The 10 measures are the data the practice reports; the improvement is the activity and there are no defined improvement targets. Each measure is the proportion of regular patients in a defined clinical group with a specified data item recorded in the relevant look-back period.
The measures below are current as at the last reviewed date at the top of this page. The Department of Health and Aged Care publishes the formal descriptors in the PIP Eligible Data Set data dictionary. Your PHN’s data team can confirm the current exact field specifications.
The proportion of regular patients with a recorded diagnosis of diabetes (type 1, type 2 or undefined) who have a current HbA1c result recorded in the previous 12 months. The measure is split into three sub-cohorts: type 1, type 2, and undefined diabetes. A ‘current’ HbA1c is one taken within the look-back window. A result outside the window counts as a fail against the measure, even if the patient is otherwise well managed.
The data fields are the diabetes diagnosis flag and the HbA1c pathology result. The pathology result enters the clinical record via the electronic download from the lab; manual entry of HbA1c into a free-text field is not picked up by the extraction.
The proportion of regular patients aged 15 and over who have a smoking status recorded in the relevant look-back window. The window is the previous 12 months for patients aged 15 and over. A patient who is recorded as a ‘never smoker’ and who has reached the age of 30 without ever having a smoking status update is correctly recorded and counts.
The data field is the smoking status drop-down. The default in many clinical software systems is blank, and the default in many patient registrations is also blank. Practices that close the gap quickly do so by making smoking status a registration-time field, with a forced update at every adult health assessment.
The proportion of regular patients aged 15 and over who have their height, weight and BMI classification recorded in the previous 12 months. The classification flag is the trigger for the measure: a height and a weight alone do not count. The clinical software calculates the BMI from the height and weight, but the classification flag (underweight, healthy weight, overweight, obese class I, II or III) is a separate field that requires clinician or practice nurse confirmation.
The data gap that hurts this measure most is the weight recorded but no height (so no BMI calculation, and no classification), and the height and weight recorded but the classification never set. The fix is a one-line addition to the practice protocol: every weight entry triggers a height check and a BMI classification.
The proportion of regular patients aged 65 and over who have an influenza immunisation status recorded in the previous 15 months. The 15-month window reflects the annual nature of the flu season and allows the result of one season’s campaign to be visible in the next season’s data.
The data field is the immunisation status, which can come from the practice’s own records (administered on site) or from the Australian Immunisation Register (AIR) download. The AIR is the authoritative source for vaccines administered anywhere; practices that have not enabled the AIR download are working from an incomplete record.
The proportion of regular patients with a recorded diagnosis of diabetes who have an influenza immunisation status recorded in the previous 15 months. Same data fields and look-back as QIM 4, with the denominator restricted to patients on the diabetes register.
The proportion of regular patients with a recorded diagnosis of COPD who have an influenza immunisation status recorded in the previous 15 months. Same data fields and look-back as QIM 4, with the denominator restricted to patients on the COPD register.
The proportion of regular patients aged 15 and over who have an alcohol consumption status recorded in the previous 24 months. The longer look-back (24 months, not 12) reflects the lower-frequency nature of alcohol screening. The data field is the AUDIT-C or equivalent drop-down. A patient who is recorded as a ‘non-drinker’ counts.
The proportion of regular patients aged 45 to 74 without a diagnosis of cardiovascular disease who have the necessary risk factors recorded in the previous 2 years to enable CVD risk assessment. The required factors are age, sex, smoking status, blood pressure, total cholesterol, HDL cholesterol and diabetes status. The data fields are the standard cardiovascular risk factors. Practices that struggle with this measure are usually missing total cholesterol or HDL, or have not enabled the pathology auto-download.
The proportion of regular female patients aged 25 to 74 who have an up-to-date cervical screening test recorded. The screen is current if the most recent test is a primary HPV test within the previous 5 years, or a Pap test within the previous 2 years for tests taken before 1 December 2017, or a co-test within the previous 5 years. The data source is the National Cancer Screening Register (NCSR) for results done anywhere, with the practice’s own clinical record as a secondary check.
The proportion of regular patients with a recorded diagnosis of diabetes who have a blood pressure result recorded in the previous 6 months. The 6-month window reflects the routine review frequency for patients with diabetes. The data field is the most recent BP reading. Practices that have a practice nurse running a diabetes review clinic lead on this measure.
