Nuclear Medicine and Positron Emission Tomography (PET) credentialling for Medicare 012-42020050
This document outlines details about the credentialling of nuclear medicine specialists and consultant physicians for Medicare purposes.
Consultant Physician or Specialist recognition
Recognition as a consultant physician or specialist in Nuclear Medicine does not automatically mean the medical practitioner is eligible to bill or claim Nuclear Medicine or PET items in the Medical Benefits Schedule (MBS). They also need credentialling.
Nuclear medicine and PET credentialling
- To access nuclear medicine or PET MBS items, medical practitioners must be credentialled in Nuclear Medicine and/or PET by the Joint Nuclear Medicine Credentialling and Accreditation Committee (JNMCAC)
- Medical practitioners must apply for credentialling through JNMCAC
- The JNMCAC secretariat advises Services Australia when the specialist’s name has been included on the Register of Credentialed Nuclear Medicine and/or PET Specialists
Services Australia:
- updates the specialist or consultant physician’s record in the Provider Directory System (PDS)
- writes to the specialist or consultant physician advising the medical practitioner that the JNMCAC have confirmed they are credentialled in Nuclear Medicine and/or PET:
- for specialist or consultant physician credentialled in Nuclear Medicine, they are advised of the start date to access nuclear medicine items in the MBS
- for specialist or consultant physician credentialled in PET, they are advised of the start date to access Medicare PET items
- The credentialling start date is the date advised by JNMCAC. This can be a date in the past, but cannot be a date before the date that specialist recognition in Nuclear Medicine was granted
- Details and relevant application forms are available from the Australasian Association of Nuclear Medicine Specialists (AANMS) website. The Resources page contains a link to the website
Medicare access
Nuclear Medicine
Recognition as a credentialled Nuclear Medicine specialist allows the medical practitioner to bill and claim for nuclear medicine imaging items listed in group 14 of the Medicare Benefits Schedule (MBS). That is, from the start date advised by JNMCAC.
PET
Being crendentialled in PET allows the medical practitioner to bill or claim PET items listed in the MBS.
Re-credentialling
- The re-credentialling process occurs biannually
- The Joint Nuclear Medicine Credentialling Accreditation Committee (JNMCAC) provides an updated list of credentialled Nuclear Medicine physicians to Services Australia
- Failure to meet re-credentialling requirements results in the cessation of the specialist or consultant physician's eligibility to access the nuclear medicine items in the Medicare Benefits Schedule
- Services Australia notifies the specialist or consultant physician (in writing) of the effective end date
Credentialling enquiries
- Further enquiries about nuclear medicine credentialling or appeal rights must be directed to the Joint Nuclear Medicine Credentialling Accreditation Committee (JNMCAC) Secretariat
- The Resources page contains a link for the Australasian Association of Nuclear Medicine Specialists (AANMS) website
The Resources page contains links to contact details for Medicare Provider Registration and the Australasian Association of Nuclear Medicine Specialists (AANMS) website.