Medicare Credentialling for Nuclear Medicine Specialists

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What is Medicare Credentialling?

Payment of Medicare benefits within Australia for nuclear medicine and PET imaging services is limited to specialists or consultant physicians who are credentialled by the Committee for Joint College Training (CJCT) of the Royal Australasian College of Physicians (RACP) and the Royal Australian and New Zealand College of Radiologists (RANZCR).

The scheme was developed by the profession in consultation with Government to ensure that specialists in nuclear medicine are appropriately trained and licensed, provide appropriate supervision of procedures and are involved in ongoing continuing medical education.

“Medicare Credentialling” is the process of gathering all of the documentation needed to provide to Medicare to become a “Credentialed Nuclear Medicine Specialist”.

If a Nuclear Medicine Specialist does not need to use the Medicare benefit numbers within nuclear imaging services, the Nuclear Medicine Specialist does NOT need to undertake Medicare Credentialling.

What Medicare Credentialling is NOT:

  • Medicare Credentialling is NOT part of your Fellowship/completion process for the Advanced Training in Nuclear Medicine (ATNM) training program.  Medicare Credentialling occurs after you have gained Fellowship of the ATNM.
  • The Medicare Credentialling process does NOT make you an AANMS full member.  If you would like to become an AANMS full member and to use the post-nominals FAANMS, please contact AANMS Admin.
  • Your place of work has no involvement with Medicare Credentialling, nor does it have anything to do with the training site accreditation process.
  • Medicare Credentialling is NOT required for Nuclear Medicine Specialist working in New Zealand.

The Medicare Credentialling Process

The following diagram highlights the key stages of the Credentialling Process, while the rest of this page goes into detail about each of these stages.  Links to websites/forms and estimated timelines are provided as a guide and are checked periodically by AANMS (current update Sept 2024).  However, it is your responsibility to ensure that you are using the correct forms, and it is encouraged that you speak to each organisation to determine the most relevant turnaround times for your submission.

The majority of the Credentialling Process is undertaken by the Trainee, however RACP, RANZCR and AANMS play a part too.

Step 1: Fellowship

RACP Fellowship/RANZCR Completion

Congratulations on nearing the end of, or completing your, Advanced Training in Nuclear Medicine. To be eligible for Medicare Credentialling, you must supply evidence that you have completed Advanced Training in Nuclear Medicine. Completion of training for all trainees (and admission to Fellowship for RACP Trainees) will be processed only when all training requirements (and training time) of Advanced Training in Nuclear Medicine are complete.

  • This process is not managed by AANMS – Please reach out to RACP, RACP OTP or RANZCR to check if you have any outstanding requirements.
  • Once all requirements are complete, it will typically take RACP 1-3 weeks to process your completion of training/fellowship. You will be advised if the process is likely to take any longer.  Once fellowship has been granted, you will receive – these documents are needed before progressing to Step 2:
    • RACP Trainees:  An RACP Fellowship certificate and the CJCT “Completion of Training” letter.
    • RANZCR Trainees:  The CJCT “Completion of Training” letter. Please also reach out to RANZCR to discuss any other RANZCR Fellowship process. RANZCR Trainees are not admitted to Fellowship of the RACP upon completion of Advanced Training in Nuclear Medicine.
    • OTP/IMG Trainees: An RACP Fellowship certificate and the RACP “Admission to Fellowship” letter.

Step 2: Sourcing of Documents needed for Credentialling

Now that you have your Fellowship/Completion documents, you can start to apply for the following documents needed to become a Credentialled Nuclear Medicine Specialist.

This stage can take 2-8 weeks, dependent on each organisation’s working times.  Be conscious of delays over Christmas and New Year, which is often the peak processing times for these organisations.

If you have any issues/rejections during this process, it’s best to reach out to either Ahpra or Medicare first to determine the issue, and then RACP and/or RANZCR to assist.

WHY:  Your Ahpra registration needs to be updated to recognise that you are now a specialist in Nuclear Medicine.

FORM: Application for specialist registration for a medical practitioner currently holding general and or specialist registration ASPC-30

FORM NEEDS:  Fellowship Certificate/Letter & Completion Letter (these will need to be certified), ID documents, Criminal History Checks, Curriculum Vitae and other documents.

FORM FEE & SUBMISSION:  $506 and submit to Ahpra online (refer to details on last page of the form).

