Acupuncture endorsement for Medicare 012-42020010

Acupuncture items 193, 195, 197 and 199 in the Medicare Benefits Schedule (MBS) are used by eligible practitioners (as defined in the Health Insurance Act 1973) who hold endorsement in acupuncture.

From 1 November 2022, changes were introduced under the Health Insurance Legislation Amendment (2022 Measures No 3) Regulations 2022. This enables a medical practitioner who holds endorsement of registration for acupuncture with the Medical Board of Australia (MBA) or is registered by the Chinese Medicine Board of Australia (CMBA) as an acupuncturist to be eligible for acupuncture recognition with Services Australia (the agency).

The Australian Health Practitioner Regulation Agency (Ahpra)

Ahpra receives and assesses applications from medical practitioners seeking acupuncture endorsement.

The agency is notified directly by Ahpra where a medical practitioner has satisfied the requirements for acupuncture endorsement. Medical practitioners are not required to submit a request for acupuncture recognition.

The Chinese Medicine Board of Australia (CMBA)

CMBA receives and assesses applications from medical practitioners seeking acupuncture endorsement.

Medical practitioners who obtain acupuncture endorsement through the CMBA must apply directly to the agency to have the acupuncture endorsement recorded to access Acupuncture items 193, 195, 197 and 199 in the Medicare Benefits Schedule (MBS).

A general practitioner is defined in the Health Insurance Act 1973 and supporting Regulations as a medical practitioner who:

• holds specialist registration in the specialty of General practice with the Australian Health Practitioner Regulation Agency (Ahpra)
• holds general registration as a General practitioner on the Vocational Register
• is in an approved program placement which gives them access to General Practitioner MBS items, for example, general practice training (GPET) placement, or
• is a medical practitioner registered in an approved 'other medical practitioner' program at an eligible location, such as:
• the Rural Other Medical Practitioners program
• the Outer Metro Other Medical Practitioners program
• MedicarePlus Other Medical Practitioners program

A consultant physician is defined in the Health Insurance Act 1973 under section 3DB or 3E as medical practitioner who:

• has successfully completed training in their specialty and holds Fellowship of the Royal Australasian College of Physicians, Royal Australian and New Zealand College of Psychiatrists or the Australasian Faculty of Rehabilitation Medicine, or
• has registered as a specialist with the Medical Board of Australia in Psychiatry, Rehabilitation Medicine or one or more of the specialties listed against the Royal Australasian College of Physicians in Schedule 1 of the Health Insurance Regulations 2018

A specialist is defined in the Health Insurance Act 1973 under section 3D, 3DB or 3E as medical practitioner who:

• has successfully completed training in their specialty and holds Fellowship with the relevant Australasian specialist medical college in Schedule 4 of the Health Insurance Regulations, or
• has registered as a specialist with the Medical Board of Australia in one or more of the specialties listed against an Australian specialist medical college in Schedule 1 of the Health Insurance Regulations 2018

Medical practitioners who hold acupuncture endorsement are eligible to access acupuncture items in the MBS. Further details about the items and rules is in the MBS.

Payment of Medicare benefits for these services is subject to the medical practitioner being registered with Ahpra and satisfying any other legislative provisions that may apply at the date of service.

The Resources page contains a link to MBS Online.

See also: Provider registrations in PDS

Before 1 November 2022, notification of acupuncture accreditation was received from the Royal Australian College of General Practitioners (RACGP) on behalf of the Joint Consultative Committee on Medical Acupuncture (JCCMA). The JCCMA was a tripartite committee with representatives from:

• the Australian Medical Acupuncture College (AMAC)
• Royal Australian College of General Practitioners (RACGP)
• Australian College of Rural and Remote Medicine (ACRRM)

JCCMA’s role in acupuncture accreditation was to receive and assess applications for acupuncture accreditation. While accreditation was available to all medical practitioners, only medical practitioners who were recognised general practitioners were issued with a specialty code 610 and could access MBS items 193, 195, 197 and 199.

Accreditation

Acupuncture endorsement is provided by Ahpra or the CMBA.

The Resources page contains a link to the Ahpra and CMBA websites.

Continuing professional development

Direct enquiries about continuing professional development requirements Ahpra or CMBA.

The Resources page contains a link to the Ahpra and CMBA websites.

Recording accreditation

Direct enquiries about recording endorsement to the Medicare Provider Registration team.