Allied Health Guide To Medicare Rebates
Medicare rebates apply for MRI examinations only when the clinical indications below are present.
Concession card holders are eligible for bulk billing for eligible MRIs.
* To be eligible for a Medicare rebate the patient must have x-ray first.
For Referrers
Allied Health Guide to Medicare
X-Ray:
57506 – hand, wrist, forearm, elbow and humerus
57512 – hand and wrist, hand wrist and forearm, forearm and elbow or elbow and humerus
57518 – foot, ankle, leg, knee or femur
57524 – foot and ankle, ankle and leg, leg and knee or knee and femur
57700 – shoulder or scapula
57706 – clavicle
57712 – hip joint
57715 – pelvic girdle
58100 – cervical spine
58103 – thoracic spine
58106 – lumbosacral spine
58109 – sacrococcygeal spine
58112 – spine; two examinations of the kind referred to in items 58100, 58103, 58106 and 58109
58120 – spine, four regions, cervical, thoracic, lumbosacral and sacrococcygeal (limitation is one per calendar year)
58121 – spine, three examinations of the kind mentioned in items 58100, 58103, 58106 and 58109 (limitation is one per calendar year)
58500 – chest (Thoracic Region)
X-Ray:
55712 – hip joint
57715 – pelvic girdle
58100 – cervical spine
58103 – thoracic spine
58106 – lumbosacral spine
58109 – sacrococcygeal spine
58112 – spine; two examinations of the kind referred to in items 58100, 58103, 58106 and 58109
58500 – chest (limited rebate)
57706 – clavicle (limited rebate)
57518 – foot, ankle, leg, knee or femur (limited rebate)
57524 – foot and ankle, ankle and leg, leg and knee or knee and femur (limited rebate)
57506 – hand, wrist, forearm, elbow and humerus (limited rebate)
57512 – hand and wrist, hand wrist and forearm, forearm and elbow or elbow and humerus (limited rebate)
57700 – shoulder or scapula (limited rebate)
Ultrasound:
55836 – ankle or hind foot
55840 – mid foot or fore foot
X-Ray:
57521 – Foot, Ankle
57527 – Foot, Ankle
X-Ray:
57509 – hand, wrist, forearm, elbow, upper arm
57515 – combination upper extremity
57521 – foot, ankle, lower leg, upper leg (femur)
58503 – chest
58506 – chest with fluoroscopy
58509 – thoracic inlet/ trachea
58521 – left ribs, right ribs or sternum
57523 – knee
57527 – combination lower extremity
57703 – Shoulder/scapula
57709 – Clavicle
57712 – hip
57715 – pelvis
57721 – Femur – internal fixation of neck or intertrochanteric fracture
58524 – both ribs or right ribs & sternum or left ribs & sternum
58527 – both ribs & sternum
Ultrasound:
55036 – abdomen
55070 – breast x 1
55076 – breast x 2
55768 – multiple pregnancy 22+ weeks
55800 – hand
55812 – chest/abdominal wall
55816 – hip
55820 – paediatric hip
55824 – buttock/thigh
55828 – Knee apply
55832 – lower leg
55836 – ankle/hindfoot
55840 – midfoot/forefoot
55844 – assessment of mass
55848 – msk pre-operative – aspiration or injection
55850 – msk pre-operative including diagnostic scan – aspiration or injection
55852 – paediatric spine
55700 – Dating Scan (Pregnancy < 12 weeks only)
Pelvis or abdomen, pregnancy related or pregnancy complication, ultrasound scan of, by any or all approaches, for determining the gestation, location, viability or number of foetuses, if the dating of the pregnancy (as confirmed by ultrasound) is less than 12 weeks of gestation
55704 – Early anatomy scan (Pregnancy 12 – 16 weeks only)
Pelvis or abdomen, pregnancy related or pregnancy complication, foetal development and anatomy, ultrasound scan of, by any or all approaches, for determining the structure, gestation, location, viability or number of foetuses, if the dating of the pregnancy (as confirmed by ultrasound) is 12 to 16 weeks of gestation
55706 – Anatomy scan (Pregnancy 17-22 weeks only. Item can only be claimed once per pregnancy.)
Pelvis or abdomen, pregnancy related or pregnancy complication, foetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, if:
-
- (a) the dating for the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks of gestation; and
- (b) the service is not performed in the same pregnancy as item 55709
55707 – Nuchal translucency scan (Crown rump length of 45 to 84 mm)
Pelvis or abdomen, pregnancy related or pregnancy complication, foetal development and anatomy, ultrasound scan of, by any or all approaches, if: (a) the pregnancy (as confirmed by ultrasound) is dated by a foetal crown rump length of 45 to 84 mm; and
-
- (b) nuchal translucency measurement is performed to assess the risk of foetal abnormality; and
- (c) the service is not performed with item 55700, 55703, 55704 or 55705 on the same patient within 24 hours
55718 – Pregnancy >22 weeks only (Item can only be claimed once per pregnancy.)
