When referring a patient to a specialist or consultant physician for treatment, the referral must include:
- relevant clinical information about your patient’s condition for investigation, opinion, treatment and management
- the date of the referral
- signature of the referring health professional.
You don’t need to refer to a specific specialist or consultant physician. Patients can choose where to present the referral.
A referral covers a single course of treatment for the referred condition. A single course of treatment is an initial attendance at the specialist or consultant physician. It includes subsequent attendances for the continuing management until the patient is referred back to the referring practitioner.
A new referral doesn’t always mean a new course of treatment.
If a referral is for continuing management of a condition for a single course of treatment, the specialist or consultant physician must bill subsequent attendance items. However, you can bill an initial attendance item if it meets all the following:
- the referring practitioner decides the patient’s condition needs to be reviewed
- the patient is seen by the specialist or consultant physician after the expiry of the last referral
- the patient was last seen by the specialist or consultant physician more than 9 months earlier.
If the patient has a new or unrelated condition, the specialist can start a new course of treatment if there is a new referral in place.
Specialists or consultant physicians must bill subsequent attendance items for continuing management of a condition. However, you can bill an initial attendance item if:
- the referring health professional decides to review your patient’s condition
- your patient sees the specialist after the expiry of the last referral
- your patient last saw the specialist over 9 months ago.
If your patient has a new or unrelated condition, the specialist can start a new course of treatment with a new referral.
A general practitioner (GP) referral to a specialist lasts 12 months from the specialist’s first meeting with the patient unless a different duration is noted on the referral instrument.
GPs can refer beyond 12 months or indefinitely if the patient needs ongoing care. However, a new referral is needed if the patient has a new or unrelated condition while on an indefinite referral.
The referral period starts from the date the specialist first meets the patient, not the date the referral was issued.
Referrals from specialists and other consultant physicians are valid for 3 months unless they’re for an admitted patient.
Specialist to specialist referrals for admitted patients are valid for 3 months or the duration of admission, whichever is longer.
If a written referral is lost, stolen or destroyed, it’s valid for only one attendance. You must get a valid referral before billing any subsequent services. The account, receipt or assignment form must include:
- the referring medical provider’s name
- practice address or provider number of the referring medical provider - if known
- the words ‘lost referral’.
Read more about referral of patients to specialists or consultant physicians on the Department of Health and Aged Care website.