Medicare Forms
On this Page:
- Application for prescriber number for a registered medical practitioner
- Pay Group Link
- Medicare Allied Health and Dental Care Initiative
- Stationery Reorder
- MRI Statutory Declaration
- Pathology Laboratory Application
- Approved Pathology Practitioner Application
- Remote Area Exemption
- EFT Payments for Claims
- Certification of Cleft Condition Form
- After-Hours Other Medical Practitioners (OMPs) Program
- Positron Emission Tomography (PET) Statutory Declaration
- Application for Late Lodgment of a claim for Assigned Medicare Benefits
- Electronic referral requests
- Transitional support package for electronic Medicare claiming
The application forms in this category cover some aspects of provider, patient and equipment eligibility. Lodgment details are listed on each form.
For enquiries about provider eligibility please call 132 150 (local call rates).
For enquiries about patient eligibility, please call 132 011 (local call rates).
For general PBS and stationery enquiries please call 132 290 (local call rates).
Application for prescriber number for a registered medical practitioner
Pay Group Link
A pay group link enables a practitioner to have Medicare benefit cheques, which would have been issued payable to that practitioner at his/her practice address, made payable to another payee associated with the practice and/or another address.
Where the payee is a third party, the payee (or person properly authorised in the case of a body corporate or other entity) must agree to the arrangement by counter-signing the application form.
Medicare Allied Health and Dental Care Initiative
The new Medicare allied health and dental care initiative allows chronically ill people who are being managed by their GP under an Enhanced Primary Care (EPC) plan access to Medicare rebates for allied health services.
Referral Forms
Referral forms are available on the Department of Health and Ageing
website or by faxing a request to (02) 6289 7120.
Eligibility
Stationery Reorder
- Medicare stationery order form - large quantities (DB6Ba) [PDF, 126Kb]

- Medicare stationery order form - small quantities (DB6Bb) [PDF, 110Kb]

- Medicare Online stationery order form [PDF, 107Kb]

- Medicare Easyclaim stationery order form [PDF, 108Kb]

MRI Statutory Declaration
Pathology Laboratory Application
Approved Pathology Practitioner Application
Remote Area Exemption
EFT Payments for Claims
Certification of Cleft Condition Form
After-Hours Other Medical Practitioners (OMPs) Program
The After-Hours Other Medical Practitioners (OMPs) Program provides access to the higher Medicare rebate for services provided through accredited Medical Deputising Services and accredited general practices by eligible non-vocationally recognised medical practitioners. Please refer to the following Guidelines and Application Form for more information:
- After-Hours OMPs Program Guidelines [PDF, 217Kb]

- After-Hours OMPs Program Application Form [PDF, 89Kb]

Positron Emission Tomography (PET) Statutory Declaration
Application for Late Lodgment of a claim for Assigned Medicare Benefits
Electronic referral requests
If you would like to transmit, scan and/or store Referrals or Requests electronically, please refer to the following Medicare Australia IT standards.
Transitional support package for electronic Medicare claiming
The transitional support package is available to general practitioners, specialists (excluding pathologists) and software vendors to support the take up of electronic Medicare claiming. The package includes a practice payment and a transaction payment per claim.
- Application form for the transitional support package for electronic Medicare claiming [PDF, 138Kb]

- Guidelines for the transitional support package for electronic Medicare claiming [PDF, 136Kb]

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Last updated: 17 July, 2008

