Rural Pharmacy Maintenance Allowance (RPMA)
The Rural Pharmacy Maintenance Allowance is continued under the Fifth Community Pharmacy Agreement in accordance with arrangements set out under the Fourth Community Pharmacy Agreement.
The Rural Pharmacy Maintenance Allowance (RPMA) recognises the additional financial burden of maintaining a pharmacy in rural and remote areas of Australia. The monthly allowance is paid to eligible proprietors of approved pharmacies, approved under section 90 of the National Health Act 1953, providing support to a significantly increased number of community pharmacies.
The allowance is calculated annually, based on the remoteness of the pharmacy according to the Pharmacy Accessibility Remoteness Index of Australia (Pharmacy ARIA), and the level of Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS) claimable processed prescriptions paid by Medicare.
The Pharmacy ARIA is effective for the allowance year. It is revised annually to incorporate new pharmacy locations as at 31 March before the beginning of the allowance year. Any changes to categories will be included in the annual revision of the allowance.
For more information about Pharmacy ARIA go to the GISCA website.
To be eligible for the full RPMA payment the proprietor of a pharmacy must have:
- approval for the pharmacy premises under section 90 of the National Health Act 1953
- the business open, with a pharmacist in attendance, for a minimum of 20 hours over a minimum of four days per week for a minimum of 48 weeks per allowance year. The premises must be located in the Pharmacy ARIA categories of:
- Accessible group A
- Accessible group B
- Moderately accessible
- Very remote.
Medicare can request evidence of the pharmacy's operating hours and that a pharmacist was in attendance during the hours of operation. If either of these requirements has not been met or the Certification Statement is not provided, no further payment(s) will be made.
From 1 July 2012, the eligibility criteria for the RPMA will change.
For more information go to the Department of Health website or call RPMA queries on (02) 6289 9388*.
If the pharmacy's normal hours are less than the minimum specified above, the proprietor can apply in writing to Medicare for an assessment of eligibility under special circumstances, based on how appropriate the service is for the community.
Pharmacies approved under special circumstances will receive a percentage of the 'standard' payment for the appropriate Pharmacy ARIA category as determined by the agreed hours of operation for the allowance period.
To receive RPMA payments the pharmacy's proprietor must:
- maintain no less than the minimum agreed trading hours with a pharmacist in attendance
- provide a Certification Statement confirming the:
- required operating hours were complied with over the relevant assessment period and a pharmacist was in attendance during the required hours of operation
- requirements of continued compliance with the required operating hours and pharmacist in attendance, for the next 12 months.
Medicare must receive a certification statement no later than 14 May each year to make payments from the beginning of the next financial year.
To receive RPMA payments, a new pharmacy should send Medicare its Certification Statement along with the application form specifying the:
- pharmacy’s advertised hours of operation
- pharmacist’s intention to comply with the hours of operation and for a pharmacist to be in attendance during these hours, for the next 12 months
- a predicted prescription count which will be reviewed by Medicare after six months.
If the pharmacy has changed its approval number during the assessment period, the Certification Statement, which should accompany the application form, should:
- confirm hours of operation for the current approval number
- indicate the pharmacist’s intention to comply with these hours of operation for next 12 months.
RPMA is not transferable and payments will stop if the pharmacy's section 90 approval number supplied in the RPMA application changes or becomes inactive.
If a new approval number is issued for a pharmacy previously approved, the proprietor will need to reapply for the allowance.
Medicare will make RPMA payments when a pharmacy has been approved. The pharmacy is entitled to the payments for the rest of the financial year starting from the first day of the month after the day the pharmacy is approved for RPMA.
The RPMA is calculated from 1 July each year and paid monthly.
The allowance for each eligible pharmacy ARIA is calculated using the RPMA payment matrix. Payment levels are calculated using the median PBS and RPBS claimable processed prescription volume for all Australian pharmacies during the relevant assessment year.
|Eligible PhARIA category|
|Prescription volume range||2 Accessible (group1)> (>1-2) #||3 Accessible (group2)> (>2-4) #||4 Moderately> accessible> (>4-6) #||5 Remote> (>6-9) #||6 Very remote> (>9-12) #|
|0 - 32 374||$10 935||$13 669||$20 777||$31 166||$41 555|
|> 32 375 – 40 468||$9 842||$12 302||$18 590||$27 885||$37 180|
|> 40 469 – 48 561||$8 748||$10 935||$16 403||$24 605||$32 806|
|> 48 562 – 56 655||$7 655||$9 568||$14 216||$21 324||$28 432|
|> 56 656 – 64 748||$6 561||$8 202||$12 029||$18 043||$24 058|
|> 64 749 – 72 842||$5 468||$6 835||$9 842||$14 763||$19 684|
|> 72 843 – 80 935||$4 374||$5 468||$7 655||$11 482||$15 310|
|> 80 936||$3 281||$4 101||$5 468||$8 202||$10 935|
# Classification based on the 9 Pharmacy Rule. For information about this index and its use in the PhARIA classifications system visit the Gisca website.
Median script volume: 32,374 per annum
The 'assessment year' for allowance years (starting 1 July each year) will be the 12 months from 1 April to 31 March immediately prior to the allowance year.
Pharmacies who have been actively trading with their current section 90 approval number for a continuous period of less than three months of the specified assessment period, will receive the ‘standard’ payment for their Pharmacy ARIA category (see RPMA payment matrix).
If the pharmacy needs a new approval number due to a:
- change in ownership or partnership
- temporary change in location (for example, refurbishment of premises)
- relocation of the pharmacy (according to ACPA guidelines - this may be either a short or a long relocation
- break in trading of less than two months
the pharmacy proprietor can apply to have their allowance assessed against their previous approval number. The pharmacy proprietor must provide evidence of the previous allocated approval number(s) and reasons for the new approval number being issued.
If a pharmacy has been actively trading with the current section 90 approval number continuously for three to twelve months of the specified assessment period, the pharmacy’s monthly PBS and RPBS claimable processed prescription volume paid by Medicare will be used to calculate an annual prescription volume. This allows the RPMA payment to be calculated using the matrix.
The allowance is revised annually incorporating updated:
- Pharmacy ARIA values
- Payment matrix
- PBS and RPBS prescription volume data for the assessment year to 31 March before to the allowance year.
Current recipients of RPMA will be reassessed automatically and do not need to reapply. However, they will be required to send Medicare a Certification Statement between 1 April and 14 May each year.
Note: back payments will not be made.
Medicare will inform recipients of any changes.
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Last updated: 27 September, 2013