Medicare provider numbers
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Medicare is Australia's universal public healthcare system.
To work as a doctor in Australia, you may need to have a Medicare Provider Number. 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, and you should ask your Australian employer which level of Medicare access for a provider number you require.
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 third type of Medicare provider number listed above. These Medicare provider number restrictions affect where an OTD can work in Australia.
Medicare provider numbers are issued by Medicare Australia, formerly known as the Health Insurance Commission (HIC), after an OTD has been offered a medical job in Australia. To apply for a Medicare provider number, you should complete the Application for a Provider number for a medical practitioner form on the Medicare Australia website. Please note that this form includes information which enables you to apply for a section 19AB exemption to the Medicare provider number restrictions at the same time.
For further information on applying for a Medicare provider number, you can ring Medicare Australia 132 150 (within Australia) and say that you wish to apply for a Medicare provider number in the particular State or Territory in which you will be practising. The operator will put your call through to the appropriate area. Alternatively, you can email the same information to medicare@medicareaustralia.gov.au and type 'Application for Medicare provider number' in the subject heading of the email.
If you are a specialist and require access to Medicare rebates that attract a higher 'specialist' payment under Medicare, you 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@hic.gov.au.