Medicare Benefits Schedule - Note GN.12.31

Medical services in Categories 2 and 3 not included in GN.12.30 and Category 5 (Diagnostic Imaging) services continue to attract Medicare benefits if the service is rendered by:‑

(a) the medical practitioner in whose name the service is being claimed;

(b) a person, other than a medical practitioner, who is employed by a medical practitioner or, in accordance with accepted medical practice, acts under the supervision of a medical practitioner. 

See Category 6 Notes for Guidance for arrangements relating to Pathology services.

So that a service rendered by an employee or under the supervision of a medical practitioner may attract a Medicare rebate, the service must be billed in the name of the practitioner who must accept full responsibility for the service.  All practitioners should ensure they maintain adequate and contemporaneous records.  All elements of the service must be performed in accordance with accepted medical practice.

Supervision from outside of Australia is not acceptable. 

While the supervising medical practitioner need not be present for the entire service, they must have a direct involvement in at least part of the service.  Although the supervision requirements will vary according to the service in question, they will, as a general rule, be satisfied where the medical practitioner has:-

(a) established consistent quality assurance procedures for the data acquisition; and

(b) personally analysed the data and written the report.

Benefits are not payable for these services when a medical practitioner refers patients to self‑employed medical or paramedical personnel, such as radiographers and audiologists, who either bill the patient or the practitioner requesting the service. 

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