DrugTheGuide
PBS Guide · 8 min read

Authority prescriptions

When PBS authority script medicines require prior approval before dispensing — and how the three authority types (streamlined authority, telephone authority, and written authority) work in practice for prescribers and pharmacists.

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The three authority types

Streamlined

Streamlined authority

Prescriber self-assesses eligibility and writes a 4-digit authority code on the prescription. No call required. Code is entered by the pharmacist at point of dispensing. Retrospective compliance audits may apply.

Examples: high-cholesterol statins (continuation), omeprazole for GORD, adalimumab continuation therapy
Telephone

Telephone authority

Prescriber calls 1800 888 333 (or lodges via HPOS online) before dispensing. Services Australia assesses criteria in real time and issues an authority approval number. This number must be written on the prescription.

Examples: biologic initiation (adalimumab, ustekinumab), antivirals for hepatitis C, some anticoagulants
Written

Written authority

Prescriber submits an application with supporting clinical documentation. Cannot be dispensed until written approval is received. Processed by Services Australia — may take several business days.

Examples: growth hormone for short stature, some anti-cancer agents, complex Section 100 HSD items

How to obtain authority approval

1

Check the PBS Schedule listing

Look up the item on the PBS Schedule ↗ and confirm: (a) the authority type required (streamlined code, telephone, or written); (b) the full restriction text — the patient must meet all clinical criteria; (c) whether this is initial or continuation therapy (different criteria often apply).

2

For streamlined: write the 4-digit code

Confirm the patient meets criteria. Write the streamlined authority code in the designated field on the prescription (paper or electronic). The pharmacist enters this code when processing the PBS claim. Keep documentation in the patient record in case of audit.

3

For telephone: call or use HPOS

Call 1800 888 333 (Monday–Friday, business hours) or lodge via HPOS ↗. Be ready to provide: prescriber number, patient Medicare details, item code, diagnosis, clinical criteria. Record the authority approval number on the prescription. HPOS online lodgement avoids wait times and provides an electronic record.

4

For written: submit application with clinical evidence

Download and complete the relevant PBS authority application form (available from the PBS Schedule item listing). Attach required supporting documents (pathology results, specialist correspondence, prior treatment history). Submit via HPOS or by mail. Do not dispense until written approval is received and recorded on the prescription.

Prescriber compliance and audits

Services Australia conducts ongoing PBS compliance reviews ↗. Prescribers may be selected for random audit or targeted review if prescribing patterns are inconsistent with clinical norms. Common audit findings include:

  • Streamlined authority codes applied to patients not meeting the clinical restriction
  • Continuation therapy authority granted without confirming initial therapy criteria were met
  • Prescribing beyond maximum quantities or repeat counts for authority items
  • Incorrect documentation of telephone authority approval numbers
Best practice: Document in the patient record each time you apply an authority code or obtain telephone authority — including the clinical basis for meeting the restriction criteria.

Frequently asked questions

What is a streamlined authority?
A streamlined authority lets prescribers self-assess criteria and write a 4-digit authority code on the script without calling Services Australia. The pharmacist enters the code at dispensing. Common for high-volume medicines like statins, PPIs, and biologics on continuation therapy. Prescribers are responsible for compliance — retrospective audits ↗ can occur. See the PBS Schedule ↗ for item-specific codes.
When do I need to call the PBS Authority line?
Call the PBS Authority line (1800 888 333) for telephone authority items. Required for high-cost or complex-criteria medicines: biologic initiation, oncology agents, some antivirals. After approval, record the authority approval number on the script. Online lodgement via HPOS ↗ (Health Professional Online Services) is available for many telephone authority items and avoids the hold queue.
What is a written authority and when is it used?
Written authorities require a paper or online application with supporting clinical documentation (test results, specialist letters). Used for growth hormone, some anti-cancer agents, and complex Section 100 items. Submit via HPOS ↗ or by mail. Processing times vary — plan ahead for continuation therapy renewals.
Can a nurse practitioner prescribe authority PBS items?
Eligible nurse practitioners ↗ can prescribe certain PBS items including some authority items within their AHPRA-endorsed scope. NPs must be approved PBS prescribers by Services Australia. Each PBS item listing specifies eligible prescriber types. NP prescribing rights have expanded under recent regulatory reforms. See the PBS Schedule item listing ↗ for prescriber eligibility on each item.
What happens if I prescribe an authority item without obtaining approval?
Dispensing without valid authority approval risks: claim rejection or clawback from Services Australia, compliance review, and potential repayment obligations. PBS compliance reviews ↗ include retrospective audit of streamlined authority claims. Significant non-compliance may be referred to AHPRA. Ensure you understand whether an item needs streamlined, telephone, or written authority before prescribing. The PBS Schedule ↗ states the authority type for each item.