Onboarding an overseas therapist: the first 90 days

Written by Callum Trevorrow. Last checked 28 October 2026 against official sources.

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Before an overseas therapist can see a Medicare-rebated client, they need Board registration (OT and physio) or Certified Practising status with Speech Pathology Australia, and then a Medicare provider number for each location they work at (Services Australia). Most provider numbers come through immediately online, but the profession-specific steps around them (OT orientation, physio supervised practice) and the two-year work rule for a 186 visa are what shape the first 90 days.

I run a multi-site paediatric practice in South East Queensland where several of the team trained overseas, and before that i commissioned a hospital avoidance service and recruited close to 30 FTE using values-based hiring. This is the plan I’d want in place before day one. It’s general information; your clinician’s Board or SPA outcome letter is what actually sets their conditions.

Before day one

• Read the outcome letter. Registration type (general or limited), any conditions, and anything the Board asks the clinician to complete. For speech pathologists, the SPA outcome.
• Medicare provider number. Allied health professionals apply in HPOS through a PRODA account (My details > My Digital Provider Number Registration). You can also apply on paper form HW093. Services Australia says most health professionals get their number immediately through HPOS, though some applications need a service officer. Apply early: Services Australia says applications surge between December and April.
• A number per location. A new provider number is needed for each practice location. If your clinician will work across two clinics, apply for both (HPOS: My provider numbers > new location).
• Eligibility. OTs need current general or limited registration with the Occupational Therapy Board; physios with the Physiotherapy Board. Speech pathologists need Certified Practising status with SPA; other SPA membership types aren’t eligible.

Week one admin for the clinician

• Tax file number: foreign passport holders with work rights who are in Australia can apply free online. The ATO posts the TFN within 28 days of receiving the application.
• Super: you may need to pay super for a worker with work rights regardless of their visa or tax residency. Temporary residents can claim it (less tax) as a Departing Australia Superannuation Payment after they leave Australia and their visa has expired.

Profession by profession

Occupational therapists: orientation and cultural safety

Where an OT’s qualification assessment found it substantially equivalent (Outcome 1, leading to general registration), the OT Board lists two requirements:

1. A one-on-one orientation to the Australian healthcare system with an OT who has held unrestricted general registration for at least 3 consecutive years. This is required.
2. Approved Aboriginal and Torres Strait Islander cultural safety training. The OT can complete it before general registration; if not, the Board may put conditions on their registration.

The Board’s pages don’t say whether these apply to OTs registered through the comparable regulator route (UK, Ireland) or a recognised qualification. Check what your OT’s letter says. If you have a senior OT who holds current unrestricted general registration and has held general registration for at least 3 consecutive years, they’re the natural person to run the orientation.

Physiotherapists: supervised practice, if it applies

Overseas physios qualify for general registration by completing the Australian Physiotherapy Council assessment. Supervision becomes your job when a physio holds limited registration (for supervised practice or postgraduate training) or has conditions. The Board’s Supervised practice framework has been in effect since 1 February 2022. It sets four levels of supervision, with risk-based requirements for the supervisor, a supervised practice plan and reports. For arrangements approved from 28 January 2025, reports use the Assessment of Physiotherapy Practice (APP) instrument. See hiring an overseas physiotherapist for the routes.

Speech pathologists: CPSP first

Speech pathologists aren’t Ahpra-registered. SPA says they must be eligible for Certified Practising membership to work in most Australian organisations, and Certified Practising status is what Medicare needs. SPA strongly discourages travelling to Australia to work before the skills assessment is complete, so line up the start date with the SPA outcome.

Every month on the job counts towards the 186

If your clinician is on a 482 and you’re both thinking about permanent residency through the 186 Temporary Residence Transition stream, the rule in the regulations is:

• In the 3 years before applying, they must have held an eligible visa (457 or 482) for a total of at least 2 years, and
• worked full-time in Australia in the nominated occupation for a total of at least 2 years, not counting unpaid leave.

Because the test is a total, time before they joined you may count too; their migration agent will confirm.

What that means for a manager:

• Hours. The rule counts full-time work. If your clinician asks to drop to part-time, they should talk to their migration agent first.
• Unpaid leave. Unpaid leave doesn’t count towards the two years, so plan extended trips home with that in mind.
• The role. Keep them working in the nominated occupation; see sponsor obligations.

General information only. Their migration agent should confirm how the rules apply to them.

A 90-day outline

Retention starts in month one

A move is about more than the job. Ask about housing, school places and their partner’s job in the first month, not the sixth. Keep supervision going past the point where it feels necessary.

Next step

Profession detail is on hiring an overseas occupational therapist, hiring an overseas speech pathologist and hiring an overseas physiotherapist. If the role covers parental leave, hiring parental leave cover sets out what you must tell the replacement and how the fixed-term contract rules apply. If you’re about to bring an overseas clinician on, or want to, tell us about the role. We’ll help you plan the start date around their registration or SPA outcome.