Nuclear Medicine and Positron Emission Tomography (PET) credentialling for Medicare 012-42020050

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.

• 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 they don’t have access to claim or bill Medicare PET items and that they must complete the Positron emission tomography statutory declaration form (HW064). See Positron Emission Tomography (PET) services for credentialed medical practitioners
• 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
• Information and relevant application forms are available from the Australasian Association of Nuclear Medicine Specialists (AANMS) website. See the Resources page for a link to the website

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, does not give access to bill or claim PET items listed in the MBS
• Access is granted if the medical practitioners Positron emission tomography statutory declaration form (HW064) is approved
• Once approved the medical practitioner will be registered as approved for:
• PET services, and
• the Location Specific Practice Number (LSPN) added
• The date of effect to claim or bill PET items is the date Services Australia receives the completed Positron emission tomography - statutory declaration form (HW064)

• 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

• Further enquiries about nuclear medicine credentialling or appeal rights must be directed to the Joint Nuclear Medicine Credentialling Accreditation Committee (JNMCAC) Secretariat
• See the Resources page for the Australasian Association of Nuclear Medicine Specialists (AANMS) website