Release of information in Pharmaceutical Benefits Scheme (PBS) 012-60100000

Confirm the caller is either a pharmacist or approved supplier staff, prescriber, a prescriber's nursing or administrative staff, patient or someone with the patient's implied consent.

If the caller is:

• a pharmacist or approved supplier staff, see Call enquiries for pharmacy online claiming and payments in Pharmaceutical Benefits Scheme (PBS)
• a prescriber, ask for their prescriber number and full name
• a prescriber's nursing or administrative staff, ask for the caller's name and prescriber name and number
• the patient, ask for their Medicare number, name and date of birth
• not the patient but is calling on the patient’s behalf and has their implied consent, ask for the caller’s name

Identify the patient and prescription queried.

Ask for:

• patient identification (for example Medicare number, name, date of birth and/or address)
• Authority prescription number
• date of prescribing
• prescribed medicine, form and strength
• prescriber details (number or name)
• Health Professional Online Services (HPOS) unique reference number

Where the medicine prescribed (description, form and strength) and patient details match the agency’s authority information, Services Australia can release information. Go to Step 4.

Where these do not match, the agency cannot release any information. Go to Step 5.

Note: Medicare is not authorised to release the prescriber number to the pharmacy if the PBS prescription was written by a:

• Dentist
• Optometrist
• Midwife
• nurse practitioner, or is a hospital prescription

The type of caller determines what information the agency can provide:

• Pharmacist or approved supplier staff or treating prescriber who wrote the prescription
• status of authority (approved or rejected)
• authority approval number
• date prescription approved by Medicare
• item description, form and strength (matching)
• PBS item code
• quantity and number of repeats
• prescriber number* (providing the prescriber's name and address is on the prescription); and
• authority ID (authority prescription number)
• Prescriber who did not write the prescription or a prescriber's nursing or administrative staff
• status of authority (approved or rejected)
• date prescription approved by Services Australia
• medicine description, form and strength (matching)
• PBS item code; and
• quantity and number of repeats
• Patient (including person with implied consent from patient)
• status of authority (approved or rejected)

See the Resources page for a quick reference table.

Where the medicine prescribed (description, form and strength) and patient details do not match the agency’s authority information, the agency cannot release information.

Read the following script:

The medicine information you provided is different to what we have recorded on the authority approval system. As the prescriber’s intentions are not clear, you will need to contact the prescribing doctor to confirm their intentions.