👩⚕️ Clinical reference for health professionals. This page summarises published clinical guidance and is not medical advice. Patients and members of the public: please don’t use this to make decisions about your own care — talk to your GP, pharmacist or treating team.
Medicinal Cannabis Prescribing — Australian GP Guide: SAS-B, AP, Scheduling & State Rules
📋 Sources (verified June 2026):
TGA — tga.gov.au (Feb 2026).
AHPRA & Medical Board medicinal cannabis guidance, July 2025 — ahpra.gov.au.
Australian Prescriber, NPS MedicineWise — australianprescriber.tg.org.au.
QLD Health medicinal cannabis prescribing, July 2025 — health.qld.gov.au.
VIC Health, Feb 2026 — health.vic.gov.au.
NSW Cannabis Medicines — medicinalcannabis.nsw.gov.au.
TEGO S8 prescribing guide, July 2026.
MBS Book July 2026 — consultation item fees.
Regulations change. Verify current state requirements with your state health department and the TGA online system before prescribing. Consult your MDO for specific legal questions.
SAS-B vs Authorised Prescriber, S4 vs S8 scheduling, state permit rules, RTPM obligations, and what patients pay.
CliniciansAUTGA 2026 · AHPRA 2025 · RACGP
⚠️ AHPRA reminder (July 2025): Prescribe only when there is an evidence-supported clinical indication and other treatments have not worked. Patient demand alone is not an indication. A full assessment including social, mental health, and substance use history is required before prescribing. Short online consultations are insufficient. AHPRA & Medical Board, July 2025
The two prescribing pathways
Most medicinal cannabis products are unapproved therapeutic goods — they have not been assessed by the TGA for safety or efficacy. You must obtain TGA approval before prescribing them. There are two pathways. TGA, Feb 2026
SAS-B — Special Access Scheme
Per-patient approval. Best starting point for most GPs.
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Approval time: 2–5 business days online
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Process: Apply via TGA online system per patient, per product category. Provide clinical justification: diagnosis, treatments tried, reasons current ARTG products are unsuitable.
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Cost: Free to apply
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Renewal: New application required each time unless you become an AP
Class of patients approval. For regular prescribers.
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Approval: Up to 5 years. No per-patient TGA notification.
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Established history list: Many common indications (chronic pain, anxiety, insomnia, PTSD, palliative nausea) are on the TGA established history of use list — no HREC or specialist college endorsement needed for these.
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Other indications: Require HREC approval or specialist college endorsement before applying.
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Reporting: 6-monthly patient reports to TGA required
💻 Single online application: The TGA SAS/AP Online System handles both TGA and most state/territory approvals in one submission. Tasmania requires a separate state application. TGA, Oct 2025 → TGA online system ↗
Schedule 4 vs Schedule 8 — the key distinction
Poisons Standard (SUSMP) · TGA
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Schedule 4 (S4) — CBD ≥98% purity
Cannabidiol products containing ≥98% CBD with <2% other cannabinoids. Prescription required but no additional state permit in most states. Simpler to prescribe. Lower dependence risk. If a registered S4 CBD product exists on the ARTG for your patient’s indication, consider it first.
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Schedule 8 (S8) — THC-containing products
Any product with THC >2% of total cannabinoid content. Treated as a controlled drug. Requires RTPM check before prescribing in QLD (QScript) and VIC (SafeScript). Additional state permits required in some circumstances (see state rules below). Higher documentation burden. Same MDO consultation considerations as opioids.
🚫 Telehealth: Medicinal cannabis — particularly S8 products — cannot be prescribed via telehealth in all jurisdictions. Check current state rules before prescribing remotely. TEGO, March 2026
State-by-state S8 permit requirements
TGA approval is always required for unapproved products. Additional state requirements vary significantly. State health departments, 2025–2026
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No additional QLD permit required for S4 or S8 medicinal cannabis. Any medical or nurse practitioner can prescribe if clinically appropriate and TGA approval obtained. QLD Health, July 2025
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QScript mandatory: Must check QScript (Queensland’s RTPM) before prescribing any S8 medicinal cannabis product. Same requirement as all other S8 medicines. QLD MPA 2019
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One medicinal cannabis product per prescription. Cannot write a substitute on the same script. If the product is unavailable, a new prescription is required.
