An animated, step-by-step explainer: how Medicare treats a doctor as a general practitioner, specialist or prescribed medical practitioner, and what that changes. No fee figures.
Follow how a doctor’s category is set and what it changes in six short steps. Swipe or tap Next.
A doctor can only claim Medicare benefits through a provider number. Interns can apply for one once they hold provisional registration, and trainees need a number for each location they work from.[5]
For trainees, Services Australia says Medicare access depends on the training program.[5] Which items a doctor can then claim depends on the kind of doctor Medicare treats them as. The next steps show those kinds.
The Health Insurance Act separates general practitioners, specialists and consultant physicians. The wider term “medical practitioner” includes GPs.[1]
MBS items are written for particular kinds of doctor. In 2018, for example, the general practice attendance items were restricted to doctors who meet the definition of a general practitioner.[1]
The Act’s definition includes doctors vocationally registered under section 3F, and medical practitioners of a kind specified in the regulations.[1]
Clause 1.1.3 of the General Medical Services Table Regulations names four kinds: a GP placement approved by the RACGP, one approved by ACRRM, a placement in the Remote Vocational Training Scheme, and an eligible non-vocationally recognised medical practitioner, defined in clause 1.1.2 by registration in named Other Medical Practitioner programs.[2]
Based on the compilation of 1 November 2024. Later amendments are possible, so check legislation.gov.au.
The Other Medical Practitioner Determination uses the term prescribed medical practitioner: a medical practitioner who is not a general practitioner, specialist or consultant physician, and who meets at least one of three conditions.[3]
The three are: registered under section 3GA of the Act (with the 19AA(3)(b) circumstances applying); covered by a 19AB(3) exemption; or first became a medical practitioner before 1 November 1996.[3] Tap a chip to highlight one route.
“Non-VR GP” is an everyday label. MBS Online notes that such doctors are often called OMPs.[4] Under Medicare’s wording, a non-VR doctor can sit on either side: counted as a GP (for example an eligible non-VR practitioner or an approved placement), or as a prescribed medical practitioner.
The category decides which set of items a service is claimed under. A 2018 explanatory statement describes a separate fee structure for attendances by medical practitioners who are not general practitioners.[1] From 1 November 2023 most items that had sat in the Determination were consolidated into the General Medical Services Table Regulations.[4]
What remains in the Determination (compilation of 1 July 2024) covers attendances involving multiple patients and after-hours attendances by prescribed medical practitioners.[3]
Some programs are open across categories. The Department of Health says vocationally registered GPs, non-vocationally registered GPs and GP registrars can all be selected as a patient’s preferred GP in MyMedicare.[6]
No fee amounts are shown. They change; use MBS Online for current benefits.
Each MBS item’s descriptor and explanatory notes say who may claim it. MBS Online publishes both and lets you subscribe to updates, and the Department of Health runs an email advice service for questions about interpreting items and rules.[4]
Services Australia publishes eligibility and provider-number information for interns, registrars and trainees.[5]
Non-VR billing guide → MBS billing conflict checker →Sources reviewed November 2026. The diagram is a simplified schematic and is not to scale.
General administrative information only. It is not medical, legal, billing or financial advice, and it does not decide any doctor’s Medicare category or what they may claim. Confirm your own position with Services Australia, the Department of Health or MBS Online.