New GP MRI items
As of 1 November 2012, six new GP magnetic resonance imaging requesting items for children under the age of 16 years will commence.
The items can be requested by GPs only and performed at all Medicare-eligible and partially Medicare-eligible MRI units across Australia.
- Medicare Rebated Paediatric MRI Scans for 6 selected items requested by GPs
- now available at Melbourne Radiology Clinic using our Wide Bore MRI Unit.
Improving access to Magnetic Resonance Imaging (MRI) services
The Australian Government supports access to high quality health care services, including MRI services, for all Australians. The Diagnostic Imaging Reform Package will ensure ongoing, affordable and convenient diagnostic imaging services for patients, with a key focus on the staged expansion of patient access to Medicare-eligible MRI services.
Improving access to Medicare-eligible MRI items:
The Package includes increased access to MRI services for primary care patients by extending requesting rights to GPs for all patients under 16 years for a small set of clinically appropriate indications from 1 November 2012.
Extending MRI requesting rights to GPs is aimed at avoiding exposure of children to unnecessary radiation associated with other types of diagnostic imaging like computed tomography (CT) scans.
Six GP MRI requested items for patients under the age of 16 were developed with the assistance of an Expert Working Group which was established to provide advice to the department on the appropriate indications for the proposed new items. These items and explanatory notes can be found at www.mbsonline.gov.au.
Health Insurance (Diagnostic Imaging Services Table) 2012 Regulations – MRI Expansion
Subject to the passage of legislation on 1 November 2012, the measure introduces six new GP requested MRI items for children under the age of 16 years for the following indications:
- scan of the head for certain indications
- the spine for unexplained neck or back pain
- the knee for internal joint derangement
- the hip for certain indications
- the elbow
- the wrist.
Referral by a medical practitioner (excluding a specialist or consultant physician) for a scan of head for any of the following:
- Unexplained seizure(s)
- Unexplained headache where significant pathology is suspected
- Paranasal sinus pathology which has not responded to conservative therapy
Referral by a medical practitioner (excluding a specialist or consultant physician) for a scan of spine following radiographic examination for any of the following:
- Significant trauma
- Unexplained neck or back pain with associated neurological signs
- Unexplained back pain where significant pathology is suspected
Referral by a medical practitioner (excluding a specialist or consultant physician) for a scan of knee following radiographic examination for internal joint derangement.
Referral by a medical practitioner (excluding a specialist or consultant physician) for a scan of hip following radiographic examination for any of the following:
- Suspected septic arthritis
- Suspected slipped capital femoral epiphysis
- Suspected Perthes disease
Referral by a medical practitioner (excluding a specialist or consultant physician) for a scan of elbow following radiographic examination where a significant fracture or avulsion injury is suspected that will change management.
Referral by a medical practitioner (excluding a specialist or consultant physician) for a scan of wrist following radiographic examination where scaphoid fracture is suspected.
Frequently Asked Questions
Where can I find the details for the Medicare MRI items?
Details of the item descriptors and explanatory notes can be found at mbsonline.gov.au
Can these items also be requested by a specialist?
No, these items are restricted to request only be medical practitioners excluding specialist or consultant physician. If requested by a specialist or consultant physician a Medicare rebate will not apply. Specialist and consultant physicians can currently request equivalent Medicare-eligible MRI services.
Are patients that are 16 years of age eligible for these items?
No, the patient must be under the age of 16 years on the day the service is performed, not on the day the service is requested.
When will GP requested items be available for adults?
Under the Diagnostic Imaging Reform package a limited number of GP requested items will be extended to adults from 1 November 2013, subject to development and use of appropriate decisions support tools.
Where can I get further information?
Further information can be obtained from www.mbsonline.gov.au.
If a request is dated pre 1 November 2012 is it eligible?
Yes. GP requests dated prior to 1 November 2012 will be Medicare-eligible as long as the service is performed from 1 November 2012.