No S8 permit required for non-drug-dependent patients. Any registered medical or nurse practitioner can prescribe S8 medicinal cannabis to non-drug-dependent patients with TGA approval only. health.vic.gov.au, Feb 2026
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Drug-dependent patients: A Victorian Schedule 8 Treatment Permit is required from the Dept of Health before prescribing S8 to any patient with a history of drug dependence. VIC and TGA approvals can be sought together via the TGA single application. health.vic.gov.au
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SafeScript mandatory: Check SafeScript (VIC’s real-time prescription monitoring) before prescribing and dispensing any S8 medicinal cannabis product to any patient. health.vic.gov.au
No NSW Health approval required to prescribe S4 CBD medicinal cannabis products. medicinalcannabis.nsw.gov.au
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Additional NSW Health approval required when prescribing S8 medicinal cannabis to: a drug-dependent person (including those on the Opioid Treatment Program); a patient under 16; or for a clinical trial. Apply to NSW Health Pharmaceutical Regulatory Unit. medicinalcannabis.nsw.gov.au
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NSW Cannabis Medicines Advisory Service: Free advisory service for NSW health practitioners (and interstate practitioners treating NSW patients): medicinalcannabis.nsw.gov.au ↗
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Specialist approval required when prescribing to patients under 16 years of age or to drug-dependent individuals. Australian Prescriber
No SA-specific S8 permit for most patients. Patients over 70 years of age or notified palliative care patients do not need SA Health Schedule 8 approval. Standard TGA approval process applies. Australian Prescriber
Separate state application required. Tasmania is the only state that does not participate in the TGA single application portal. A separate TAS Department of Health application is needed alongside the TGA SAS-B application. Australian Prescriber — Table
The TGA does not specify a list of approved indications. Any condition may be submitted via SAS-B with clinical justification. The TGA has published condition-specific guidance documents — read the relevant one before applying.
AskMyGP does not rate clinical evidence — use the TGA’s own guidance for your patient’s condition.TGA, 2026
Common conditions for which SAS-B approvals are regularly submitted include: chronic pain, anxiety, insomnia, PTSD, chemotherapy-related nausea, epilepsy, MS spasticity, and palliative symptom management. Epidyolex (CBD for certain epilepsies) is TGA-registered — if it covers your patient’s indication, consider it before an unapproved product. TGA · NCBI 2022
⚠️ AHPRA (July 2025): Evidence of poor prescribing practice has been identified — particularly short online consultations, inadequate histories, and prescribing for conditions with limited evidence. Ensure your clinical reasoning is documented regardless of the indication. AHPRA & Medical Board, July 2025
Before you prescribe — interactive checklist
AHPRA and the Medical Board expect the same standard of care as any other S8 medicine. AHPRA & Medical Board, July 2025
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Full assessment — including social history, mental health history, and substance use history. Cannot be done in a short online consultation.
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Document clinical indication — specific diagnosis, symptom severity, impact on function.
Check RTPM — QScript (QLD) or SafeScript (VIC) before prescribing any S8 product. Check PDMS in your state if applicable.
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Informed consent — document that patient understands this is an unapproved product not assessed by TGA for safety or efficacy. Discuss driving restrictions (S8 THC products and zero-tolerance road rules).
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Driving warning (critical): THC-containing (S8) medicinal cannabis is subject to zero-tolerance road laws in all states. Patients must not drive while any THC is detectable — which may be days after a dose. Document this clearly. Driver medical guide →
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Confirm pharmacy stock — contact the dispensing pharmacy before writing the prescription. Cannot substitute with an alternative brand on the same script — a new prescription is required if unavailable.
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Plan follow-up — review efficacy, safety, and ongoing clinical need. Document at each review. If no response, consider discontinuation.
What does it cost the patient?
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Not PBS-listed. Medicinal cannabis products are not subsidised by the Pharmaceutical Benefits Scheme (PBS). Patients pay full retail price — typically $100–$400/month depending on product and dose. Some patients pay considerably more.
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One exception: Epidyolex (CBD for certain epilepsies) is TGA-registered and may be PBS-listed for specific indications. Check current PBS schedule. PBS Schedule
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Out-of-pocket burden: Set patient expectations clearly before prescribing. Cost is a common reason for non-adherence and discontinuation. Consider whether the cost/benefit is justified for the indication.
Tap each item as you complete it
MBS billing
There is no specific MBS item for medicinal cannabis assessment or prescribing. Bill via standard consultation items based on time and complexity. MBS Book July 2026
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Item 23 ($45.05) — standard <20 min; Item 36 ($87.10) — 20–40 min; Item 44 ($128.35) — >40 min. Initial assessments often involve significant time.
ℹ️ This page covers regulatory pathways and process. It is not clinical advice. All prescribing decisions are yours as the treating practitioner — apply clinical judgement and consult current TGA guidance for your patient’s specific condition. Consult your MDO for medico-legal questions.