The short answer
For a Medicare rebate, yes. You need a valid referral, usually from your GP, to see an ear, nose and throat (ENT) specialist at the referred Medicare rate, and without one you'll usually pay more. A GP referral lasts 12 months from your first appointment unless your GP writes a different period. Sudden hearing loss or any breathing difficulty needs emergency care, not a referral.
On this page
When should you go to emergency instead?
Some ear, nose and throat problems need emergency care, not a specialist referral. NSW Health lists these as reasons to go to an emergency department [9]:
- any problem with your airway, such as noisy breathing (stridor), drooling or difficulty breathing
- something stuck in the airway, including the nose
- a nosebleed you can't control
- sudden hearing loss in one or both ears
- tonsillitis with a blocked airway, including quinsy (a peritonsillar abscess)
Healthdirect says sudden hearing loss is an emergency and you should go to your local emergency department [10]. If you or your child is struggling to breathe, call 000.
Do you need a referral to see an ENT specialist?
To get a Medicare rebate at the referred rate, yes. You can see a specialist without a referral, but the Medicare item they can bill is lower, so your out-of-pocket cost is likely to be higher [1]. Better Health puts it plainly: you need a referral from a doctor to see an ENT specialist [7].
ENT specialists, also called otolaryngologists, diagnose, treat and manage conditions of the ear, nose and throat and related areas of the head and neck, including with surgery [7]. They're Fellows of the Royal Australasian College of Surgeons [7]. Common reasons for an adult ENT referral include [8]:
- hearing loss, tinnitus, or a discharging ear
- vertigo
- rhinosinusitis (ongoing sinus problems)
- recurrent tonsillitis
- obstructive sleep apnoea
- a hoarse voice or difficulty swallowing
- lumps in the neck, salivary glands or thyroid
- a broken nose
ENT specialists see children too, and NSW Health has separate ENT emergency criteria for children aged 0 to 15 [9]. If you're unsure whether your child should see an ENT or a paediatrician first, see our paediatrician referral page.
Who can refer you to an ENT specialist?
GPs are the main source of specialist referrals [1]. Other specialists can also refer you, in consultation with or by notifying your GP, and nurse practitioners can refer in certain circumstances [1]. Optometrists, by contrast, can only refer to ophthalmologists [2].
Audiologists can't write a Medicare referral to an ENT. Referrals from practitioners outside the categories in Medicare's rules aren't valid and only attract unreferred rates [2]. If you've had a hearing test, take the audiogram to your GP, who can include it with the referral. Healthdirect recommends seeing an audiologist for a hearing test if you notice hearing loss [10].
For the referral to count, the referring practitioner must have consulted with you and considered whether you need a referral [2]. A specialist's referral must also name your GP or practice, or say you can't or won't nominate one [2].
What should an ENT referral include?
A valid referral includes the reason for referral, relevant clinical information, the date and the referring practitioner's signature [1][3]. It can be on paper or electronic [1]. Helpful extras include how long you've had symptoms, what treatments you've tried, any hearing test results, and any scans, such as a CT scan of the sinuses. See what goes in a referral letter.
Does it need to name a specific ENT?
No. For private rooms and other community settings, a referral doesn't have to name a specialist [1][3]. If it does, you can still take it to another ENT unless you've already started seeing the named one [1]. If you'll be a private patient in a public hospital outpatient clinic billed to Medicare, it must be addressed to a named specialist [1].
How long does an ENT referral last?
| Who wrote it | How long it lasts |
|---|---|
| Your GP | 12 months, unless a shorter, longer or indefinite period is stated [1] |
| Another specialist | 3 months, or the length of a hospital admission [1][3] |
The period starts at your first ENT appointment, not the date the referral was written [1][3]. For ongoing care, your GP can write a referral for longer than 12 months or an indefinite one [3]. A new, unrelated problem needs a new referral [1]. More in how long a referral lasts.
What will Medicare cover, and what will you pay?
