Medicare Benefits Schedule - Note GN.5.14

A medical practitioner who:

· is registered as a specialist under State or Territory law; or

· holds a fellowship of a specified specialist College and has obtained, after successfully completing an appropriate course of study, a relevant qualification from a relevant College

and has formally applied and paid the prescribed fee, may be recognised by the Minister as a specialist or consultant physician for the purposes of the Health Insurance Act 1973. 

A relevant specialist College may also give Services Australia's Chief Executive Officer a written notice stating that a medical practitioner meets the criteria for recognition. 

A medical practitioner who is training for a fellowship of a specified specialist College and is undertaking training placements in a private hospital or in general practice, may provide services which attract Medicare benefits.  Specialist trainees should consult the information available at Services Australia's Medicare website. 

Once the practitioner is recognised as a specialist or consultant physician for the purposes of the Health Insurance Act 1973, Medicare benefits will be payable at the appropriate higher rate for services rendered in the relevant speciality, provided the patient has been appropriately referred to them. 

Further information about applying for recognition is available at Services Australia Medicare website.  

Services Australia (SA), in consultation with the Department of Health and Aged Care, has developed a Health Practitioner Guideline to substantiate that a valid referral existed (specialist or consultant physician) which is located on the Department of Health and Aged Care website.

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