Nurse and midwife eligibility requirements

Eligibility for nurses and midwives who claim a Medicare benefit for a service

To claim a Medicare benefit for a service, nurses and midwives must:

  • meet the qualification requirements set out in the Health Insurance (Midwife and Nurse Practitioner) Determination 2011
  • be registered and authorised by the Nursing and Midwifery Board of Australia (NMBA)
  • be in private practice - Nurses and midwives who are employed by a public hospital or health services aren’t eligible to claim Medicare benefits
  • have a collaborative care arrangement in place.

Section 84AAF/84AAJ of the National Health Act 1953 has more information about claiming Medicare benefits, and applying for prescriber number as a nurse or midwife.

Collaborative arrangements must include at least one medical practitioner. Collaborative arrangements can’t include entities such as health services.

You can demonstrate collaborative arrangements by:

  • being employed or engaged by a medical practitioner or an entity that provides medical services. These practitioners or entities must be seeing patients who have a written referral from a medical practitioner or a signed written agreement with a medical practitioner.

Page last updated: 22 October 2019