Resources

This guideline relates to the MBS item numbers 80000 to 80170, rendered by allied health professionals under the Better Access program.

This guideline outlines what you can do to substantiate a service to be requested by another medical practitioner for Medicare Benefits Schedule (MBS) items 57521 and 65070.

This guideline outlines what you can do to substantiate Medicare Benefits Schedule (MBS) items 104, 105, 110, 116, 122, 132, 133, 135, 141, 143, 145 and 147 that require receipt of a valid referral before the service is provided.

This guideline outlines what you can do to substantiate valid individual Allied Health services were provided for Medicare Benefits Schedule (MBS) items 10950 to 10970.

This fact sheet provides advice on preparing a submission.

Under the Health Insurance Act 1973 (Health Insurance Act), a person (including a practitioner) engages in inappropriate practice if they knowingly, recklessly or negligently cause or permit a practitioner who they employ or otherwise engage to engage in inappropriate practice.

Information on the definition of inappropriate practice and how it applies to practitioners and corporate entities.

Information on the department’s role in identifying and intervening with practitioners and corporate entities where potential inappropriate is found.

Information on the common compliance issues associated with inappropriate practice based on Professional Services Review outcomes.

Information on how to avoid practicing inappropriately, your responsibilities and sources of information to meet Medicare requirements.

Information about the Practitioner Review Program (PRP) 6-month period of review.

Information about the Practitioner Review Program (PRP) where practitioners are referred to a delegate of the Chief Executive Medicare (delegate) after an interview without a six-month period of review.

Information about the Practitioner Review Program (PRP) and the review by a delegate of the Chief Executive Medicare (delegate).

Information about inappropriate practice and prescribed pattern of services (the 80/20 and 30/20 rules) and which professional attendance services apply.

Information about how a breach of the prescribed pattern of services (the 80/20 and 30/20 rules) is detected and the next steps when an 80/20 or 30/20 breach is found.

Frequently asked questions about the Practitioner Review Program.

Our Corporate Plan outlines how we will deliver the health system for all Australians throughout 2025–26.

This document provides answers to some frequently asked questions raised during the Commonwealth Home Support Program sector readiness webinar held on 12 June 2025.

Information on the new prescribed pattern of service 30/20 telephone rule, including relevant telephone attendance services. From 1 October 2022, GPs, Other Medical Practitioners and consultant physicians that claim relevant Medicare telephone items will be subject to the new rule.