Amend Location Specific Practice Number (LSPN) register for Medicare 012-41040040

An authorised representative must be nominated for partnerships, companies, government agencies and public bodies. This person may also be the responsible executive officer who signs the form, but the 2 roles are to be distinguished. Examples of a responsible executive officer include:

• Chief Executive Officers
• Account Managers, and
• Directors

The nomination of an authorised representative is optional for practices owned by an individual.

The proprietor, or a currently listed authorised representative, must sign the amendment form to nominate a new authorised representative. If one of the above are not able to sign the form, the practice must:

• have the forms signed by someone in a managerial position at the practice
• include a signed letter outlining the change and why an authorised representative is unavailable to sign the declaration form

Note: authorised representatives cannot nominate themselves.

Both authorised representatives have equal authority to act on the proprietor's behalf. The only difference between the 2 is that system generated correspondence is addressed to the primary authorised representative.

Where a new authorised representative:

• has been nominated on the amendment form, and
• the form is not signed by a listed proprietor or current authorised representative:
• the applicant can attach a letter to the form that has been signed by a responsible executive officer authorising the change of representative
• this request must explain the authority this person has to act on behalf of the proprietor, including their position
• it must also outline the circumstances which prevented the eligible people from signing the request

Service Officers must address manual correspondence to the authorised representative or proprietor that sent the request/forms.

LSPN and HPOS

Users who have their HPOS account linked to their LSPN registration can:

• view
• amend, and
• renew their practice registration online

See LSPN and systems (Provider Directory System and Health Professional Online Services) for more details on LSPN and HPOS.

Diagnostic Imaging and Radiation Oncology Practices are needed to update registration details as recorded by Services Australia (the agency) when those changes occur. An annual reminder letter is sent to practices requesting an update to details contained on the register.

Should an authorised person from the practice fail to respond by the 'end date,' their registration may be suspended. If they fail to respond within 3 months from the date of suspension, their registration may be cancelled.

Service Officers renew the registration of active and suspended practices. Where an application to amend LSPN details is received 3 months prior to an LSPN expiry date, and 3 months after expiry, an LSPN record should be renewed. During this period, the Renew LSPN function will be available in PDS. Registrations of active and suspended practices can also be renewed via HPOS by an Administrator.

Delegate approval is required to suspend or cancel a practice. Delegate approval is required to reinstate a cancelled practice registration. Any request to register a practice which was cancelled in the previous 12 months must be escalated to Local Peer Support (LPS) for consideration by the Pathology and Diagnostic Imaging Team.

Staff must not renew the registration of a cancelled LSPN record.

The Provider and Engagement Service Delivery Support Team (PESDST) will escalate these requests to the Pathology and Diagnostic Imaging team for consideration.

For more details on the renewal, suspension and cancellation process, see Eligibility and Location Specific Practice Number (LSPN) registration for Diagnostic Imaging (DI) and Radiation Oncology (RO)

The Process page contains processing instructions for annual LSPN practice registration renewals and suspensions.

The Resources page contains links to forms, contact details and examples relating to the LSPN register.

A practice may require an equipment list to confirm that equipment on the LSPN record is correctly listed and current as part of their annual review. Practices must access their equipment list through HPOS. This information is no longer available via email except in exceptional circumstances. Do not provide equipment lists to practices under any circumstances.

HPOS

HPOS users can download an equipment list at any time if linked to the LSPN record as an Administrator or Staff. Please guide practice staff on how they can register for HPOS and be linked to their LSPN record if they are not already.

See LSPN - HPOS User Guide for more details.

A diagnostic imaging practice can only request accreditation of Diagnostic Imaging modalities with an accreditor once the practice is registered and been allocated an LSPN. The practice can contact one of the approved accrediting bodies to arrange accreditation. Details of the accrediting bodies are on the Services Australia website. The Resources page contains a link.

The chosen accrediting body will provide a report to the agency with the modalities and accreditation period for which the practice is accredited. Eligibility for Medicare benefits for services on specified modalities will commence on the accreditation start date.

Current accreditation details are available on the published extract of the LSPN Register. The Resources page contains a link to the register.

Note: accreditation is not required for Radiation Oncology practices.

Processing Accreditation Reports in PDS

Accreditation reports are sent to the agency and uploaded into PaNDA. There are 4 types of accreditations updates. These include:

• creating new start and end dates for each modality
• ending accreditation for a modality
• amending existing start and end dates for a modality
• renewing accreditation for each modality

Only one current accrediting body should be listed on the Modality Accreditation screen. A cessation report is not needed where the accrediting body changes. A new accreditation report supersedes previous reports and should be entered as per the details on the new report.

