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Eligibility for PBS prescriptions
The Pharmaceutical Benefits Scheme (PBS) subsidises the cost of many prescription medicines. It covers:
- all Australian residents
- eligible visitors from countries we have Reciprocal Health Care Agreements with.
A patient is eligible for a subsidised prescription if it’s:
- written by an eligible PBS prescriber
- listed in your prescriber type
- listed in the PBS Schedule.
Prescriber types include:
Eligible veterans, war widows and their dependents can get medicines through the RPBS. The Department of Veterans’ Affairs (DVA) administers the RPBS.
Pharmaceutical benefits categories
|Unrestricted||Medicine prescribed through the PBS and RPBS without therapeutic use restrictions.|
|Restricted benefit||Medicine prescribed through the PBS and RPBS with specific therapeutic uses as listed in the schedule.|
There’s 2 types of Authority Required listed medicines:
There’s no Authority Required medicines listed for dental items.
A PBS prescription is only valid if it meets certain requirements. You must:
- tell us on the prescription if your patient is eligible for the PBS
- prescribe within your scope of practice and prescribing accreditation
- comply with state or territory legislation
- comply with PBS requirements
- use the correct prescription stationery.
Find out more about PBS and RPBS stationery.
PBS prescribing rules
You can only prescribe a PBS listed medicine once in one day if it’s the same medicine for the same person.
If you provide the original supply and all repeat supplies on one occasion, you need to:
- write or print either ‘Reg 24’, ’Regulation 24’, ‘one supply’, or ‘1 supply’ on the prescription
- sign the prescription with your initials.
You can prescribe up to 3 medicines on standard PBS prescription stationery. However, there are exceptions for:
- Authority Required medicines
- Authority Required (STREAMLINED) medicines.
In these cases, you can only prescribe one medicine per prescription.
Before prescribing Authority Required medicines, make sure you get approval from DVA or us. You don’t need to do this for an Authority Required (STREAMLINED) medicine.
You also need to get DVA’s approval or ours for quantities or repeats that are more than those specified in the schedule.
On the prescription, you must include all of the following:
- your name, practice address, and prescriber number
- your patient’s name and address
- whether you’re prescribing a PBS or RPBS medicine
- the name, strength and form of medicine
- the dose and instructions for use
- the quantity and number of repeats
- your signature
- the date you wrote the prescription - you can’t forward or backdate the prescription
- your patient’s Medicare number and any entitlement details, including Commonwealth concession, pension or health care card details or veterans’ entitlement number
- whether a brand substitution is permitted, if it applies.
For Authority Required medicines, you need to also add the:
- authority prescription number - you need to quote this number when applying for telephone approvals
- authority approval number.
For Authority Required (STREAMLINED) medicines, you need to add the 4 or 5 digit streamlined authority code from the schedule.
Collaborative arrangements for nurse practitioners
If you’re a nurse practitioner, you need to have collaborative arrangements in place to prescribe PBS medicines.
A collaborative arrangement means you:
- work for medical practice that has at least one medical practitioner
- see patients a medical practitioner refers to you
- have a single agreement with a medical practitioner
- have written records showing you work collaboratively with a medical practitioner.
You also have to check extra conditions for prescribing some medicines.
- Continuing Therapy Only (CTO), if a medical practitioner starts treatment and prescribes medicine, but an authorised nurse practitioner continues prescribing it
- Shared Care Model (SCM), if an authorised nurse practitioner and a medical practitioner share the care of a patient with an agreed management plan.
To check if a medicine is CTO or SCM select the ‘Note’ information in the schedule listed with the medicine.
If you’re prescribing under CTO or SCM, you don’t need to note this on the prescription.
If you write a non-PBS prescription using a prescription pad or computer-generated PBS prescription paper, you need to:
- cross out the PBS and RPBS boxes
- endorse the prescription as non-PBS.
You need to write a non-PBS prescription if you’re prescribing any of the following:
- a medication outside the PBS restrictions, if your patient’s clinical condition doesn’t match the indications in the schedule
- a quantity or number of repeats that exceed the maximum PBS quantity without an approved authority
- a medicine, or form and strength of a medicine, not in the schedule for patients not entitled to PBS medicines
- a medicine outside its PBS manner of administration - for example, a PBS eye ointment for topical non-ophthalmic use.