What is percept NIPT?
This simple blood test analyses DNA, comparing all 23 pairs of chromosomes to screen for conditions such as Down Syndrome
When do Medicare rebates for MRI apply?
Only specific MRI scans listed on the MBS are eligible for a Medicare rebate. Even if a scan is performed on a fully licensed MRI machine, Medicare rebates only apply when specific MBS criteria is met. The criteria outline the medical reasons or conditions for which Medicare will offer funding for the scan.
For example, some MRI rebates apply only to certain age groups or when there is clinical evidence. The idea behind this is to ensure that scans are referred appropriately, helping patients who will benefit most while maintaining sustainable healthcare spending.
If a patient requiring an MRI scan falls outside the MBS criteria, it can still be performed, but it will not be able to be bulk billed. Thus, a fee will apply (even if the MRI machine is fully licensed). This is referred to as a ‘non-rebated MRI’.
Does bulk billing depend on practitioner speciality?
A referral is required by a registered medical practitioner to obtain an MRI scan.
Whilst the MRI scan must meet eligibility for a rebate to be offered and performed on a machine with a licence, Medicare also has boundaries around the practitioner referring the MRI.
Some MRI scans are only eligible for a rebate when referred by a specialist, while other types of scans are eligible for rebates with a GP referral (so long as MBS criteria is met). MRI can be referred by a Physiotherapist or Osteopath, however the scan won’t qualify under Medicare, and the patient will bear the full cost of the ‘non-rebated MRI’.
This is why practitioners need to ask patients detailed questions about symptoms and medical history before providing a referral. They have a Duty of Care to ensure the scan qualifies according to Medicare and follow the government regulations to protect their own medical indemnity.
Government regulations on MRI equipment
All diagnostic imaging, including MRI, is regulated to ensure patient safety and a high-quality standard of care is met. The government assigns a ‘lifespan’ to radiology equipment to ensure it is fit for purpose and not used beyond its working lifespan.
Once an MRI machine reaches its ‘end of life’ time limit, any images taken on these machines cannot be bulk billed. This ensures radiology providers regularly replace or upgrade their equipment so that patients get the best quality imaging.
MRI machines cost radiology providers millions of dollars to purchase and run continuously. While upgrades also represent a significant investment for providers, they are part of our commitment to delivering world-class imaging to all patients.
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