Medicare Benefits Schedule - Note GN.4.13

Last reviewed: 1 February 2024

SUMMARY

This general note sets out which medical practitioners can use the MBS general practitioner (GP) items.

Medical practitioners that are eligible to provide Medicare services who are not GPs but provide services in a general practice setting can use the medical practitioner and prescribed medical practitioner (explanatory note AN.7.1) MBS items.

WHO CAN USE THE MBS GP ITEMS?

The Health Insurance Act 1973 (the Act), and legal instruments made under the Act, set out which medical practitioners can claim MBS GP items. The four categories of medical practitioner that can access MBS GP items are those that are:

1. Fellows of a General Practice College
   
   
2. On an approved placement in a general practice training program
   
   
3. Listed on the Vocational Register of GPs (closed to new participants)
   
   
4. Eligible non-VR GPs (closed to new participants)      

Before you can claim MBS GP items you must have a Medicare provider number for the location at which you are practising. You can apply for a Medicare provider number through Services Australia.

1. Medical practitioners who are fellows of a General Practice College

Medical practitioners that are fellows of either the:

• Australian College of Rural and Remote Medicine (ACRRM), or
  
  
• Royal Australian College of GPs (RACGP)

are GPs for MBS purposes.

Services Australia uses the Australian Health Practitioner Regulation Agency (Ahpra) Register of Medical Practitioners to determine practitioners’ access to the GP items. Fellows of the RACGP and ACRRM must hold specialist registration as a GP with the Medical Board of Australia to access the GP items. The Ahpra registration for these medical practitioners will indicate that they are a specialist in the field of general practice.

2. Medical practitioners on an Approved Placement in a general practice training program

Section 1.1.3 of the Health Insurance (General Medical Services Table) Regulations 2021 provides access to the MBS GP items to medical practitioners undertaking an approved training placement. That is, a training placement that will lead to fellowship with the RACGP or ACCRM.

• For more information on approved training placements see the General Practice Fellowship Program Placement Guidelines.

Your placement organisation must advise Services Australia of the placement before MBS GP items can be accessed.

3. Medical practitioners on the Vocational Register of GPs

The Vocational Register of GPs closed to new participants on 16 June 2021.

Section 16 of the Health Insurance Regulation 2018 allows medical practitioners whose names are entered onto the Vocational Register of GPs to access MBS GP items provided they continue to be registered with Ahpra.

4. Eligible non-vocationally recognised medical practitioners

The programs below closed to new participants on 1 January 2019.

Section 1.1.2 of the Health Insurance (General Medical Services Table) Regulations 2021 specifies which non-vocationally recognised medical practitioners can access MBS GP items:

1. Medical practitioners who have been notified by the Chief Executive of Medicare that they have completed the requirements of the MedicarePlus for Other Medical Practitioners Program before 31 December 2023.
   
   
2. Participants in the Other Medical Practitioners Extension Program who were enrolled in one of the following programs as at 30 June 2023:
   
   1. After Hours Other Medical Practitioner Program
   2. Outer Metropolitan Other Medical Practitioner Program
   3. Rural Other Medical Practitioner Program

RELEVANT LEGISLATION

Details of the legislative arrangements applying to the categories of medical practitioners able to use the MBS GP items can be found on the Federal Register of Legislation, and are set out in three regulatory instruments:

• Health Insurance Act 1973
  
  
• Health Insurance (General Medical Services Table) Regulations 2021
  
  
• Health Insurance Regulations 2018

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