MRI

Are Your Patients Eligible for a Medicare Rebate?

For your patient to be eligible for a Medicare rebate, they must have a specialist referral and not exceed the indications as listed below.

Number of Scans Per Patient Per Year Allowed:

Brain and ENT

  • Tumour of the brain or meninges – Unlimited;
  • Skull base or orbital tumour – Unlimited;
  • Acoustic neuroma – 3;
  • Pituitary tumour – 3;
  • Inflammation of the brain or meninges – Unlimited;
  • Toxic, ischaemic or metabolic encephalopathy – 3;
  • Demyelinating disease – 3;
  • Congential malformation – 3;
  • Venous sinus thrombosis – 3;
  • Head trauma – 3;
  • Epilepsy – 3;
  • Stereotactic scan for neurosurgery planning – Unlimited;
  • Intracranial aneurysm – 3;
  • Intracranial arterio-venous malformation – 3.

MR Investigation for Stroke

  • MRI of brain only – 3;
  • MRI of brain and MRA Intracranial vessels – 3;
  • MRI of brain and MRA Extracranial vessels – 3;
  • MRI of brain and MRA I/C and E/C vessels – 3.

MR Angiography

  • Vascular abnormality – previous anaphylactic reaction to iodinated contrast medium – 3;
  • Obstruction to vena cava or major pelvic vein – 3.

Paediatrics < 16 Years of Age

  • Pelvic or abdominal mass – Unlimited;
  • Mediastinal mass – Unlimited;
  • Congenital uterine or anorectal abnormality – Unlimited;
  • Post-inflammatory or post-traumatic physeal fusion – 2.

GP Referred 16 Years of Age and Over

  • Head MRI – unexplained seizure(s), unexplained chronic headache with suspected intracranial pathology;
  • Cervical Spine MRI – for suspected cervical radiculopathy, for suspected cervical spine trauma;
  • Acute Knee MRI (only available for patients 16 years of age & over and under 50 years of age) – following acute knee trauma with inability to extend the knee suggesting the possibility of acute meniscal tear, clinical findings suggesting acute anterior cruciate ligament tear;

Spine

  • Infection – Unlimited;
  • Tumour – Unlimited;
  • Demyelinating disease – 3;
  • Congenital malformation – 3;
  • Myelopathy – 3;
  • Syrinx (congenital or acquired) – 3;
  • Cervical radiculopathy – 3;
  • Sciatica – 3;
  • Spinal canal stenosis – 3;
  • Previous spinal surgery – 3;
  • Tauma – 3.

Musculoskeletal System

  • Internal derangement of the:
    • Shoulder – 3;
    • Elbow – 3;
    • Hand/Wrist – 3;
    • Hip – 3;
    • Knee – 3;
    • Foot/Ankle – 3;
    • Temporomandibular joint – 3;
  • Brachial Plexus – 3;
  • Tumour arising in MSK system – Unlimited;
  • Infection arising in MSK system – Unlimited;
  • Osteonecrosis – Unlimited.

Body

  • Adrenal mass in a patient with malignancy which is otherwise resectable – 1;
  • MRCP – suspected biliary or pancreatic pathology – 3;
  • Liver (non-rebateable) – n/a;
  • Rectal cancer staging – 1 per lifetime;
  • Prostate (non-rebateable) – n/a;
  • Prostate (suspected cancer) – 1;
  • Prostate (follow-up) – refer MBS;
  • Breast (non-rebateable) – n/a;
  • Cervical cancer ≥ Stage 1B – 1 per lifetime;
  • Enterography to evaluate small bowel for Crohn’s disease – 1;
  • Evaluation of fistulising perianal Crohn’s disease – 1.

Cardiovascular System

  • Congenital disease of the heart or great vessel – 2
  • Tumour of the heart or great vessel – 2;
  • Abnormality of the thoracic aorta – 2;
  • Cardiac function (non-rebateable) – n/a;
  • Cardiac valvular (non-rebateable) – n/a;
  • Cardiac viability (non-rebateable) – n/a.

If you would like further information, please call (08) 9320 1288.