The short answer
For a Medicare rebate on your consultations, yes. You need a valid referral, usually from your GP, to see a fertility 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. If you've been trying to conceive for a year, or six months if you're a woman over 35, it's time to talk to your GP.
On this page
Do you need a referral to see a fertility 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]. That matters with fertility care, where you may have several consultations before and between treatment cycles.
Fertility specialists include obstetricians and gynaecologists who hold RANZCOG's subspecialty certification in reproductive endocrinology and infertility (CREI), which involves at least three years of extra subspecialty training [10]. Other qualified doctors also treat infertility, so a fertility specialist won't always hold the CREI [10]. If your needs are more general, such as period problems or endometriosis, a gynaecologist referral may be the better fit.
When should you see your GP about fertility?
VARTA, the Victorian government's assisted reproductive treatment authority, suggests [9]:
- speaking to your GP if you've been trying to have a baby for a year or more
- seeing a doctor after six months of trying if you're a woman over 35
Your GP is the usual first step. They start the infertility investigation, which includes a physical examination of both partners and basic tests to check ovulation and sperm production [9]. If the tests show a problem, your GP will refer you to a fertility specialist straight away. If everything looks normal, they may suggest trying a little longer [9].
Depending on your situation, your GP may request blood tests or an ultrasound as part of these investigations. Depending on results, a male partner may also be referred to a urologist.
Who can refer you to a fertility specialist?
GPs are the main source of specialist referrals [1]. Another specialist, such as your gynaecologist, can also refer you, in consultation with or by notifying your GP [1]. Nurse practitioners can refer in certain circumstances [1].
The referring practitioner must have consulted with you and considered whether a referral is needed [2]. A specialist's referral must also name your GP or practice, or say you can't or won't nominate one [2].
Do both partners need a referral?
A referral is a request to a specialist about a patient's condition [2]. If your partner will have their own consultations and be billed as a patient, ask your GP whether they need a separate referral.
What should the 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]. For fertility, helpful details include how long you've been trying, menstrual history, previous pregnancies, relevant medical history and medicines, and any test results for both partners. See what goes in a referral letter.
Does it need to name a specific clinic or specialist?
No. In private rooms and other community settings, a referral doesn't have to name a specialist [1][3]. If it names one, you can still take it to another fertility specialist without a new referral, unless you've already started seeing the named one [1].
How long does a fertility specialist 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 from your first appointment with the specialist, not the date on the letter [1][3]. If your treatment is likely to continue for some time, ask your GP about a referral for longer than 12 months or an indefinite one, which GPs can write when you need ongoing care [3]. More in how long a referral lasts.
What does Medicare cover for fertility treatment?
Consultations. With a valid referral, a specialist's first appointment is usually item 104, with a schedule fee of $103.95 and an 85% Medicare benefit of $88.40 (schedule fee updated 1 July 2026, checked November 2026) [4]. Specialists set their own fees, so you pay any gap.
Treatment cycles. IVF and related treatment is billed under a separate group of assisted reproductive technology (ART) items, 13200 to 13221 [5]. For example, item 13200 covers the first ART treatment cycle in a calendar year that proceeds to egg collection, with a schedule fee of $3,723.25 (checked November 2026) [6]. Medicare doesn't pay specialist consultation items 104 or 105 in association with these ART items [5].
One limit is worth knowing: Medicare benefits aren't payable for assisted reproductive services provided in conjunction with surrogacy arrangements [5]. Clinics set their own fees, so ask for a written estimate of your out-of-pocket costs before you start.
Does private health insurance help?
Not for consultations in the specialist's rooms. Health insurers can't contribute to out-of-hospital treatment for Medicare services [7]. Hospital cover can include a clinical category called "assisted reproductive services", which covers hospital treatment for fertility procedures such as egg retrieval and IVF [8]. Check whether your policy includes it, and whether any waiting periods apply.
Can you see a fertility specialist by telehealth?
Some consultations may be possible by video, so ask the clinic. You'll still need a valid referral for the Medicare rebate [1]. Treatment itself, including scans and procedures, happens in person.
Referrals can be issued electronically [1], so you can get one through a telehealth GP consultation and have it sent to you or straight to the clinic.
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 a fertility specialist and, where appropriate, request initial blood tests or an ultrasound.
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.
This page is general information, not medical advice.
Common questions
Do I need a referral for IVF?
When should I see a GP about fertility?
Does my partner need a referral too?
A referral is a request to a specialist about a patient's condition [2]. If your partner will also be seen and billed as a patient, ask your GP whether they need their own referral.
How long does a fertility specialist referral last?
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 TN.1.4: Assisted reproductive technology (ART) services. Accessed November 2026. www9.health.gov.au/mbs/fullDisplay.cfm?type=note&q=TN.1.4&qt=noteID
- MBS Online. Item 13200: initial assisted reproductive technology treatment cycle (schedule fee updated 1 July 2026). Accessed November 2026. www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=13200&qt=item
- 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
- privatehealth.gov.au (Commonwealth Ombudsman). Clinical categories. Accessed November 2026. privatehealth.gov.au/health_insurance/howitworks/clinical_categories.h
- Victorian Assisted Reproductive Treatment Authority (VARTA). Suspecting infertility. Accessed November 2026. varta.org.au/suspecting-infertility
- RANZCOG. Certification in Reproductive Endocrinology and Infertility (CREI). Accessed November 2026. ranzcog.edu.au/training/subspecialty/crei
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.