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

Partnerships, companies, government agencies and public bodies must have a person nominated as an authorised representative.

This person may also be the responsible executive officer who signs the form, but the 2 roles are different. 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

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 signed by a responsible executive officer authorising the change of representative. This request must:
• include the position of the person authorising the change
• outline the circumstances which prevented an eligible person 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 record can:

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

HPOS users can download an equipment list at any time if linked to the LSPN record as an Administrator or Staff. Staff should tell practice staff how they can register for HPOS and be linked to their LSPN record if they are not already. HPOS users cannot amend registration or equipment details.

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 need 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.

If an authorised person from the practice fails to respond:

• by the 'end date', their registration will be suspended
• within 3 months from the date of suspension, their registration will be cancelled

Service Officers renew the registration of active and suspended practices.

If an application to amend LSPN details is received 3 months before an LSPN expiry date, and 3 months after expiry, the 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 needed to:

• suspend or cancel a practice
• reinstate a cancelled practice registration

Escalate requests to register a practice cancelled in the previous 12 months to the Pathology and Diagnostic Imaging Team. See Escalation process for Pathology, Diagnostic Imaging and Radiation Oncology (LSPN)

Staff must not renew the registration of a cancelled LSPN record

Requests to renew a cancelled LSPN record must be escalated to the Pathology and Diagnostic Imaging Team.

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, suspensions, and cancellations.

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

A practice may need an equipment list to confirm 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. Requests for equipment lists are considered by the Pathology and Diagnostic Imaging Team.

Do not provide equipment lists to practices under any circumstances.

A diagnostic imaging practice can only request accreditation of Diagnostic Imaging modalities with an accreditor when:

• 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 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 start on the accreditation start date.

Current accreditation details are available on the published extract of the LSPN Register.

Note: Radiation Oncology practices do not need accreditation.

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 if the accreditor changes. A new accreditation report supersedes previous reports and should be entered as per the details on the new report.

Equipment can be added to, upgraded or removed from LSPN records. For mandatory information, depending on the type of amendment request about equipment see Eligibility and Location Specific Practice Number (LSPN) practice registration for Diagnostic Imaging (DI) and Radiation Oncology (RO). The details needed vary depending on the type of request.

The following details are recorded in PDS for equipment:

• Equipment Code - the type of equipment, depending on the function/s
• Serial No - the serial number of the equipment. This is usually found on the largest component
• Manufacturer - the name of the company which manufactured the equipment
• Model No - the particular model number or name of the equipment
• Date installed in Australia or date manufactured - the date that capital sensitivity begins on the equipment (the start of the effective life age)
• Upgrade indicator - whether equipment has been upgraded. If upgraded, the equipment can be used to claim Medicare benefits for an extended period
• Date upgraded - the date a significant upgrade is made to equipment, that improves the overall performance of the equipment so that it is equivalent to new equipment
• Date operational - the date equipment was first listed as being operational at the practice
• Date removed - the date equipment stopped being operational at the practice
• Associate ABN - to declare if there is a financial interest in the equipment by a provider/s not employed to provide services at the practice
• Exceptional circumstances exemption - whether an exemption has been granted by the Department of Health and Aged Care (DHAC). Only applicable for equipment that has reached the end of its effective life age
• ECE Start Date - the start date of the exemption period
• ECE End Date - the end date of the exemption period

Note: the date manufactured or date installed in Australia is not recorded for Radiation Oncology equipment.

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 Department of Health and Aged Care (DHAC)to add 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 to be eligible for Medicare benefits. Beside 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 and Partially eligible (MR3) equipment in any MM locations to the Pathology and Diagnostic Imaging Team.. See Escalation process for Pathology, Diagnostic Imaging and Radiation Oncology (LSPN)

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. It they do not have Medicare eligibility to provide MRI services, the services will be cancelled.

Provider eligibility is effective from the date a complete LSPN form (HW061) is received by the agency or a future date if specified.

See Eligibility and Location Specific Practice Number (LSPN) practice registration for Diagnostic Imaging (DI) and Radiation Oncology (RO) for information about MRI provider eligibility.