The PIP Eligible Data Set is the de-identified data the practice extracts against the 10 measures for submission to the PHN. The data set is defined by the Department of Health and Aged Care. The data dictionary is published and updated periodically; your PHN’s data team can confirm the current version.
The data set is de-identified at the practice before submission. The fields are the 10 measures, the patient counts, the practice identifier, and the quarter. Direct identifiers (name, address, date of birth, Medicare number) are not part of the submission. Indirect identifiers (age band, sex, postcode) are limited to what is required for the measure calculation.
The submission is via the PHN’s data exchange platform. The platform receives the data, processes it against the data dictionary, and produces a practice-level report. The PHN uses the aggregated regional data to support practice benchmarking and population health planning. The individual practice data is returned to the practice as a quarterly report.
The data set is de-identified before it leaves the practice. The Department of Health treats the data sharing as covered by the practice’s existing clinical relationship with the patient. There is no specific consent form required for the data submission.
Patients can request that their data be excluded from the extraction. The practice’s process for handling such requests is a matter of practice policy. The simplest process is a flag on the patient record (commonly a ‘do not extract’ or ‘PIP QI opt-out’ flag) that the extraction tool respects. Document the request in the patient record and in the practice’s privacy policy.
The broader privacy position is that the quality assurance and evaluation exemption in the Privacy Act 1988 covers most in-practice QI work, including the PIP QI submission. The exemption has specific conditions around use, disclosure and storage; your practice’s privacy policy should describe how the data is handled.
Two data extraction tools dominate the Australian PIP QI landscape. Both are licensed to practices through their local PHN; in most regions the practice pays nothing directly.
PenCS Cat4 is a data extraction and analysis tool that connects to the major clinical software systems (Best Practice, Medical Director, Zedmed, MedTech, Genie, Communicare, MMEX, PCIS, practiX). It generates the 10 PIP QI measures, supports a wide range of additional clinical audits, and produces patient-level reports that the practice can use for follow-up. PHN licensing varies by region; some PHNs provide PenCS at no cost to local practices, others charge a per-practice fee.
POLAR (formerly POLAR GP, owned by Outcome Health) is a similar data extraction and analysis tool with strong uptake in several PHN regions. It connects to the same major clinical software systems, generates the 10 PIP QI measures, and supports additional audits. PHN licensing arrangements vary.
In most cases the choice is made for you by your PHN. Some PHNs license one tool exclusively; others offer both. From the practice’s perspective, the two are interchangeable for the PIP QI submission. The differences are in the additional audit options and the user interface. If you are in a region with both available, ask your PHN’s data team for a 30-minute demo of each and pick the one your practice team finds easier to use.
The built-in audit and search functions in Best Practice, Medical Director, Zedmed and MedTech will generate the 10 measures, with more manual effort and less benchmarking. For practices that are not yet connected to a PHN-licensed data extraction tool, the built-in functions are a workable interim step. The extraction and submission still happen; the practice does the joins and the percentages manually.
The PIP QI data submission runs on a calendar-quarter cycle. The four submission windows each year are:
The submission window for each quarter is set by the Department of Health and notified via your PHN. The PIP QI payment for a quarter is paid in the month after the submission window closes, provided the data was submitted during the window.
A missed submission means a missed payment for that quarter. The next quarter’s submission is a fresh start. There is no clawback of payments already received; the missed quarter is simply unpaid.
Practices that are new to PIP QI register through Health Professional Online Services (HPOS) using their PRODA account. The Services Australia PIP team confirms eligibility and the practice’s SWPE before the first payment.
PIP QI is a practice-level obligation, not a CPD obligation. The two are separate but compatible. A practice-wide PDSA cycle that addresses a PIP QI measure generates CPD hours for the GPs who participated, against the Measuring Outcomes category, and contributes to the practice’s PIP QI data for the relevant quarter. Practices also have the opportunity to seek permission from the PHN to submit their own PDSAs unrelated to the 10 quality improvement measures. If approved by the PHN, these can address both the CPD requirements and the PIP quality requirements.
The CPD home’s record of the PDSA cycle is the GP’s audit evidence. The practice’s PIP QI folder is the PIP QI audit evidence. The two are different documents for different audiences, but the underlying activity is the same.