The capital sensitivity measure's purpose is to encourage diagnostic imaging practices to regularly upgrade and replace their equipment. This provides more access to higher quality equipment.

This means that any diagnostic imaging services that have been performed are no longer payable where that equipment:

• has exceeded its effective life age, or
• maximum extended life age

Diagnostic imaging services are still payable if they have a current approved exemption.

This is in place for almost all diagnostic imaging equipment providing services (excluding PET and radiation oncology) under Medicare.

See Eligibility and Location Specific Practice Number (LSPN) for Diagnostic Imaging (DI) and Radiation Oncology (RO) for more details on capital sensitivity.

MRI equipment is not automatically eligible for Medicare payable services. There are currently 3 types of MRI equipment to reflect this:

• Fully eligible (MR1)
• Partially eligible (MR3)
• Ineligible (MR4)

Staff do not need approval from DHAC before adding the following equipment to an LSPN record:

• Ineligible (MR4) equipment
• Fully eligible (MR1) equipment for practices in MM 2-7 locations

Medicare eligible MRI equipment

MRI equipment must be co-located in a practice which also provides x-ray, ultrasound, and computed tomography services in order to be eligible for Medicare benefits.

In addition to this requirement, an MRI machine can be fully eligible if it is:

• granted a licence from DHAC, or
• located in a MMM 2-7 area (after 1 November 2022)

MRI equipment can only become partially eligible if a licence is granted by DHAC.

Staff must escalate all requests for Medicare eligible equipment in MM1 locations to PESDST. The Pathology and Diagnostic Imaging team will assess these requests.

All applications for Partially eligible (MR3) equipment in any MM locations need to be escalated to PESDST. The Pathology and Diagnostic Imaging team will assess these requests.

Eligible MRI providers

To provide services on eligible MRI equipment a specialist must have ongoing participation in the Royal Australian College of Radiologists' quality and accreditation program. Failure to do so will result in the cancellation of Medicare eligibility to provide MRI services.

Provider eligibility is effective from the date a complete LSPN form is received by the agency or a future date if specified.

All requests for backdating eligibility to perform MRI services are escalated to PESDST via LPS. PESDST will forward requests to the Pathology and Diagnostic Imaging Team.

On receipt of a complete LSPN form from a proprietor or an authorised representative, Service Officers must make sure:

• active MRI equipment is located at the LSPN site
• the provider names and numbers listed on the form are specialists in radiology with access to Medicare benefits, and
• the address of the provider location matches the address of the LSPN site

Note: in the case of hospitals, minor variations in the address are permitted due to hospitals often having multiple entry points. The name of the hospital should however match.

If the provider is eligible link them to the LSPN. The system will automatically add the MRI specialty code 118 to the Provider Stem and Location.

When an MRI provider is linked to the LSPN register, the system will check whether the LSPN address exactly matches the provider location address. If there is a match, the provider location address will be locked and cannot be amended.

The provider location cannot be edited until the:

• LSPN address is amended to be different to the provider location, or
• provider link to the LSPN is end dated

The system is designed to automatically add the MRI specialty code (118) to the Provider Stem and Location if the MRI provider has been linked to the LSPN and the Provider Stem has a current 046 or 047 specification code.

To prevent inappropriate claiming, whenever the specialty codes 046 or 047 are end dated, the specialty code 118 on the provider stem and provider locations will need to be end dated at the same time.

If an MRI provider is unlinked or end dated from an LSPN then the system will end date the 118 at the relevant provider location with the same end date.

Practice staff that have access to the LSPN in HPOS will be able to generate a list of MRI providers for that site.

For more details, see the Resources page for a link to the HPOS user guide.

Transfers of MRI eligibility within MM1 locations have to be approved by DHAC. Processing can only be done once National Office receives approval via email notification from DHAC.

DHAC will provide the date and details for the return of eligibility to the original site or equipment.

Cardiac MRI providers are:

• a specialist in diagnostic radiology or a consultant physician; and
• recognised by the Conjoint Committee for Certification in Cardiac MRI

DHAC send Services Australia a list of providers that have been certified. Services Australia assess that the provider is a recognised specialist in diagnostic radiology or a consultant physician. The specification code 655 is added on the provider stem in PDS if all eligibility criteria is met.

Credentialed Positron Emission Tomography (PET) providers must complete a specific PET provider statutory declaration (HW064) prior to being eligible to claim Medicare benefits for the PET services they provide. See Positron Emission Tomography services for credentialed medical practitioners for eligibility requirements and processing instructions in PDS and LSPN.

