Recognised providers

Are you planning to claim for a treatment or service under Extras (such as acupuncture or physiotherapy)?  We can only pay benefits if you use a recognised provider.

Some recognised providers are also members of our CBHS Choice Network. These providers may also reduce or remove gap payments for selected Extras.

Find out more about the CBHS Choice Network.

Providers registered with Medicare Australia

Providers registered with Medicare Australia are all recognised providers.

This could include the following healthcare professionals:

Providers registered with AHPRA

If your provider is registered with the Australian Health Practitioner Regulation Agency (AHPRA), they are a recognised provider.

These services can include:

• Acupuncture
• Chinese herbal medicine

Complementary and alternative therapies

Providers who belong to relevant associations and/or boards are recognised providers.

They must also have:

• Relevant qualifications for the service provided
• Current Professional Indemnity Insurance Certificate of Currency
• Current Senior First Aid Certificate

Rule 10 of the Private Health Insurance (Accreditation) Rules 2011 applies to complementary or alternative providers. This rule requires the provider or treatment to meet each of the following criteria.

• The standard for treatment is that the complementary or alternative therapy health care provider (among others) providing the treatment must be a member of a professional organisation which covers health care practitioners who provide that type of treatment (the profession).
• The professional organisation must be a national entity which has membership requirements for the profession.
• The professional organisation must provide assessment of the health care provider in terms of the appropriate level of training and education required to practise in that profession.
• The professional organisation must administer a continuing professional education development scheme in which the health care provider is required, as a condition of membership, to participate.
• The professional organisation must maintain a code of conduct which the health care provider must uphold in order to continue to be a member.

Provider recognition and other services

These providers must also meet our recognition criteria for us to pay benefits.

We don’t recommend practitioners to you, and we don’t participate in the clinical relationship between you and your provider. We are not responsible for the outcome of clinical services provided or not provided by recognised providers. The extent of our responsibility, as a health insurer, is to determine whether or not to pay fund benefits. In doing so, we act in accordance with the CBHS Health Benefit Fund Rules and the applicable Government regulations.