A common misconception is that the PIP QI submission itself counts as a CPD activity. It does not. The CPD hours come from the planning, the measurement, the analysis, the team meeting and the embedded change. The submission is a data transfer, not a learning activity.
The RACGP Standards for general practices (5th edition) include a Quality Improvement criterion (Criterion QI 1.1) that requires the practice to participate in QI activities that improve clinical care, patient experience or practice systems. PIP QI participation is the most common way practices meet the criterion for accreditation.
For an accreditation surveyor, the evidence is a folder containing the PIP QI data, the PDSA cycle documents, the team meeting minutes, and the changes embedded from each cycle. The same folder is your audit evidence for PIP QI. The two programs reinforce each other, and the practice that runs PIP QI well is well-positioned for accreditation.
PIP is the broader Practice Incentives Program, which includes teaching, eHealth, after-hours, Indigenous health, procedural, and other incentive streams. PIP QI is one specific stream within PIP, focused on quality improvement. A practice can be on any combination of PIP streams.
The maximum is $12,500 per quarter per practice. The actual payment is $5.00 per SWPE per year, which works out to $1.25 per SWPE per quarter. For a practice of 5,000 SWPE, the quarterly payment is around $6,250. For a practice of 10,000 SWPE, the quarterly payment is at or near the $12,500 cap.
The SWPE is calculated by Services Australia from the practice’s patient data. It reflects the practice’s active patient population, weighted by age and sex. The calculation is the same as for other PIP streams. Your practice’s SWPE is visible in HPOS.
The practice does not receive the payment for that quarter. The next successful submission reinstates the payment. There is no clawback of previously paid quarters.
Yes. PIP QI is an independent stream. A practice can register for PIP QI without being on teaching, eHealth, or any other PIP stream. The eligibility for PIP QI is the eligibility for PIP plus the two PIP QI-specific components.
No. The submission is a data transfer, not a learning activity. The CPD hours come from the planning, measurement, analysis, team meeting and embedded change. The data submission is the audit trail, not the activity.
Yes. The PDSA cycle is the activity. It contributes to the practice’s PIP QI commitment (by addressing a measure or by the QI commitment more broadly) and generates CPD hours for the participating GPs. The two programs share the same evidence trail.
The data is de-identified at the practice before submission. The Department of Health treats the submission as covered by the practice’s clinical relationship. Patients can request that their data be excluded; the practice should have a documented process for handling such requests.
All major Australian clinical software systems (Best Practice, Medical Director, Zedmed, MedTech) interface with both PenCS Cat4 and POLAR. If you are running a less common system, ask your PHN’s data team for the current compatibility list.
Each site registers separately. The PIP QI payment is per practice, where a practice is defined by the site registration. Multi-site practices can run a coordinated QI program across sites but each site must satisfy the eligibility components independently. There is an advantage in splitting the QI payments over multiple practices to minimise the payment capping out.
Raise it with your PHN’s data team. Most apparent data discrepancies are data dictionary issues (a field mapped to the wrong code, a denominator inclusion that should be an exclusion). Your PHN can usually resolve these. Where the data is genuinely an outlier for your practice, document the issue and the resolution; it is part of your audit trail.
Contact your local PHN. The PHN’s PIP QI coordinator will walk you through the eligibility criteria, the registration process and the data extraction tool. Most PHNs offer a one-hour onboarding session at no cost.
The PIP QI payment rate, the 10 measures, the eligibility components and the quarterly submission cycle are current as at the last reviewed date at the top of this page. Verify against the Department of Health and your PHN before relying on the figures for your practice’s submission.
Disclaimer: PIP QI is administered by the Department of Health and Aged Care and Services Australia. The eligibility criteria, the 10 measures, the payment rate and the submission cycle are set by the Department. The data dictionary is updated periodically; verify the current version with your PHN before each quarterly submission. This page is a working guide for practice teams, not a substitute for the formal guidelines.
Cross-link: this guide is a companion to the Australian GP CPD and quality improvement: comprehensive FAQ. For the CPD hours generated by a PIP QI activity, for the RACGP standards crossover, and for the privacy and consent framework, see the FAQ hub.