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.

About Medicare provider numbers

This 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 additional characters that identify your practice location, such as 1A or AA

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’re registered in multiple health professions, we usually issue a separate number for each profession.

Applying for your initial Medicare provider number

If you’re a graduating health professional and have an intern position, you need to register for an initial Medicare provider number.

This number identifies you as a health professional at your practice location.

It’s important to get your application in early. The processing timeframe for applications is up to 6 weeks between November to March each year due to the increased demand.

When you register for a provider number, it’s important you give us your contact details and supporting documents. If you are intending on claiming Medicare benefits, it’s important you give us your bank account details to avoid delays in receiving your benefit.

Depending on your profession, there are different forms you need to complete:

If you’re a new health professional you will need to be registered with the Australian Health Practioner Regulation Agency (AHPRA), or a relevant registration body, before applying for an initial provider number.

Processing times for applications

The processing time for applications can be up to 6 weeks. New health professionals can’t start billing until they are advised of their provider number and Medicare eligibility.

Make sure you’re using the most current form from our website so your application isn’t delayed.

Applications are processed in the order we receive them. We have dedicated staff working hard to process these as quickly as possible.

You’ll get a letter from us once your application has been processed.

Applications from health professionals registered with us as a General Practitioner or Specialist can generally claim from the date requested on their application. This means these providers can start working but should wait to lodge Medicare claims until their application is processed.

Using your Medicare provider number

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

It doesn’t automatically mean you’re eligible to access Medicare benefits.

We’ll confirm in writing the type of access granted and your eligibility to access Medicare benefits. You 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're working in a private capacity and not getting other government funding for these services.

Applying for additional Medicare provider numbers

If you’re registering for a provider number for a new location, it’s fast and easy to use HPOS.

You can also update your bank account details and contact details using HPOS.

Page last updated: 27 August 2017