Medicare provider numbers
Related Links
There are different levels of Medicare access under the provider number scheme depending on medical board registration and satisfying the legislative requirements on accessing Medicare rebates.
A Medicare provider number does not automatically allow a doctor to attract Medicare rebates for their services.
A Medicare Provider Number may allow a doctor to:
1. raise referrals for specialist services; and
2. make requests for pathology or diagnostic imaging services.
Where the doctor satisfies the legislative requirements, their provider number may also be used to:
3. attract Medicare rebates for professional services rendered (that is, treat private patients).
A Medicare provider number uniquely identifies the medical practitioner and the location where they render the service.
Overseas trained doctors (OTDs) are subject to Medicare provider number restrictions if they require the 3rd type of Medicare provider number listed above. These restrictions differ depending on whether the OTD is a permanent resident or a temporary resident.
Medicare provider numbers are issued by Medicare Australia, formerly known as the Health Insurance Commission (HIC). Applications for a Medicare provider number can only be made after an OTD has been offered a medical job in Australia and after a visa has been granted.
It is possible for an employer/recruiter to speed up the process a little by providing the OTD with an Application for a Provider number for a medical practitioner form, which is available from the Medicare Australia website. Once the OTD has signed this, and as long as they can return it to the employer with all of the other required documentation that they must provide (such as a copy of their passport), the employer may make the application on their behalf.
If the position requires a Medicare Provider Number and the doctor is unable to obtain this, then you, as the employer, are responsible for advising the Department of Immigration and Citizenship (DIAC) of this.
For further information on the requirements for applying for a Medicare provider number, ring Medicare Australia 132 150 (within Australia) and advise the operator of the State or Territory in which the OTD will be practising. Alternatively, the email your query to medicare@medicareaustralia.gov.au and type 'Application for Medicare provider number' in the subject heading of the email.
If your OTD will be working as a specialist and requires access to Medicare rebates that attract a higher 'specialist' payment under Medicare, they will also need to apply to Medicare Australia for recognition as a specialist for Medicare billing purposes. For enquiries about specialist recognition, you can ring Medicare Australia on (02) 6124 6939 (in Australia) or email your enquiry to srac@medicareaustralia.gov.au.