ENT fees vary between providers, so ask about costs before your appointment [7]. As a guide, item 104, a specialist's initial attendance after referral, has a schedule fee of $103.95 and an 85% Medicare benefit of $88.40 (schedule fee updated 1 July 2026, checked November 2026) [4]. You pay any gap above the rebate.
Does private health insurance help?
Not for consultations in the ENT's rooms. Health insurers can't contribute to out-of-hospital treatment for Medicare services [6]. If surgery such as a tonsillectomy is recommended, check what your hospital cover includes before you book.
Can you see an ENT specialist by telehealth?
Sometimes. Medicare has permanent specialist telehealth items: first appointments can be by video, and some follow-ups by phone where clinically appropriate [5]. A valid referral is still needed, but not a separate one for telehealth [5]. Ask the practice whether an in-person examination is needed.
You can get the referral itself through a telehealth GP consultation, and referrals can be issued electronically [1]. See can you get a referral online.
Getting a referral
Referral GP offers telehealth consultations, by phone or video, with AHPRA-registered Australian GPs. If it's clinically appropriate, your GP can refer you to an ENT specialist and send the referral electronically. Parents or guardians can request a consult for their child, and the child attends with them.
A consultation doesn't guarantee a referral. Your GP decides what's clinically appropriate.
Bulk billed for eligible patients. If you're not eligible, a consultation fee may apply, and we'll confirm it with you before your consult.
Referral GP is not an emergency service. For sudden hearing loss, go to an emergency department. For breathing difficulty, call 000.
This page is general information, not medical advice.
Common questions
Can a GP refer me to an ENT specialist?
Can an audiologist refer me to an ENT?
Not for Medicare purposes. Medicare's referral rules only recognise referrals from GPs and other medical practitioners, specialists, and in limited cases dentists, optometrists, midwives and nurse practitioners [1][2]. An audiologist's hearing test report is still useful to take to your GP and the ENT.
How long does an ENT referral last?
Is sudden hearing loss an emergency?
Yes. Healthdirect advises going to your local emergency department if you have a sudden loss of hearing [10]. Don't wait for a referral.
References
- MBS Online. Factsheet: Referrals for specialist services (July 2026). Accessed November 2026. mbsonline.gov.au/internet/mbsonline/publishing.nsf/650f3eec0dfb990fca2
- MBS Online. Explanatory note GN.6.16: Referral of patients to specialists or consultant physicians. Accessed November 2026. www9.health.gov.au/mbs/fullDisplay.cfm?type=note&q=GN.6.16&qt=noteID
- Services Australia. Referrals for specialist treatment (updated 15 August 2025). Accessed November 2026. servicesaustralia.gov.au/referrals-for-specialist-treatment
- MBS Online. Item 104: specialist initial attendance after referral (schedule fee updated 1 July 2026). Accessed November 2026. www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=104&qt=item
- MBS Online. Explanatory note AN.40.1: Specialist and consultant physician MBS telehealth attendance items. Accessed November 2026. www9.health.gov.au/mbs/fullDisplay.cfm?type=note&q=AN.40.1&qt=noteID
- Medical Costs Finder (Australian Government). A guide to out-of-pocket medical costs. Accessed November 2026. medicalcostsfinder.health.gov.au/resources/a-guide-to-out-of-pocket-me
- Better Health Channel (Victorian Government). Ear, nose and throat specialist services. Accessed November 2026. betterhealth.vic.gov.au/health/ServiceProfiles/Ear-nose-and-throat-spe
- Victorian Department of Health. Statewide referral criteria for public hospital ENT services for adults (updated 4 July 2025). Accessed November 2026. health.vic.gov.au/statewide-referral-criteria/ent-adult
- NSW Health. Outpatient referrals: ear, nose and throat emergencies (current as at 3 September 2024). Accessed November 2026. health.nsw.gov.au/outpatients/referrals/Pages/ent-emergencies.aspx
- healthdirect. Hearing loss (last reviewed April 2025). Accessed November 2026. healthdirect.gov.au/hearing-loss
Published by Referral GP. Last updated 6 November 2026. This page is general information only and isn’t a substitute for advice about your own situation. If you or someone else is in danger, call 000.