Medicare freeze to end for x-ray and ultrasound imaging


The Federal Government has agreed to widen the number of radiology and diagnostic imaging services that will have Medicare rebates indexed from 2020.

In 2017 health minister Greg Hunt said the Medicare freeze would be lifted on 59 of 891 radiology items listed on the MBS for mammography, fluoroscopy, interventional radiology and CT scans. This has now been extended to include ultrasound and X-ray services, which will cover 90% of the funding of diagnostic imaging items in Medicare.

However the indexing deal excludes MRI and nuclear medicine.

The radiology rebate freeze dates back to 1998 and has led to large out of pocket costs for patients, with average gaps of around $110 for ultrasound, $152 for CT and $182 for MRI, according to the Australian Diagnostic Imaging Association (ADIA).

In its budget submission for 2019, the ADIA noted that patients needing cancer scans were often forced to pay more than $2000 in upfront fees, and the total gap fees paid by patients for scans in 2017-18 were estimated to be $553.2 million.

ADIA President Dr Siavash Es’haghi welcomed the indexing announcement, saying it was “great news for patients” after two decades of stagnation.

“It is a real step forward in terms of access and affordability for patients and is a crucial decision for the ongoing sustainability of Medicare.

“[This] means more than nine in ten radiology services provided under Medicare will be indexed from 1 July 2020, with flow-on effects for the hip pockets of the nine million Australians who access these services every year,” he said.

“There is still some work to do in terms of ending the freeze for all radiology services,” Dr Es’haghi added.

“We look forward to the day when all x-rays and scans are indexed.”

The move has also been welcomed by the Royal Australian and New Zealand College of Radiologists (RANZCR), as a “long overdue win for Australian patients.”

“Indexation will allow more Australian patients the opportunity to afford ultrasound and X-ray services, which are essential and the first diagnostic test for many common health conditions and injuries,” RANZCR President Dr Lance Lawler said.

“Many Australians are therefore being forced to choose between risking their health by not doing a scan or paying the gap payment themselves,” Dr Lawler said.

“This also puts immense pressure on clinical radiologists to manage their workload while providing safe, high-quality services.”

According to the ADIA the indexing will apply to services such as

  • Ultrasound for diagnosis of breast cancer
  • Pelvic ultrasound for diagnosis of ovarian cancer
  • Carotid ultrasound to assess the risk of stroke
  • Stress echo to diagnosis heart disease
  • Chest x-rays to diagnose pneumonia and other respiratory conditions
  • X-ray to diagnose the cause of shoulder pain, instability or stiffness
  • Digital subtraction angiography to diagnose brain aneurysm

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