Getting Your Medicare Provider Number: Step by Step

Your Medicare provider number is the thing that lets your patients claim their rebate. Without it, you can treat people privately and charge whatever you like, but anyone referred to you under a Chronic Disease Management plan (GPCCMP) has no way to get their Medicare rebate for seeing you. For most allied health professionals going into private practice, getting this number sorted is one of the first admin tasks on the list.

The process is not difficult, but it has a few moving parts that trip people up. This guide walks through the whole thing from start to finish: setting up your PRODA account, filling in the application, avoiding the common mistakes, and what to do once you have your number.

What a provider number actually is

A Medicare provider number is a unique identifier that links you (the practitioner) to a specific practice location. Services Australia uses it to process Medicare claims for your patients. When a patient sees you under a GPCCMP referral and you submit a claim, Medicare looks at your provider number to confirm who you are, where the service happened, and whether it is eligible for a rebate.

The important thing to understand early is that provider numbers are location-specific. You do not get one provider number that follows you everywhere. You get one provider number per practice address. This catches a lot of people off guard, and it is worth understanding properly before you apply. More on this further down.

If you only see private-paying clients and have no intention of billing through Medicare, you technically do not need a provider number. But in practice, most allied health professionals in private practice will want one. A large portion of your referrals will come through the CDM pathway, and patients expect to be able to claim their rebate. Turning that away limits your client base significantly.

Step 1: Set up your PRODA account

Before you can apply for a provider number online, you need a PRODA account. PRODA stands for Provider Digital Access, and it is your login to Services Australia's online health professional services. Think of it as the gateway. You cannot access HPOS (Health Professional Online Services) without it, and HPOS is where you apply for your provider number, manage your details, and eventually submit claims.

Here is how to set it up:

1. Go to proda.humanservices.gov.au and click “Register”.
2. You will need to verify your identity. This requires 100 points of ID, similar to opening a bank account. Your driver's licence, passport, or Medicare card all count. The system checks your identity documents against government records in real time.
3. Create your account with a strong password. PRODA uses multi-factor authentication, so you will also set up a second verification method (usually your mobile phone).
4. Once your identity is verified and your account is created, you can link it to HPOS. This is done from within PRODA by selecting “Link my provider number to HPOS” (or, if you do not have a provider number yet, you can still access the HPOS application form through PRODA).

The PRODA registration process itself is free. There is no cost for the account or for accessing HPOS. Once your account is active, you can use it for provider number applications, claim submissions, and managing your Medicare details going forward.

Step 2: Gather what you need before applying

Before you start the actual provider number application, get these things together. Having everything ready avoids the back-and-forth of incomplete applications getting rejected and having to resubmit.

Your registration or accreditation number. For AHPRA-regulated professions (physiotherapy, podiatry, chiropractic, osteopathy), this is your AHPRA registration number. For exercise physiologists, it is your ESSA (Exercise & Sports Science Australia) accreditation number. For dietitians, it is your Dietitians Australia (DA) APD accreditation number. The details on your application must match your registration records exactly. Mismatches are one of the top reasons applications get rejected.

Your confirmed practice address. This is the physical location where you will be seeing patients. You need a real address. A PO Box will not work. If you are renting a room in a clinic, you need the full street address of that clinic. If you are working from a home office, your home address becomes your practice address (and there are implications for that, covered below).

Your bank account details. Medicare payments go directly into a nominated bank account. You will need your BSB and account number. This should be your business account, not a personal account. If you have not set up your business banking yet, do that first.

Your ABN. You will need an active Australian Business Number. If you have not registered one yet, you can do it at abr.gov.au for free. It is processed instantly in most cases.

Step 3: Submit your application

You have two options for submitting your provider number application: online through HPOS, or by submitting a paper form (HW093). Online is faster and is what Services Australia recommends. The paper form still exists, but it adds processing time and introduces more room for errors.