Pelvis or abdomen, pregnancy related or pregnancy complication, foetal development and anatomy, ultrasound scan of, by any or all approaches, if:
-
- (a) the dating of the pregnancy (as confirmed by ultrasound) is after 22 weeks of gestation; and
- (b) the service is not performed in the same pregnancy as item 55723
Dental Practitioner:
57901 – 57969 – Skull
58300 – Bone Age Study And Skeletal Surveys
59733 – Sialography, one side, with preparation and contrast injection, not being a service associated with a service to which item 57918 applies (R)
59739 – Sinogram or fistulogram, one or more regions, with or without preliminary plain films and with preparation and contrast injection (R)
Oral & Maxillofacial Surgeon:
55028 – Head, ultrasound scan of (R)
55030 – Orbital Contents, Ultrasound scan on (R)
55032 – Neck, one or more structures of, ultrasound scan of (R)
56001 – Computed tomography—scan of brain without intravenous contrast medium, not being a service to which item 57001 applies (R) (Anaes.)
56224 – Computed tomography—scan of spine, cervical region, with intravenous contrast medium and with any scans of the cervical region of the spine before intravenous contrast injection when undertaken (R) (Anaes.)
56801 – 57007 – Computed tomography—scan of chest, abdomen and pelvis with or without scans of soft tissues of neck without intravenous contrast medium, not including a study performed to exclude coronary artery calcification or image the coronary arteries (R) (Anaes.)
57341 – Interventional techniques
Computed tomography, in conjunction with a surgical procedure using interventional techniques (R) (Anaes.)
57362 – Cone beam computed tomography
Cone beam computed tomography—dental and temporo mandibular joint imaging (without contrast medium) for diagnosis and management of any of the following:
(a) mandibular and dento alveolar fractures;
(b) dental implant planning;
(c) orthodontics;
(d) endodontic conditions;
(e) periodontal conditions;
(f) temporo mandibular joint conditions
Applicable once per patient per day, not being for a service to which any of items 57960 to 57969 apply, and not being a service associated with another service in Group I2 (R) (Anaes.)
57703 – Shoulder or scapula (R)
57709 – Clavicle (R)
57712 – Hip joint (R)
57715 – Pelvic girdle (R)
58103 – Spine—thoracic (R)
58306 – Skeletal survey (R)
58506 – Chest (lung fields) by direct radiography with fluoroscopic screening (R)
58521 – Left ribs, right ribs or sternum (R)
58909 – Examination Of Alimentary Tract And Biliary System
Barium or other opaque meal of one or more of pharynx, oesophagus, stomach or duodenum, with or without preliminary plain films of pharynx, chest or duodenum, not being a service associated with a service to which item 57939, 57942 or 57945 applies (R)
59103 – Localisation of foreign body, if provided in conjunction with a service described in Subgroups 1 to 12 of Group I3 (R)
59703 – Dacryocystography, one side, with or without preliminary plain film and with preparation and contrast injection (R)
60000 – Digital subtraction angiography, examination of head and neck with or without arch aortography—1 to 3 data acquisition runs (R) (Anaes.)
60506 – Fluoroscopy using a mobile image intensifier, in conjunction with a surgical procedure lasting less than 1 hour, not being a service associated with a service to which another item in this Group applies (R)
60509 – Fluoroscopy using a mobile image intensifier, in conjunction with a surgical procedure lasting 1 hour or more, not being a service associated with a service to which another item in this Group applies (R)
61109 – Fluoroscopy in an angiography suite with image intensification, in conjunction with a surgical procedure using interventional techniques, not being a service associated with a service to which another item in this Group applies (R)
61372 – Nuclear medicine – non PET – Salivary study (R)
61421 – Bone study—whole body, with, when undertaken, blood flow, blood pool and delayed imaging on a separate occasion (R)
61425 – Bone study—whole body and single photon emission tomography, with, when undertaken, blood flow, blood pool and delayed imaging on a separate occasion (R)
61429 – Whole body study using gallium (R)
61430 – Whole body study using gallium, with single photon emission tomography (R)
61433 – Whole body study using cells labelled with technetium (R)
61434 – Whole body study using cells labelled with technetium, with single photon emission tomography (R)
61446 – Regional scintigraphic study, using an approved bone scanning agent, including when undertaken, blood flow imaging, blood pool imaging and repeat imaging on a separate occasion (R)
61449 – Regional scintigraphic study, using an approved bone scanning agent and single photon emission tomography, including when undertaken, blood flow imaging, blood pool imaging and repeat imaging on a separate occasion (R)
61450 – Localised study using gallium (R)
61453 – Localised study using gallium, with single photon emission tomography (R)
61454 – Localised study using cells labelled with technetium (R)
61457 – Localised study using cells labelled with technetium, with single photon emission tomography (R)
61462 – Repeat planar and single photon emission tomography imaging, or repeat planar imaging or single photon emission tomography imaging on an occasion subsequent to the performance of item 61364, 61426, 61429, 61430, 61442, 61450, 61453, 61469 or 61485, if there is no additional administration of radiopharmaceutical and if the previous radionuclide scan was abnormal or equivocal (R)
63007 – MRI—scan of head (including MRA, if performed) for skull base or orbital tumour (R) (Anaes.) (Contrast)