Medicare subsidies for diagnostic imaging
For services listed on the Medicare Benefits Schedule (MBS), Medicare covers some or all of the costs of:
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CT scans
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nuclear medicine scans
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MRI scans
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ultrasounds
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X-rays.
Only accredited practices can provide Medicare-eligible services.
Helping people find diagnostic imaging services
We maintain a list of accredited MRI and PET units across Australia.
Some MRI units have partial Medicare eligibility and can only perform a small set of specific services listed on the MBS.
You can also get help with diagnostic imaging from Services Australia.
Providing information on costs
Diagnostic imaging providers set their own fees. Before your scan, ask about the costs. If the provider chooses to bulk bill you, you won’t pay any out-of-pocket costs.
To find the the Medicare subsidy for a diagnostic imaging service, you can look up its Medicare Benefits Schedule (MBS) item number. Note that some items may have restrictions that can relate to gender, age, frequency of services and requestor requirements. These restrictions are based on clinical evidence.
Service type |
MBS item numbers |
---|---|
Ultrasound |
55028–55895 |
Computed tomography (CT) |
56001–57364 |
Diagnostic radiology (including x-ray) |
57506–61109 |
Nuclear medicine (including PET) |
61310–61650 |
MRI (magnetic resonance imaging) |
63001–63743 |
Management of bulk-billed services |
64990–64995 |
You can also use the Medical Costs Finder to search for medical services or MBS items, including some diagnostic imaging.
Ensuring providers update equipment
Service providers need special equipment and training to operate the equipment and interpret the diagnostic images created.
Once equipment has reached the end of its expected life, Medicare no longer pays any benefits for imaging taken using that piece of equipment. This is called ‘capital sensitivity’. It ensures practices regularly upgrade and replace their equipment, so that patients have access to the highest possible quality services. Capital sensitivity does not apply to PET equipment.
We assign diagnostic imaging equipment (excluding PET scanning equipment) a lifespan to ensure equipment is up to date.
If the equipment is new, we calculate its age from the date it was first installed.
If the equipment is used, we calculate its age from the date:
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of first use in Australia (for equipment previously used in Australia)
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of manufacture of its oldest component (for equipment previously used outside Australia).
Service providers can upgrade their equipment to improve its overall performance, so it is equal to new equipment supplied in Australia at the time. Service providers must keep records such as:
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suppliers’ technical brochures or quotes
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service installation reports
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purchase orders
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invoices confirming that the relevant upgrade(s) have been completed.
Practices must keep their Location Specific Practice Number (LSPN) record up to date.
Equipment |
Effective lifespan (years) |
Maximum extended lifespan (years) |
---|---|---|
Ultrasound |
10 |
15 |
Computed tomography (CT) |
10 |
15 |
Other diagnostic radiology (x-ray) |
15 |
20 |
Orthopantomogram (OPG) |
15 |
20 |
Mammography |
10 |
15 |
Fluoroscopy |
15 |
20 |
Nuclear medicine (excluding PET) |
10 |
15 |
Magnetic resonance imaging (MRI) |
10 |
20 |
Angiography |
10 |
15 |
Exemptions from capital sensitivity arrangements may be granted where:
- the equipment has not yet reached its effective life age or maximum extended life age (or the end of an already approved exemption period); and
- due to circumstances beyond the control of the practice, the practice will be unable to replace or upgrade the equipment before it has reached its relevant life age (or the end of an already approved exemption period).
For questions 3 to 6 in the application form (for a specified piece of equipment):
- only questions 3 & 4 need to be completed for an initial exemption and
- only questions 5 & 6 need to be completed for all subsequent applications.
Applications for a capital sensitivity exemption due to unforeseen delays application form – capital sensitivity – initial exemption.