Medicare provider number for health professionals

We issue you with a Medicare provider number to identify you as a health professional at your practice location.

The provider number is used for Medicare and Department of Veterans’ Affairs (DVA) claims processing.

A provider number consists of:

  • a 3 to 6 digit number that identifies you, such as 123456, and
  • 2 alpha or numeric characters that identify your practice location, such as 1A

In this example, the Medicare provider number would be 1234561A.

A Medicare provider number lets you:

  • claim Medicare benefits for services you provide at a particular practice location
  • refer patients to another practice where they can claim a Medicare benefit, such as
    • to another health professional
    • for diagnostic imaging, or
    • for pathology services

If you are registered in multiple health professions, we will usually issue a separate number for each profession.

Using your Medicare provider number

Your Medicare provider number is used to identify you and your practice location when processing claims.

It does not automatically mean you are eligible to access Medicare benefits.

We will confirm in writing the type of access you have been granted and your eligibility to access Medicare benefits. You will need an additional Medicare provider number for each location where you provide, refer or request Medicare services.

Your Medicare provider number is also used for:

  • claiming benefits through DVA, and
  • determining eligibility for incentive payments

Let us know immediately when you stop practising at a certain location to make sure your Medicare provider number is not used inappropriately.

You should claim for Medicare benefits when you are working in a private capacity and not receiving other government funding for these services.

Page last updated: 6 April 2016

This information was printed Sunday 25 September 2016 from humanservices.gov.au/health-professionals/services/medicare/medicare-provider-number-health-professionals It may not include all of the relevant information on this topic. Please consider any relevant site notices at humanservices.gov.au/siteinformation when using this material.