Submit a Medicare claim online
You can submit a claim for some Medicare benefits using your Medicare online account or using the Express Plus Medicare app.
How to submit a claim
The easiest way to submit a Medicare claim is at your doctors. If your doctor doesn’t offer electronic claiming, you can submit a claim for some services using your Medicare online account or Express Plus Medicare app.
To submit a Medicare claim online, you must be registered for a Medicare online account and have your Medicare card and the doctor’s account for the items you want to claim.
What you can claim online
Only some consultations can be claimed through your Medicare online account. You can claim these item numbers online:
- Item 3 – GP Consultation - Level A
- Item 23 – GP Consultation - Level B
- Item 36 – GP Consultation - Level C
- Item 44 – GP Consultation - Level D
- Item 53 – Other Medical Practitioner Standard Consultation
- Item 54 – Other Medical Practitioner Long Consultation
- Item 57 – Other Medical Practitioner Prolonged Consultation
- Item 5020 – GP Consultation - Level B (after hours)
- Item 5060 – GP Consultation - Level D (after hours)
- Item 5200 – Other Medical Practitioner Brief Consultation (after hours)
- Item 5203 – Other Medical Practitioner Standard Consultation (after hours)
- Item 5207 – Other Medical Practitioner Long Consultation (after hours)
- Item 5208 – Other Medical Practitioner Prolonged Consultation (after hours)
- Item 10951 – Diabetes Education Service
- Item 10952 – Audiology Health Service
- Item 10953 – Exercise Physiology Service
- Item 10954 – Dietetics Services
- Item 10956 – Mental Health Service
- Item 10958 – Occupational Therapy Health Service
- Item 10960 – Physiotherapy Health Service
- Item 10962 – Podiatry Health Service
- Item 10964 – Chiropractic Service
- Item 10966 – Osteopathy Health Service
- Item 10968 – Psychology Health Service
- Item 10970 – Speech Pathology Health Service
Item numbers are 1 to 5 digits and will be listed on your doctor’s account.
What you can't claim online
Although you may have a claim for an eligible item, you can't claim online if:
- the item is for a service provided to someone who is not on your Medicare card
- the service was provided more than 2 years ago
- the item is for a service provided for a hospital or approved day facility in-patient
- you have been bulk billed for the item
If you can't submit your Medicare claim using your Medicare online account, you can submit it:
Who you can make a claim for online
You can submit claims for anyone listed on your Medicare card.
How your claim will be paid
If you have claimed 1 of the 25 common items and you have registered your bank account details with us, your benefit will usually be paid into your bank account the next working day.
Claims submitted using the Express Plus Medicare app can take up to 5 days to be paid into your bank account.
There are daily and monthly claiming limits. You can claim a maximum of $125 per day or $250 per 30 days per Medicare card and bank account. The monthly limit is calculated as a 30 day rolling limit. If you exceed a claiming limit, your Medicare claim can still be submitted:
If you have successfully submitted your claim and realise you have made a mistake, call us.