Medicare Funding Criteria
The majority of radiology examinations performed at Global Diagnostics fall under the Medicare Benefits Schedule (MBS). For a patient to be eligible for a Medicare rebate the doctor’s referral must display:
- Referrer name, provider number and contact details
- Examination requested
- All relevant clinical history
Global Diagnostics provides referrers with customised referral pads, at no charge, to assist with the provision of correct documentation. You can order our referral pads online.
General Practitioners can now order Medicare rebated MRI services for patients less than 16 years of age for particular regions, as listed below. Patients must also meet specific Medicare criteria to receive a rebate.
- Head: any of the following; unexplained seizure(s), unexplained headache where significant pathology is suspected, and/or paranasal sinus pathology that has not responded to conservative therapy
- Spine: following radiographic examination for any or the following – significant trauma, unexplained neck or back pain with associated neurological signs and unexplained back pain where significant pathology is suspected
- Knee: following radiographic examination for internal joint derangement
- Hip: following radiographic examination for suspected – septic arthritis, slipped capital femoral epiphysis or Perthes disease
- Elbow: following radiographic examination where a significant fracture or avulsion injury is suspected that would change the way in which the patient is managed and
- Wrist: following radiographic examination where a scaphoid fracture is suspected
All GP referred MRI examinations that meet Medicare criteria below will be bulk-billed for eligible patients aged 16 years and over, who hold a valid concession card.
Medicare Funded Examinations:
- unexplained seizures
- unexplained chronic headache when intracranial pathology is suspected
- suspected cervical radiculopathy
- cervical spine trauma
Knee (16 to 49 years of age) following acute knee trauma with either:
- clinical findings suggesting anterior cruciate ligament tear or
- inability to extend the knee suggesting possible acute meniscal tear