Medicare Indexation of Diagnostic Imaging Services Factsheet

Page last updated: 27 March 2019

Medicare Indexation of Diagnostic Imaging Services Factsheet (PDF 177 KB)
Medicare Indexation of Diagnostic Imaging Factsheet (DOC 88 KB)

· In the 2019-20 Budget the Government announced it would index Medicare Benefits Schedule rebates for ultrasound and diagnostic radiology (x-ray) services from 1 July 2020. This is in addition to targeted diagnostic imaging services including mammography, fluoroscopy, CT scans and interventional procedures, already scheduled for indexation from 1 July 2020.

· The changes will mean that more than 90 per cent of diagnostic imaging services will be indexed from 1 July 2020.

· These changes are relevant for diagnostic imaging providers, including radiologists, cardiologists, obstetricians and gynaecologists and vascular surgeons.

· Medicare rebates will be increased for services provided by diagnostic imaging providers, which will reduce out-of-pocket costs for patients using these services

What are the changes?

From 1 July 2020, indexation will apply to the following range of diagnostic imaging items:

· Ultrasound – Group I1 – item range 55005 to 55855

· Computed tomography – Group I2 – item range 56001 to 57363

· Diagnostic radiology – Group I3 – item range 57506 to 61110, which includes mammography, fluoroscopy and interventional radiology items.

Indexation is ongoing.

Why are the changes being made?

Fees for most diagnostic imaging services have not been indexed since 1998. Indexation will mean that patients will have reduced out-of-pocket costs.

What does this mean for diagnostic imaging service providers?

From 1 July 2020 the Medicare rebates available for ultrasound, computed tomography and diagnostic radiology services will be increased. Providers of these services will need to make adjustments to their systems to reflect these increases.

How will these changes affect patients?

From 1 July 2020, Medicare rebates will be increased for these services provided by diagnostic imaging providers, which will reduce out-of-pocket costs for patients using these services.

Ongoing analysis of MBS data collected through claims processing will be undertaken to monitor the effectiveness of the introduction of indexation.

Where can I find more information?

The full item descriptor(s) and information on other changes to the MBS can be found at MBS Online (www.mbsonline.gov.au). You can also subscribe to future MBS Online updates by visiting www.mbsonline.gov.au and clicking ‘Subscribe’.

The Department of Human Services (DHS) is responsible for the day-to-day administration and payment of benefits under Medicare arrangements. If you have a query relating exclusively to interpretation of the Schedule, email DHS at askMBS@humanservices.gov.au or call 13 21 50.

      Please note that the information provided is a general guide only. It is ultimately the responsibility of treating practitioners to use their professional judgment to determine the most clinically appropriate services to provide, and then to ensure that any services billed to Medicare fully meet the eligibility requirements outlined in the legislation.

      This sheet is current as of the Last updated date shown above, and does not account for MBS changes since that date.

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