At the desk

Medicare and referral intake

A valid referral from an eligible referrer is what unlocks the Medicare rebate. Get this wrong and the patient pays full fee. Check every time.

What to check on a referral

Scan these in order before you accept it:

Referrer name + provider number. Both must be present and legible. No provider number = no rebate.
Patient details match Medicare card. Full name and DOB. A typo on the referral is fixable — a mismatch on the card is not.
Body region + clinical indication. Must be specific enough to justify the scan. "Back pain" alone is usually fine for GP referrals; vague indications like "check up" are not.
Date signed. GP referrals are valid for 12 months from the date signed. Specialist referrals are valid for 3 months from the date of the first service (not the date signed).
Modality requested. The referral should specify or clearly imply the scan being performed. If it just says "imaging," confirm with the referrer before scanning.

Eligible referrers, by shorthand

GP — most modalities (X-ray, ultrasound, most CT, most MRI with specific indications)
Specialist — all modalities the patient is rebated for
Dentist / chiropractor / physiotherapist / podiatrist — limited. Only certain items, and usually only certain modalities. See the modality page for your scan before assuming.

When in doubt, check the modality page — the eligibility rules change and the modality notes are the source of truth.

When a referral is invalid or expired

You have three options. Offer them in this order:

Call the referrer for a quick re-referral. Most GPs will fax/email a fresh one within the hour if the patient is already at the desk. This is the smoothest path for the patient.
Proceed as non-referred (NR item), if the modality has an NR item available. Some items don't — check first. Rebate is typically lower.
Pay privately. Full fee at desk, no rebate.

Don't cancel the scan without offering at least one of the above.

Medicare card oddities

Interim card (paper, green) — treat as a normal Medicare card. Numbers are valid.
No card on them — see them, flag it, patient claims rebate later by presenting receipt to Medicare.
DVA Gold card — treat like Medicare for billing; covers the full fee for eligible services.
DVA White card — covers only conditions listed on the card. Check before assuming cover.
Overseas visitor / no Medicare eligibility — no rebate available. Pay privately. Offer an itemised receipt for their travel/health insurance.
Reciprocal Health Care Agreement countries (UK, NZ, Ireland, Italy, Malta, Sweden, Belgium, Netherlands, Norway, Slovenia, Finland — per Services Australia) — may be eligible for some services with a valid passport. The full conditions vary; if in doubt, check the patient's eligibility before promising bulk-billing.

What to check on a referral

Scan these in order before you accept it:

Referrer name + provider number. Both must be present and legible. No provider number = no rebate.

Patient details match Medicare card. Full name and DOB. A typo on the referral is fixable — a mismatch on the card is not.

Body region + clinical indication. Must be specific enough to justify the scan. "Back pain" alone is usually fine for GP referrals; vague indications like "check up" are not.

Date signed. GP referrals are valid for 12 months from the date signed. Specialist referrals are valid for 3 months from the date of the first service (not the date signed).

Modality requested. The referral should specify or clearly imply the scan being performed. If it just says "imaging," confirm with the referrer before scanning.

Eligible referrers, by shorthand

GP — most modalities (X-ray, ultrasound, most CT, most MRI with specific indications)

Specialist — all modalities the patient is rebated for

Dentist / chiropractor / physiotherapist / podiatrist — limited. Only certain items, and usually only certain modalities. See the modality page for your scan before assuming.

When in doubt, check the modality page — the eligibility rules change and the modality notes are the source of truth.

When a referral is invalid or expired

You have three options. Offer them in this order:

Call the referrer for a quick re-referral. Most GPs will fax/email a fresh one within the hour if the patient is already at the desk. This is the smoothest path for the patient.

Proceed as non-referred (NR item), if the modality has an NR item available. Some items don't — check first. Rebate is typically lower.

Pay privately. Full fee at desk, no rebate.

Don't cancel the scan without offering at least one of the above.

Medicare card oddities

Interim card (paper, green) — treat as a normal Medicare card. Numbers are valid.

No card on them — see them, flag it, patient claims rebate later by presenting receipt to Medicare.

DVA Gold card — treat like Medicare for billing; covers the full fee for eligible services.

DVA White card — covers only conditions listed on the card. Check before assuming cover.

Overseas visitor / no Medicare eligibility — no rebate available. Pay privately. Offer an itemised receipt for their travel/health insurance.

Reciprocal Health Care Agreement countries (UK, NZ, Ireland, Italy, Malta, Sweden, Belgium, Netherlands, Norway, Slovenia, Finland — per Services Australia) — may be eligible for some services with a valid passport. The full conditions vary; if in doubt, check the patient's eligibility before promising bulk-billing.