FORM TIMING:  If you have successfully submitted all relevant documentation, Ahpra aims to complete your application within 2 weeks.  However, you can commence this process up to three months before you are expected to complete all of your course requirements.

FOR MEDICARE CREDENTIALLING: Submit Ahpra’s certificate showing your registration number and the inclusion of the Nuclear Medicine specialty.

WHY:  You need to have an in-date Provider Number for site(s) your practice Nuclear Medicine at.  If you already have an this, please use this number within your Medicare Recognition application and submit as part of Medicare Credentialling.  If you need a new number for a new location, please complete the below form.

FORM:  Additional Provider Numbers – a separate application is required for each location you work at.  Can also be managed through HPOS/PRODA.

FORM NEEDS:  Fellowship Letter/Certificate, Completion Letter, Ahpra Registration Number, ID documents, and other documents.

FORM TIMING:  The application will be processed within 2-4 weeks.

FORM FEE:  None

FOR MEDICARE CREDENTIALLING:  Submit Medicare’s confirmation letter advising the provider number, Nuclear Medicine location and start date.  If you don’t have a letter, please submit a print/screenshot from PRODA showing your provider number/location/in-date.

WHY: Medicare recognition as a specialist or consultant physician is required if you want to provide services to private patients that attract Medicare Benefits at the specialist or consultant physician rates.

FORM: Application for recognition as a specialist or consultant physician form (HW077)

FORM NEEDS:  An active Medicare Provider Number for a location that you practice Nuclear Medicine at, Fellowship Certificate/Letter, Completion Letter, AHPRA Registration Number, ID documents, and other documents.

FORM TIMING: Processed within 28 days of submission.    If you are submitting an application for a new Medicare Provider Number, these forms can be submitted and processed both together.

FORM FEE:  None

FOR MEDICARE CREDENTIALLING: Submit Medicare’s confirmation letter advising recognition of Nuclear Medicine specialty.

WHY:  Nuclear Medicine Specialists must have a “use licence” to use unsealed radioactive material used in nuclear medicine and/or a computed tomography (CT) unit.

FORMS: Each Australian state/territory has their own licensing body and application form.  All states, except for QLD fall under the Automatic Mutual Recognition Scheme (AMRS), which means your licence from one state will apply if you work in another state:

FORM NEEDS:  Fellowship Letter, Completion Letter, AHPRA Registration Number, ID documents, and other documents as required by each state.

FORM TIMING:  Dependent on each organisation, between 2-4 weeks.

FORM FEE:  Yes – Refer to each organisation

FOR MEDICARE CREDENTIALLING:  Submit the organisation’s letter/certificate/licence to use radiation.

Step 3: Medicare Credentialling

Once you have all of the outcome letters from the above organisations:

  1. Pay the application fee of $110
  2. Complete the online “Credentialling Form – NM and PET” application form, upload all relevant documentation and submit the form.

What happens next:

  • AANMS reviews your application.  AANMS will either ask you for more information, or if all documentation is in order, will advise Medicare that you can be deemed a “Credentialed Nuclear Medicine Specialist”.  AANMS will provide you with notification of this occurring (up to 1 week).  If you have any questions out this, please contact AANMS.
  • Medicare will update your details so that you can use the Nuclear Medicine benefit numbers (up to 2 weeks).
  • If you do not see any changes within Medicare within 2 weeks, please reach out to them directly, either via HPOS or Call

Step 4: PET Statutory Declaration

To be eligible to perform Positron Emission Tomography (PET) services, a provider must complete a statutory declaration that lists the provider number and Location Specific Practice Number (LSPN) of the diagnostic imaging practice.  A separate Stat Dec is required for EVERY PET location you work at.

WHY: To be recognised as a PET specialist and to bill or claim MBS items for any PET services.  A separate PET Stat Dec form is required for every PET location you work at.

FORM: Positron emission tomography – statutory declaration form (HW064) , Claim Medicare benefits using your Location Specific Practice Number (LSPN)

FORM NEEDS:  Credentialling to be completed, Medicare Provider Number for that location.

FORM TIMING: Processed within 2-4 weeks

FORM FEE:  None

OUTCOME: Medicare will provide a dated confirmation letter advising acceptance or rejection of the application.  You do NOT need to provide this to AANMS.