Medicare benefits for health professionals

About Medicare provider numbers

A provider number is a unique number issued to eligible health professionals who participate in the Medicare Program.

Please note your provider number location address is publicly available. Your location address is included on patient Medicare claims history statements and written referrals. It’s also available to private health funds. You need to think carefully about using a residential or private address as your provider number service location.

A Medicare provider number:

  • is required if you bill, prescribe or request services that are eligible for a Medicare benefit
  • identifies your qualifications, registration, eligibility status and any restrictions in your access to Medicare benefits
  • identifies your practice location so we and the Department of Veterans’ Affairs can process your claims
  • lets you refer patients to another health service where they can claim a Medicare benefit.

We’ll always record your name on your provider number exactly as it’s registered with the relevant registration board or professional body.

You’ll need more than 1 Medicare provider number if you:

  • deliver health services in different locations
  • are registered in multiple health professions.

We’ll tell you in writing if you’re eligible and we’ll include your Medicare provider number for each practice location. Until you have this letter you can’t bill, refer, prescribe or request services that attract a Medicare benefit.

You can’t use another health professional’s Medicare provider number under any circumstances.

Example of a Medicare provider number

Your provider number has:

  • a 6 digit number that identifies you, such as 123456
  • 2 other characters that identify your practice location, such as 1A.

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

Page last updated: 13 March 2019