Shrinking or non-existent Medicare rebates mean gastroenterology patients are now having to pay hundreds and sometimes thousands of dollars for standard radiology tests, advocacy groups say.

Patients with bowel cancer are forced to pay up to $2327 in upfront costs and are left $688 out of pocket for CT scans, bone studies and MRI scans of the pelvis because the imaging fees are not fully covered by Medicare, a Senate inquiry has been told.the Senate’s Community Affairs Reference Committee was told at a recent public hearing.

Gap fees of between $130-180 were typical for scans that are considered standard of care, the inquiry has been told by the Australian Diagnostic Imaging Association.

Patients faced high gap costs for “standard of care” imaging tests because Medicare rebates have been frozen since 1998, the ADIA representative told the inquiry into the availability and accessibility of diagnostic imaging equipment around Australia.

High out of pocket costs also arose because the Medicare system wasn’t keeping pace with imaging technology and rebates had not been approved for many tests that are now considered the basic standard of care, the Association said.

“[Cancers]  often require more than one radiology service for diagnosis, treatment and monitoring, meaning that patients pay thousands of dollars upfront and are left hundreds of dollars out of pocket,” the ADIA said in its submission to the inquiry

The claims were backed up by patient advocacy groups, who told the hearing that imaging gap fees were now the major financial burden for cancer patients.

Cancer patients can expect gap fees for scans to double in costs over the next decade unless action is taken to unfreeze the Medicare rebates for imaging, the hearing was told.

There was also a need to reform the slow and outdated system of approvals for Medicare rebates, with the Medicare Services Advisory Committee, taking three or more years to consider applications.

By the time the MSAC rulings come out, technology had often moved on to better tests that were adopted as standard practice overseas, the committee was advised.