Private midwives who are also 'endorsed midwives', can apply for a Medicare Provider Number (MPN) so that their clients can claim Medicare rebates for the midwifery care they receive.
Endorsement: what does it mean for my practice?
Approved programs of study covering prescribing and diagnostic requirements can be found on the AHPRA website:
As an endorsed midwife, you may access the Midwifery Practice Insurance Scheme (MPIS), and your services may be covered through certain private health funds, including home birth services.
You may also apply to Medicare for a Pharmaceuticals Benefits Scheme (PBS) number, which will allow you to provide Medicare rebateable services, including prescribing PBS approved medications for mothers and babies, prescribing medicines that have been endorsed by the NMBA, and ordering ultrasound scans and some pathology tests that may be required during pregnancy and early parenting, and can refer women and babies directly to medical practitioners
(comprehensive information about midwives and Medicare can be consulted here).
Information about endorsement for scheduled medicines and how to apply can be found on the NMBA website.
To provide Medicare rebateable services an eligible midwife is required to:
- have a Medicare provider number (see below how to apply for one);
- be working in private practice;
- have professional indemnity insurance; and
- have collaborative arrangements in place with a specified medical practitioner.
What is a 'collaborative arrangement'?
In order for you, as a endorsed midwife, to provide Medicare rebateable services, you must have a collaborative arrangement with either a doctor who provides obstetric services; a hospital that has credentialed the midwife; or a health service/organisation that employs or engages at least one obstetric specified medical practitioner. This is to provide for seamless consultation, referral or transfer when the woman’s care requires it. More information here.
Collaborative arrangements vary depending on what you negotiate with doctors and hospitals. You may have formal collaborative arrangements with a GP, hospital or an obstetrician, may follow a more informal process with a particular doctor, or may provide care to a woman who has been referred to you by a doctor.
Medicare requires a copy of the collaborative arrangement in the form of a Collaborative Agreement, as evidence that a collaborative arrangement is in place. More information here.
What does this mean for collaborating doctors?
As part of the Collaborative Arrangement, the doctor's role is to provide support to facilitate easy consultation, referral or transfer if the need arises for the benefit of the woman and her baby. Doctors are not responsible for your practice. Further information about maternity care collaboration can be found here. Principles that underpin communication between midwives and obstetricians (GP or specialist) - this document is intended to provide guidance for eligible midwives and obstetricians about appropriate communication in relation to the care of women who choose an eligible midwife as their maternity care coordinator.
An example of collaborative arrangement can be found here. You will need to go to the Apendices (page 49) of the 'Eligible midwives and collaborative arrangements' document developed and released by the Victorian Department of Health.
What about Medicare rebates and home birth?
Home birth services can be provided by any midwife, but there are no Medicare rebates for birth at home, even if you have a MPN. However, if the woman has private health insurance, she may be able to claim a benefit for the birth through her private health fund. Antenatal and postnatal care are eligible for a Medicare rebate.