All requests for backdating eligibility must be escalated to the Pathology and Diagnostic Imaging Team. See Escalation process for Pathology, Diagnostic Imaging and Radiation Oncology (LSPN)

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

• active MRI equipment is listed on the LSPN record
• 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 record

Note: minor variations in the address of hospitals are permitted because hospitals often have multiple entry points. The name of the hospital should match.

See Eligibility and Location Specific Practice Number (LSPN) practice registration for Diagnostic Imaging (DI) and Radiation Oncology (RO) for information about MRI provider eligibility.

If the provider is eligible link them to the LSPN record. PDS will automatically add the MRI specialty code 118 to the Provider Stem and location.

When an MRI provider is linked to an LSPN record, the PDS 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 record is end dated

PDS 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 record and the Provider Stem has a current 046 or 047 specialty code.

To prevent inappropriate claiming, if the specialty codes 046 or 047 are end dated, the specialty code 118 on the provider stem and provider locations must also be end dated.

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

Practice staff with access to the LSPN record in HPOS can generate a list of MRI providers for that practice.

The Resources page has a link to the HPOS user guide.

Transfers of MRI eligibility within MM1 locations must be approved by DHAC. Processing can only be done once the Pathology and Diagnostic Imaging Team gets approval via email notification from DHAC.

DHAC will provide the date and details for the return of eligibility to the original practice 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 are 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.

Where the practice has made changes to their primary information, the practice must tell 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 or radiation oncology 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 tell the agency of these changes by completing an Application to register or amend a diagnostic imaging or radiation oncology practice (HW061) form.

Requests to backdate changes to primary information, including requests to backdate the operational start date of equipment, must be escalated to the Pathology and Diagnostic Imaging Team.. See Escalation process for Pathology, Diagnostic Imaging and Radiation Oncology (LSPN).

Note: a change of address requires the practice to apply for a new LSPN record, see the Practice relocations section for more details. A change of ownership or ABN does not need a new LSPN.

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 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

See Eligibility and Location Specific Practice Number (LSPN) practice registration for Diagnostic Imaging (DI) and Radiation Oncology (RO) for assessing information.

Assessing LSPN applications for takeover or change in ownership/proprietorship

If Service Officers receive an application for an LSPN record that contains 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 the Pathology and Diagnostic Imaging Team. See Escalation process for Pathology, Diagnostic Imaging and Radiation Oncology (LSPN). 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 Agreement'. 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 practice registration as part of a takeover.

A new LSPN record is needed 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 record.

Moving levels or suites within the same address is considered a relocation and needs a new LSPN record. 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 details on the Application to register or amend a diagnostic imaging or radiation oncology practice (HW061) form:

• a closure date at Question 4 of the form for their existing LSPN record, and
• a start date at Question 6 for their new LSPN record

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 record 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 record.

If Medicare eligible MRI equipment is located at a diagnostic imaging practice that is changing location, they are required to contact DHAC about their 'Deed of Agreement'. Tell the practice to email all the details to MRI enquiries.

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 (PDS does not do this automatically)
• the date of lodgement is also used as the operational start date for the new LSPN record
• Do not backdate relocations

For temporary or urgent instances of relocation, escalate the application to the Pathology and Diagnostic Imaging Team. See Escalation process for Pathology, Diagnostic Imaging and Radiation Oncology (LSPN).

See Register for a Location Specific Practice Number (LSPN) for Medicare for more details on practice registration 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.

Additional address details can be added if a practice advises:

• no relocation has occurred and
• gives additional address details which were missing (for example: street number, suite number or level)

Do not change existing address details.

If there is any doubt whether a relocation has taken place, or if a practice requests a change to an existing address, escalate the application. See Escalation process for Pathology, Diagnostic Imaging and Radiation Oncology (LSPN).

Where a practice has closed, a completed Application to register or amend a diagnostic imaging or radiation oncology practice (HW061) form is needed. 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 a Z2374 letter.

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 on the form, whichever is later.

If the closure date specified on the form is before the date of lodgement, all open equipment must be manually end dated as per the closure date on the form.