The Scaling Initiative - Questions and Answers

This page provides information about the Scaling Initiative for the Bonded Medical Places (BMP) Scheme in the form of questions and answers.

Page last updated: 08 October 2013

1. What is scaling?
2. What are Remoteness Area categories?
3. Where can I work?
4. When can I begin to reduce my return of service using scaling?
5. What are the eligibility criteria?
6. How will scaling discounts be calculated?
7. How is the total 'value of claims' threshold determined?
8. Where are the eligible Medicare services?
9. What if I only work in an area for a short period of time of work in more than one location in a month?
10. How will I be informed of the discount applied to my record?
11. What if I don't agree with the discount(s) I have received?
12. What happens when I finish my return of service obligation?
13. How can I get more information?

1. What is scaling?

The scaling initiative was announced in the 2009-10 Federal Budget as part of the Rural Health Workforce Strategy. Scaling is being applied to a range of Australian Government programs that have a return of service obligation, including the Bonded Medical Places (BMP) Scheme. Scaling increases the attractiveness of working in rural areas by fast tracking your return of service obligation based on the Remoteness Area (RA) catgeory you are working in. The greatest reward will be for those willing to work in the most remote locations of Australia.

2. What are Remoteness Area categories?

The BMP Scheme uses the Australian Standard Geographical Classification - Remoteness Areas (ASGC-RA) system, which groups locations into 'remoteness areas'.

The RA categories for the BMP Sceme are outlined below:
RA category number as used by the Department in the BMP Scheme
RA1 - Major Cities of Australia
RA2 - Inner Regional Australia
RA3 - Outer Regional Australia
RA4 - Remote Australia
RA5 - Very Remote Australia

From January 2010, RA categories have applied to the BMP Scheme to determine eligible work areas for doctors completing their return of service obligation, replacing the Rural, Remote and Metropolitan Areas (RRMA) classification system.

Further information on the Remoteness Area (RA) categories can be found on the Department of Health DoctorConnect website.

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3. Where can I work?

While the scaling system will offer opportunities to reduce your return of service obligation, BMP Scheme doctors still have to work:

  • for general practitioners - in districts of workforce shortage (DWS) in RA1 (Outer Metro) and DWS in RA2 (Inner Regional) to RA5 (Very Remote Australia) categories;
  • for specialists (other than general practitioners) - in districts of workforce shortage for their specialty in RA1 ( Inner Metro); outer metropolitan areas of RA1 (Major Cities of Australia); and RA2 (Inner Regional Australia) to RA5 (Very Remote Australia) categories; and
  • for general practitioners and specialists - any location in Australia if work is undertaken at an Aboriginal Medical Service.

You can check the Remoteness Area (RA) classification of a location at the DoctorConnect website.

4. When can I begin to reduce my return of service using scaling?

Once BMP Scheme doctors have attained Fellowship, any remaining return of service obligation can be reduced using scaling.

All BMP Scheme participants who signed a Deed of Agreement prior to 2010 will need to sign a Deed of Variation to allow them to access scaling.

There is no formal application process for doctors to apply for scaling. If you are billing Medicare and meet the eligibility criteria, you will automatically have scaling discounts applied to your return of service period on a monthly basis. If you work in a salaried position and meet the eligibility criteria, scaling will be applied six monthly or when you move locations.

5. What are the eligibility criteria?

If you are billing Medicare, scaling discounts will be applied to your return of service obligation each month if:

  • your return of service period has commenced;
  • you have worked in a RA2 (Inner Regional Australia) to RA5 (Very Remote Australia) category; and
  • you have met the 'value of claims' threshold of $5,000 for that month.

If you are working in a salaried position, scaling discounts will be applied to your return of service obligation if:

  • your return of service period has commenced;
  • you have worked in a RA2 (Inner Regional Australia) to RA5 (Very Remote Australia) category; and
  • you are working at least 20 hours per week.
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6. How will scaling discounts be calculated?

If you are billing Medicare, discounts will be based on your claiming activity every month. Medicare Australia will look at your claiming history and determine the RA category in which the highest 'value of claims' occurred and apply the scaling discount to that RA category. The scaling discount applicable to the major RA category will be discounted from your return of service period end date.

If you are a salaried officer, then the Department of Health will apply scaling. The scaling discount applicable to the major RA category will be discounted from your return of service period end date.

Scaling will be applied monthly at the following rates:
RA Category Scaling Discount Rate %
RA 2 - Inner Regional Australia 10%
RA 3 - Outer Regional Australia 30%
RA 4 - Remote Australia 40%
RA 5 - Very Remote Australia 50%

7. How is the total 'value of claims' threshold determined?

The 'schedule' fee value for all eligible services rendered (based on the date of service) will be totalled and used to determine if you have reached the 'value of claims' threshold each month. This will be applied where the 'value of claims' threshold is met.

8. Where are the eligible Medicare services?

The 'schedule fee' of the following Medicare services will contribute to the total 'value of claims' each month:

  • all MBS services, including assist at operation item numbers;
  • MBS items used for DVA consultations; and
  • late claims.

The following Medicare services will not be counted:

  • rejected claims;
  • additional bulk billing incentive items; and
  • MBS services undertaken in RA 1 (Major cities of Australia)

9. What if I only work in an area for a short period of time or work in more than one location in a month?

Medicare Australia will calculate the claiming activity in all eligible RA locations, irrespective of the number of services provided in each RA category. If you met the 'threshold', Medicare Australia will apply the discount applicable to the RA category where the major activity occured.

10. How will I be informed of the discount applied to my record?

Doctors billing Medicare

You are able to view your return of service period and scaling discount(s) through Medicare Australia's Health Professionals Online Services (HPOS). HPOS offers improved access to Medicare Australia's provider online services and provides access to information concerning your identity, eligibility and details necessary for the processing and payments of Medicare claims.

To access the HPOS system, you will need a Public Key Infrastructure (PKI) logon. Registration forms for a PKI logon.

Alternatively, information regarding HPOS can be obtained by contacting the Medicare Australia eBusiness Service Centre on 1800 700 199.

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Salaried doctors

The Department of Health will email you on a six monthly basis, or when you move locations, with your return of service period and scaling discount.

11. What if I don't agree with the discount(s) I have received?

Once you have begun your return of service period, enquiries in reference to the scaling discount can be made to Medicare Australia. Service officers will explain the process used to determine the monthly discount.

Medicare Australia will run monthly scaling and include the recalculation of the previous three months. This will identify any claims with a date of service during the previous three month period. Furthermore, to ensure all late claims are included, an automated recalculation will occur twice yearly (March and September). The twice yearly recalculations will calculate the previous six month period and up to two years once this data exists.

If you work in a salaried position, enquiries in reference to the scaling discount can be made to the Department of Health.

12. What happens when I finish my return of service obligation?

When your 'return of service period' end date is equivalent to the 'actual date', the Department will notify you that your contractual obligations have been completed.

13. How can I get more information?

For questions regarding the BMP Scheme contact the Department of Health

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Phone: 1800 987 104
Email: BMP Scheme@health.gov.au
Website: Bonded Medical Places Scheme (http://www.health.gov.au/bmpscheme)
Mail: BMP Scheme
Department of Health
GPO Box 9848, MDP 149
CANBERRA ACT 2601

Further information on the RA categories can be found on the DoctorConnect wesbite.