Applying online (recommended)

1. Log in to PRODA and navigate to HPOS.
2. Select “My details” and then “Apply for a new provider number/stem”.
3. Fill in your personal details, registration information, practice address, and bank details. Double-check that your name matches your AHPRA (or equivalent) registration exactly. If your AHPRA record says “Catherine” and you put “Kate”, it will be rejected.
4. Review and submit. You will get a confirmation number. Keep this.

Applying by paper (HW093 form)

The HW093 form is available on the Services Australia website. Download it, print it, fill it out by hand or digitally, and post it to the address on the form. Paper applications typically take longer to process and are more prone to errors (illegible handwriting, missed fields). Unless you have a specific reason to go paper, apply online.

Why applications get rejected

Rejections are frustrating because they add weeks to the process. Each time you resubmit, the clock resets. Here are the most common reasons applications are knocked back, so you can avoid them the first time around.

Name mismatch with your registration body. As mentioned above, your name needs to match your AHPRA record (or ESSA/DA record) exactly. Middle names included, hyphenation included. If your registration says “Sarah Jane Smith” and you put “Sarah Smith”, that can be enough to cause a rejection.

Wrong or incomplete practice address. The address needs to be a physical practice location, formatted correctly. Unit numbers, suite numbers, and building names all matter. If you are renting a room inside a larger clinic, check exactly how that address appears in official records.

Applying before you have a confirmed address. You cannot apply for a provider number until you have a confirmed practice location. If you are still negotiating a room rental or waiting on a lease, you need to wait. Services Australia will not issue a provider number for a location that is not yet confirmed.

Missing information. Blank fields, skipped sections, or forgetting to include supporting documents (if requested). The online form is harder to accidentally leave incomplete, which is another reason to apply through HPOS rather than paper.

Registration not yet active. If your AHPRA registration (or equivalent) is not yet showing as active on their public register, your provider number application will be rejected. Make sure your registration is fully processed before applying.

The location-specific trap

This is the thing that catches the most people out, so it gets its own section.

Your provider number is tied to a specific practice address. One address, one provider number. If you work at two different clinics, you need two provider numbers. If you work at three, you need three. Each one requires a separate application.

The provider number itself has two parts: a “stem” (which identifies you as a practitioner and stays the same) and a “location suffix” (which changes for each practice address). So your numbers might look something like 1234567A at one clinic and 1234567B at another. Same stem, different suffix.

This matters because if you bill Medicare using the wrong provider number for the location where the service actually happened, the claim can be rejected or flagged. You need to make sure your practice management software is set up to use the correct provider number for each location.

When you move practices or change locations, you need to apply for a new provider number at the new address. Your old provider number becomes inactive once you stop practising at that location. Do not keep billing under an old provider number at an address where you no longer work.

The home address visibility issue

If you are starting out and your practice address is your home (which is common for telehealth-only practitioners or those just getting started), there is something you need to know.

Your practice address is listed on the Services Australia provider directory. This directory is publicly searchable. That means if your practice address is your home address, your home address becomes publicly visible. Anyone can look it up.

You can request to have your practice address withheld from the public directory, but you need to actively ask for this. It is not the default. When you submit your provider number application, there is an option to request that your practice address not be displayed publicly. If you missed it on the application, you can contact Services Australia afterwards to request it.

This matters for personal safety and privacy, especially if you are a sole practitioner working from home. It also matters if you are doing telehealth from your home and do not want clients knowing your residential address. Do not skip this step.

How long it takes

Processing times vary, but here is what to expect as of early 2026:

• Online applications (via HPOS): Typically 2 to 4 weeks. Some are processed faster, but do not count on it. Plan for the full 4 weeks.
• Paper applications (HW093): Longer. The form has to be received, manually entered, and processed. Allow 4 to 6 weeks minimum, sometimes more.

Once your provider number is approved and issued, there is an additional 2-business-day wait before it becomes active in the Medicare system. That means you cannot submit claims on the day you receive your number. You need to wait for it to propagate through the system.

Factor all of this into your timeline. If you are planning to start seeing CDM patients on a specific date, work backwards from there. You want your PRODA account set up, your application submitted, and your number approved and active before your first patient walks in the door. Starting the process at least 6 weeks before your planned launch date gives you a comfortable buffer.

