The traditional use of line-item budgeting, which categorizes public expenditures by detailed economic items, has negatively impacted the financing of primary care services in low- and middle-income countries (LMICs). This approach reduces budget visibility, fragments expenditures, and limits accountability. Programme-based budgeting, which groups inputs into budgetary programmes aligned with policy goals or outputs, offers a promising alternative. It can enhance budget prioritization, increase spending flexibility, and improve accountability for results. However, its potential has not been fully realized in the health sector due to flaws in reform design and implementation, and limited connection with the requirements for primary care financing. This policy note provides key recommendations for practitioners on designing and implementing programme-based budgets to effectively finance primary care services. The policy note is structured around five key dimensions that address critical technical aspects of programme-based budget allocation, execution, and oversight from the perspective of financing primary care: 1) Formulation in national budget structure; 2) Formulation in subnational budget structure; 3) Coverage of costs; 4) Disbursement policies and provider payment; and 5) Performance-monitoring frameworks.