Professional recognition information

You’re eligible for GP recognition if you either:

• hold specialist registration in General Practice with the Medical Board of Australia
• were registered for Medicare purposes on the Vocational Register on 16 June 2021 and continue to hold general registration with the Medical Board of Australia.

You don’t need to apply to be recognised as a GP if you have both of the following:

• a Medicare provider number
• specialist registration in General Practice with the Australian Health Practitioner Regulation Agency (Ahpra).

We’ll get your registration details automatically.

If you were registered on the Vocational Register for Medicare purposes on 16 June 2021, you must maintain general registration with Ahpra. This means you can continue to access GP Medicare items.

If you don’t maintain general registration with Ahpra after 16 June 2021, you’ll lose access to GP Medicare items.

You don’t need to apply for recognition as a specialist for Medicare purposes if your specialty is general practice . We’ll do this automatically.

You can apply for recognition as a medical specialist or consultant physician if you have one of the following:

• fellowship with an Australasian specialist college and either general or specialist registration with the Australian Health Practitioner Regulation Agency (Ahpra)
• specialist registration with Ahpra
• limited, area-of-need registration with Ahpra
• provisional, competent authority pathway (specialty) registration with Ahpra.

This includes:

• overseas trained doctors (OTD)
• foreign graduates of an accredited medical school (FGAMS).

We’ll approve your application for 2 years if you apply using only your Ahpra registration.

You may not need to apply for recognition if you meet both of these:

• you’re a permanent resident or Australian citizen
• you’ve completed your specialist fellowship through an Australasian college.

You may be subject to section 19AB of the Health Insurance Act 1973 (the Act). Read more about restrictions and exemptions for overseas trained doctors.

For Medicare purposes, you need a qualification in one of the specialties listed in the Health Insurance Regulations 2018 to apply.

To bill or claim MBS items for nuclear imaging and Positron Emission Tomography (PET) you need to be accredited.

We recognise credentials from the Joint Nuclear Medicine Credentialling and Accreditation Committee (JNMCAC) of either:

• the Royal Australasian College of Physicians
• the Royal Australian and New Zealand College of Radiologists.

The JNMCAC will tell us when you’re added to the Register of Credentialled Nuclear Medicine Specialists. We’ll update your record.

Recognition as a nuclear medicine specialist allows you to bill and claim MBS items for nuclear medicine imaging.

Recognition as a PET specialist won’t automatically allow you to bill or claim MBS items for PET services.

Read more about applying for recognition as a Positron Emission Tomography specialist.

To bill or claim MBS items for sleep apnoea, you need to provide advice from the Royal Australasian College of Physicians that you have either:

• obtained equivalent to Level I of the advanced training program in either adult or paediatric sleep medicine
• post-fellowship specialist recognition in sleep medicine.

You don’t need to pay an application fee to have this specialist recognition added to your provider record.

To access Medicare benefits, you must meet the recognition rules as set out in the Health Insurance (Allied Health Services) Determination 2014.

There are specific criteria for different types of allied health professionals. You must meet the recognition rules from the determination as well as specific criteria relevant to you.

Find out more about specific criteria for allied health professionals.

To be recognised as a dentist or dental practitioner for Medicare you must meet all of the following:

• be registered or licensed with the Australian Health Practitioner Regulation Agency (Ahpra) or the Dental Board of Australia
• meet the eligibility requirements set out in the Dental Benefits Act 2008 and the Dental Benefits Rules 2014.

You also need to meet specific eligibility criteria for different types of dental practitioners.

Find out more about specific criteria for dental practitioners.

To be recognised as an optometrist for Medicare purposes, you must have current general or limited registration with the Optometry Board of Australia. The Australian Health Practitioner Regulation Agency (Ahpra) supports this national board.

You must send us a copy of your Ahpra registration certificate with your application for your first provider number.

We’ll remove your recognition if the registering body tells us you no longer meet Medicare eligibility requirements.

You can also write to us to tell us to stop recognising you for Medicare purposes. This can be an email or a letter and must include your:

• provider number
• full name
• date of birth.

You must send the request yourself. No one can send it on your behalf.