Dual recognition of medical practitioners for Medicare 012-42020040

Referrals from specialists and consultant physicians are valid for 3 months unless the patient is an admitted patient. Referrals for admitted patients are valid for 3 months or the duration of admission, whichever is longer.

A referral from a general practitioner to a specialist or consultant physician is valid for 12 months, unless noted otherwise. If a patient needs continuing care, general practitioners can write a referral beyond 12 months or for an indefinite period.

The purpose of dual recognition is to allow a specialist or consultant physician, acting in their capacity as a general practitioner to provide referrals for their patients for greater than the standard 3 month period.

Once reflected with dual recognition on the provider record, referrals will be valid for a 12 month period.

Medical practitioners eligible for dual recognition need to be:

• recognised by Services Australia as a specialist (in a specialty other than General Practice) or consultant physician, and
• recognised by Services Australia as a Specialist general practitioner (Ahpra registered and identified with a 540 speciality code), or
• recognised by Services Australia as a General practitioner as determined by the Department of Health and Aged Care (identified with a 530 speciality code), or
• recognised by Services Australia as a General practitioner as determined by the Department of Health and Aged Care (identified with a 530 specialty code), or
• holding general registration and is recorded on the Vocational Register (identified with a 130 specialty code), or
• an Other Medical Practitioner (identified with a 104 specialty code) working in general practice
• non specialist temporary resident medical practitioner with a 180 specialty code, or
• registered with an approved 3GA placement in general practice at any open location

Dual recognition is reflected in the Provider Directory System (PDS) with a 165 specialty code on the medical practitioner’s stem.

Dual recognition may be added to the medical practitioner’s provider record via one of the following:

• a telephone call from the medical practitioner
• a signed written request for dual recognition submitted to Services Australia

This can also be added where:

• they are previously recognised as a specialist or consultant physician, and
• a work item has been received notifying that Ahpra has registered the medical practitioner as a Specialist general practitioner
• the medical practitioner is already recognised as a general practitioner and recognition as a specialist (in a speciality other than General Practice) and/or,
• consultant physician has been processed on the medical practitioner’s provider record

If a request for dual recognition is received via telephone, it is to be effective from the date the call was received. If it is received as a signed written request, the date of lodgement is the effective date.

When processing applications for specialist and/or consultant physician recognition, the medical practitioner dual recognition is effective from the date specialist recognition is granted.

Dual recognition is effective from the date of general practitioner recognition where:

• processing recognition as a general practitioner is required, and
• the medical practitioner has existing recognition as a specialist (in a specialty other than General Practice) or consultant physician

Where the medical practitioner no longer meets the requirements for dual recognition, the Provider Registration team will end date the provider’s dual recognition.

See also: Process provider registrations in PDS

Further enquiries should be directed to Medicare Provider Registration.