If your application is taking longer than expected, you can check the status in HPOS under “My details”. If it has been more than 4 weeks for an online application, contact Services Australia on 132 150 (select the provider enquiries option) to follow up.

After you get your number

Getting the provider number is the milestone, but there are a few things to sort out before you start billing.

Set up HPOS properly

Now that you have a provider number, make sure your HPOS access is fully configured. HPOS is where you can submit claims manually, check patient eligibility, view your claiming history, and manage your provider details. Spend 30 minutes exploring it so you are not fumbling around when you need it.

Connect your practice management software

If you are using practice management software (Halaxy, Cliniko, Nookal, or similar), you need to enter your provider number into the system so it can submit Medicare claims on your behalf. Each software handles this slightly differently, but it is usually under your practitioner profile or Medicare settings. Your software provider will have documentation for this.

Make sure you enter the correct provider number for the correct location. If you have multiple provider numbers for multiple clinics, each location in your software needs the corresponding number.

Understand how claims work

There are two main ways to submit Medicare claims for CDM patients:

• Online claiming through your practice management software. This is the most common approach. Your software submits the claim to Medicare electronically, and the rebate goes directly to the patient (or to you, if you are bulk billing). This happens in close to real time.
• Manual claiming through HPOS. You can submit claims individually through the HPOS portal. This is slower and more manual, but it works as a backup if your software has issues or you are just getting started and have not set up electronic claiming yet.

For a deeper walkthrough of how CDM billing works from the clinical side (referrals, the 5-session cap, item numbers by profession), see the Medicare CDM billing guide.

Keep your details current

Any time your details change (practice address, bank account, name change, registration status), you need to update them in HPOS. Outdated details can cause claim rejections or payment delays. If you move to a new practice address, remember that you need a new provider number for the new location.

Quick reference checklist

Here is the full process condensed into a checklist you can work through:

1. Confirm your AHPRA registration (or ESSA/DA accreditation) is active and your details are correct on the public register.
2. Confirm your practice address. You need a physical location, not a PO Box.
3. Register your ABN at abr.gov.au if you have not already.
4. Set up your business bank account if you have not already. You will need the BSB and account number.
5. Create your PRODA account at proda.humanservices.gov.au. Allow a few days for identity verification.
6. Apply for your provider number through HPOS (via PRODA). Use the online application, not the paper form.
7. If your practice address is your home, request that your address be withheld from the public provider directory.
8. Wait for approval (2 to 4 weeks for online, longer for paper).
9. Once approved, wait 2 business days for the number to become active in the Medicare system.
10. Enter your provider number into your practice management software.
11. Test a claim submission (either through your software or manually via HPOS) to confirm everything is connected and working.
12. If you work at multiple locations, repeat the application for each practice address.

Common questions

Can I apply before I have a practice address?

No. You need a confirmed physical practice address to apply. If you are still looking for a room or finalising a lease, wait until that is locked in. Applying with a tentative address will result in a rejection.

What if I only do telehealth?

You still need a provider number, and it still needs to be tied to a physical address. For telehealth-only practitioners, this is typically your home address or a registered business address. The telehealth service is billed under the provider number linked to the address from where you are delivering the service. If that is your home, consider requesting your address be withheld from the public directory.

Do I need a separate provider number for telehealth and in-person?

If you deliver both telehealth and in-person services from the same address, one provider number covers both. You only need a separate provider number if the physical addresses are different.

How do I check my application status?

Log in to PRODA, go to HPOS, and check under “My details”. Your application status will be shown there. If it has been more than 4 weeks with no update, call Services Australia on 132 150.

What happens if I change clinics?

You need a new provider number for the new location. Apply through HPOS the same way you did the first time, with the new practice address. Your old provider number becomes inactive once you stop practising at that address. Notify Services Australia when you leave a location so the old number is deactivated properly.

This guide covers the provider number process for allied health professionals billing through the Medicare CDM pathway. For profession-specific Medicare item numbers and rebate amounts, see the CDM billing guide. For a full breakdown of what it costs to set up a practice, see the practice costs guide.