Medicare Benefits Schedule - Note GN.2.5

Practitioners eligible to have Medicare benefits payable for their services and/or who for Medicare purposes wish to raise referrals for specialist services and requests for pathology or diagnostic imaging services, may apply in writing to Services Australia for a Medicare provider number for the locations where these services/referrals/requests will be provided.  The form may be downloaded from the Services Australia website. 

For Medicare purposes, an account/receipt issued by a practitioner must include the practitioner's name and either the provider number for the location where the service was provided or the address where the services were provided. 

Medicare provider number information is released in accord with the secrecy provisions of the Health Insurance Act 1973 (section 130) to authorized external organizations including private health insurers, the Department of Veterans' Affairs and the Department of Health and Aged Care. 

When a practitioner ceases to practice at a given location they must inform Medicare promptly.  Failure to do so can lead to the misdirection of Medicare cheques and Medicare information. 

Practitioners at practices participating in the Practice Incentives Program (PIP) should use a provider number linked to that practice.  Under PIP, only services rendered by a practitioner whose provider number is linked to the PIP will be considered for PIP payments. 

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