Where the practice has made changes to their primary information, the practice must notify the agency within 28 days of these changes taking effect. Primary information includes:

• the business name
• the details of the proprietor (including, where the proprietor is a company) of the practice or the base for mobile diagnostic imaging equipment
• the Australian Company Number (ACN)
• the Australian Business Number (ABN)
• details of the equipment on the premises or base for mobile diagnostic imaging or radiation oncology equipment
• the address of the premises
• the address of the proprietor or base (for bases for mobile diagnostic imaging or radiation oncology equipment, if applicable)

The practice can notify the agency of these changes by completing an Application to register or amend a diagnostic imaging or radiation oncology practice form (HW061). The Resources page contains a link to the form.

Requests to backdate changes to primary information must be escalated to Medicare and Aged Care - Local Peer Support (LPS) for consideration by the Pathology and Diagnostic Imaging Team.

Certain changes to primary information require the practice to apply for a new LSPN, see the LSPN relocations section for more details.

Changes to LSPN business information, including takeovers and change in ownership

Practices must:

• tell Services Australia of a change to business information within 28 days
• advise of the changes using an Application to register or amend a diagnostic imaging or radiation oncology practice form (HW061). The Resources page contains a link to the form. If ownership has changed, the form must be signed by the:
• outgoing proprietor or authorised representative, and
• incoming proprietor

Note: where there has been a change of ownership, existing Associates should be removed.

Assessing LSPN applications for takeover or change in ownership/proprietorship

If Service Officers receive an application for an LSPN that is subject to a change of business information, the application should be assessed as below:

• Where the practice has notified the agency within 28 days of the changes, the dates on the application form are to be used
• Where the practice has notified us more than 28 days after these changes taking effect, the date of lodgement should be used
• Escalate requests to backdate changes of business information to Medicare and Aged Care - Local Peer Support (LPS) for consideration by the Pathology and Diagnostic Imaging Team. These changes cannot be backdated more than 28 days from the date of lodgement

If Medicare eligible MRI equipment is located at a diagnostic imaging practice that is changing practice/trading name, they are required to contact DHAC about their 'Deed of Undertaking'. Ask the practice to email all the details to MRI enquires.

See the Register for a Location Specific Practice Number (LSPN) for Medicare process page for more details on Registration for an LSPN as part of a takeover.

A new LSPN is required when a practice changes address. To make sure there are no gaps between billing dates, practices are responsible for closing their existing LSPN record and applying for a new LSPN.

Moving levels or suites within the same address is considered a relocation and requires a new LSPN. Practice addresses should only be updated if the practice has not relocated and the request is to correct or provide more detail to the address details.

Practices need to provide the below information on the Application to register or amend a diagnostic imaging or radiation oncology practice form (HW061):

• A closure date at question 4 of the form for their existing LSPN, and
• A start date at question 6 for their new LSPN

All equipment owned by the closing practice must be:

• end-dated on the practice being closed (cancellation at the request of the proprietor), and
• added to the LSPN register for the new practice if included on the new registration form

Practices must supply all equipment details, including the date equipment was manufactured or first installed in Australia and upgrade dates (if applicable). If not provided on the application form, missing equipment details should not be taken from the equipment list of the closing LSPN.

If Medicare eligible Magnetic Resonance Imaging (MRI) equipment is located at a diagnostic imaging practice that is changing location, they are required to contact DHAC about their 'Deed of Undertaking'. Tell the practice to email all the details to MRI enquires.

Assessing LSPN applications for relocation

If Service Officers receive an application for a practice that is relocating, assess the application as below:

• If the proposed relocation is in the future, the dates on the application form are to be used
• If the application is submitted after the relocation date:
• the date of lodgement should be used as the closure date for the existing LSPN record
• all equipment recorded at the existing LSPN record must be manually end dated on the closure date requested on the form (the system does not do this automatically)
• the date of lodgement is used as the operational start date for the new LSPN record
• Do not backdate relocations

For temporary or urgent instances of relocation, escalate to the Pathology and Diagnostic Imaging Team via an LPS.

See Register for a Location Specific Practice Number (LSPN) for Medicare for more details on Registration for an LSPN as part of a relocation.

Note: if the closure and start date have not been provided on the form, the application form should be returned with the appropriate standard letter template.

Where a practice has closed, a completed Application to register or amend a diagnostic imaging or radiation oncology practice form (HW061) is required. The practice will need to provide a closure date at question 5 of the form. The Resources page contains a link to the form.

Note: if the closure date has not been provided on the form, the application should be returned with the appropriate standard letter template.

Practice closures cannot be backdated. The cancellation of the practice's registration takes effect the date after the date of lodgement or the date specified in the form, whichever is later.