Your Guide to Obtaining a Medicare Provider Number in Australia

At Elective Recruitment, we’re here to help you navigate the process of obtaining your Medicare provider number. Whether you’re a new graduate or an experienced doctor who has secured their first job in Australia, or a locum doctor applying for additional locations, this guide will provide you with all the essential information you need.

What is a Medicare provider number?

A Medicare provider number is a unique number issued to eligible health professionals that allows practitioners to bill, refer and request services that are eligible for Medicare benefits, the Australian Government funded health system.

You must apply for a unique provider number for each place of practice and profession you practise in.

To qualify for a rebatable Medicare provider number to bill for services, you must satisfy section 19AA of the Health Insurance Act 1973 and be either:

• Vocationally recognised as a specialist, consultant physician or specialist general practitioner
• Registered on the Vocational Register with general registration with the Australian Health Practitioner Regulation Agency (AHPRA)
• Registered in an approved placement under section 3GA of the Act
• First registered before 1 November 1996 – some exclusions apply
• A temporary resident doctor with an exemption under section 19AB of the Act

As an intern, registrar or trainee, you may be required to hold a non-rebatable provider number to refer to specialists and request diagnostic tests that are eligible for a Medicare benefit.

To apply for a Medicare Provider Number, you’ll require:

• AHPRA registration
• Identity documents

You can read more information here about identity documents you need before you start.

How to apply: 

If you have Australian Government identity documents you can apply online:

1. You need a Provider Digital Access (PRODA) account to access Health Professional Online Services (HPOS). If you don’t have one, register for PRODA online. The set-up process should take 10-15 mins. HPOS is a secure online portal that connects healthcare professionals directly with the Department of Human Services (DHS). The DHS is responsible for managing Medicare.

2. Set up your HPOS access using either your Australian Health Practitioner Regulation Agency (AHPRA) registration number or other healthcare identifier.

3. Once you have HPOS access, apply for your initial Medicare provider number online to work in Australia.

4. To apply for an initial Medicare provider number, log in to your PRODA account to access HPOS, then:

• Select My Details.
• Select My Digital Provider Number Registration.
• Select Apply.
• Complete the questions in the application and select submit.

If you don’t have Australian Government issued identity documents you’ll need to:

1. Complete the Manual Identity Verification Provider Digital Access form to register a PRODA account.

2. Set up your HPOS access using either your AHPRA registration number, or other healthcare identifier.

3. Once you have HPOS access, you can apply for your initial Medicare Provider Number online to work in Australia following step 4  above.

If you can’t apply online, you’ll need to complete an application form and return it with supporting documents by:

• post to

Services Australia
Provider Registration Section
GPO Box 9822
In your capital city

• email to provider.registration@servicesaustralia.gov.au

You can download the application forms here

Processing Time:

Applying for a new Provider Number via PRODA grants the number instantaneously. Email and postal Medicare provider number applications can take up to 28 days to process from the date of your application.

Apply for Additional Provider Numbers

You can apply for an additional provider number through HPOS or by completing a form.

You will need to apply for an additional provider number if you work:

• in a new practice location
• for a new service at the same location
• in a new health profession or discipline

Obtaining a Pharmaceutical Benefits Scheme (PBS) Prescriber Number

In addition to your Medicare provider number, you will also need a PBS prescriber number if you’re a health professional who prescribes medications. This number allows you to prescribe medications under the PBS.

To apply for a PBS prescriber number, log in to your PRODA account to access HPOS, then:

1. Go to the Location Details section in the Practice Address Tab.
2. Select yes to the question ‘Do you want a prescriber number for prescribing Pharmaceutical Benefits Scheme medicines under the National Health Act 1953?’.

A prescriber number can also be requested by completing the form as linked above.

If you have any questions about obtaining your Medicare provider number, our friendly team is here to answer your questions and guide you smoothly through the process. Don’t hesitate to reach out! Contact us at hello@elective.com.au.