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View Districts of Workforce Shortage (DWS), Inner/Outer Metro areas, ASGC Remoteness Areas (ASGC-RA 06) and associated information.

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OTDs & FGAMS scaling FAQs

What is scaling?


Scaling is a non-cash incentive offering OTDs and FGAMS opportunities to reduce the 10 year moratorium restriction period. Time reductions are significantly greater for doctors who choose to work in more remote areas. (See the Australian Standard Geographical Classification – Remoteness Areas (ASGC-RA) table below.)

RA Classification RA Category Scaling % discount Restriction period reduced to
RA 1 Major Cities Nil 10 years
RA 2 Inner Regional 10%  9 years
RA 3 Outer Regional 30%  7 years
RA 4 Remote 40%  6 years
RA 5 Very Remote 50%  5 years


What is the ASGC-RA system?


The ASGC-RA system was developed in 2001 by the Australian Bureau of Statistics to determine remoteness. ASGC-RA is the most up to date classification system as it contains 2006 census data.
More info on ASGC-RA

Will I still need to work in a district of workforce shortage (DWS)?


Yes. The scaling system offers opportunities to reduce the 10 year moratorium restriction period, but it doesn’t replace the requirement to hold a section 19AB exemption in a DWS in order to access Medicare benefits.

When did the scaling system start?


1 July 2010

Will time served under the ‘10 year moratorium’ be taken into account?


No. Previous time served will remain as is. For example, if on 1 July 2010, a doctor had served 5 years of their restriction period, they’re only eligible for scaling on the remaining 5 year restriction period.

Do I need to apply for scaling discounts?


No. There’s no formal application process for scaling discounts. If you meet monthly eligibility criteria you’ll automatically receive scaling discounts.

What are the eligibility criteria?


Scaling discounts are applied to your moratorium period each month if:
  • your ‘moratorium period’ has begun
  • you hold a section 19AB exemption for your location(s) (ie your medical services are attracting Medicare benefits)
  • your total ‘value of claims’ is equal to the monthly threshold of $5,000
  • you’ve worked in an eligible ASGC-RA 2 – 5 category.
Note:
  • The minimum ‘value of claims’ threshold is $5,000 per month.
  • Doctors who don’t reach the minimum threshold won’t receive scaling incentives for that period.
  • Doctors participating in the 5 Year OTD Scheme should contact their Rural Workforce Agency for further information.

How are scaling discounts calculated?


Discounts are based on doctors claiming activities every month. Medicare Australia looks at claiming histories to determine which ASGC-RA category the highest ‘value of claims’ occurred in. The scaling discount applicable to this ASGC-RA category is then discounted from your ‘moratorium period’.

What’s the total ‘value of claims’ threshold?


The total ‘value of claims’ threshold amount is $5,000 per month.

How’s the total ‘value of claims’ threshold determined?


The ‘schedule fee’ for eligible item numbers you provided in a month is totalled to determine your ‘value of claims’ for that month. If your value of claims is more than $5000, you’re eligible for scaling discount.

What are the eligible item numbers?


The ‘schedule fee’ of the following item numbers is counted towards the total ‘value of claims’ each month:
  • all MBS services, including assist at operation item numbers
  • MBS items used for DVA patients
  • late claims.
The following item numbers are not counted:
  • act of grace payments
  • rejected claims
  • bulk billing incentive items.

What if I work in an area for a short time, or work in more than one location in a month?


Medicare Australia calculates your claiming activity in all eligible ASGC-RA locations, irrespective of how many services you provided in each ASGC-RA category.
If you’ve met the ‘threshold’, Medicare Australia will apply the discount applicable to the location where the majority of your activity occurred.

How do I know what discount I‘ve received?


If you have a Public Key Infrastructure (PKI) individual certificate you’ll be able to view their scaling progress using Medicare Australia’s Health Professionals Online Services (HPOS).
Register online for a PKI individual certificate
or call Medicare’s eBusiness Service Centre: 1800 700 199
Find out more about HPOS services

What if I don’t agree with the discount(s) I’ve received?


Call Medicare: 132 150
Medicare Australia runs monthly scaling using the date of service for the month being scaled.
Monthly scaling identifies any claims with a date of service during the previous 3 month period.
To ensure all late claims are included, an automated recalculation runs in March and September each year to identify any outstanding claims during the previous 6 month period.
The automated process collects additional claims for the previous 2 year period.

I’m in the 5 Year OTD Scheme. Do I get the scaling benefit?


The 5 Year Overseas Trained Doctor Scheme is an incentive offered to OTDs working in a minority of locations. It entitles participants to significant reductions to the moratorium period.
For more information, contact your Rural Workforce Agency.

What happens when I finish my service obligations?


On the day your ‘discount’ date is equivalent to the ‘actual date’, you’ll become eligible for a ‘scaling class’ 19AB exemption. This will be in place for the remainder of your actual ‘10 year moratorium’ period.
You’ll receive formal written notification from Medicare Australia.