MBS Category 5
Diagnostic imaging services: MBS items and fees.
All 540 items in Category 5, with each item’s schedule fee and Medicare benefits, from the MBS edition of 1 November 2026.
Source: the MBS XML file of 1 November 2026, published by the Department of Health, Disability and Ageing. We update these pages for each MBS edition.
I1 Ultrasound
134 items
| Item | Description | Fee and benefits |
|---|---|---|
| 55028 | Head, ultrasound scan of (R) | $128.60 75% benefit $96.45 85% benefit $109.35 |
| 55029 | Head, ultrasound scan of (NR) | $44.55 75% benefit $33.45 85% benefit $37.90 |
| 55030 | Orbital contents, ultrasound scan of (R) | $128.60 75% benefit $96.45 85% benefit $109.35 |
| 55031 | Orbital contents, ultrasound scan of (NR) | $44.55 75% benefit $33.45 85% benefit $37.90 |
| 55032 | Neck, one or more structures of, ultrasound scan of (R) | $128.60 75% benefit $96.45 85% benefit $109.35 |
| 55033 | Neck, one or more structures of, ultrasound scan of (NR) | $44.55 75% benefit $33.45 85% benefit $37.90 |
| 55036 | Abdomen, ultrasound scan of (including scan of urinary tract when performed), for morphological assessment, if: (a) the service is not solely a transrectal ultrasonic examination of any of the following:(i) prostate gland;(ii) bladder base;(iii) urethra; and(b) within 24 hours of the service, a service mentioned in item 55038 is not performed on the same patient by the providing practitioner (R) | $131.00 75% benefit $98.25 85% benefit $111.35 |
| 55037 | Abdomen, ultrasound scan of (including scan of urinary tract when performed), for morphological assessment, if the service is not solely a transrectal ultrasonic examination of any of the following:(i) prostate gland;(ii) bladder base;(iii) urethra (NR) | $44.55 75% benefit $33.45 85% benefit $37.90 |
| 55038 | Urinary tract, ultrasound scan of, if: (a) the service is not solely a transrectal ultrasonic examination of any of the following: (i) prostate gland; (ii) bladder base; (iii) urethra; and (b) within 24 hours of the service, a service mentioned in item 55036 or 55065 is not performed on the same patient by the providing practitioner (R) | $128.60 75% benefit $96.45 85% benefit $109.35 |
| 55039 | Urinary tract, ultrasound scan of, if the service is not solely a transrectal ultrasonic examination of any of the following: (a) prostate gland; (b) bladder base; (c) urethra (NR) | $44.55 75% benefit $33.45 85% benefit $37.90 |
| 55048 | Scrotum, ultrasound scan of (R) | $129.00 75% benefit $96.75 85% benefit $109.65 |
| 55049 | Scrotum, ultrasound scan of (NR) | $44.55 75% benefit $33.45 85% benefit $37.90 |
| 55054 | Ultrasonic cross-sectional echography, in conjunction with a surgical procedure (other than a procedure to which item 55848 or 55850 applies) using interventional techniques, not being a service associated with a service to which any other item in this Group applies (R) | $128.60 75% benefit $96.45 85% benefit $109.35 |
| 55065 | Pelvis, ultrasound scan of, by any or all approaches, if:(a) the service is not solely a service to which an item (other than item 55736 or 55739) in Subgroup 5 of this Group applies or a transrectal ultrasonic examination of any of the following: prostate gland; bladder base; urethra; and (b) within 24 hours of the service, a service mentioned in item 55038 is not performed on the same patient by the providing practitioner (R) | $115.80 75% benefit $86.85 85% benefit $98.45 |
| 55066 | Breasts, both, ultrasound scan, in conjunction with a surgical procedure using interventional techniques, if:(a) the request for the scan indicates that an ultrasound-guided breast intervention be performed; and(b) the service is not performed in conjunction with a service to which any other item in this Group applies (other than item 55070, 55071, 55073, 55076, 55079 or 55812) (R) | $257.00 75% benefit $192.75 85% benefit $218.45 |
| 55068 | Pelvis, ultrasound scan of, by any or all approaches, if the service is not solely a service to which an item (other than item 55736 or 55739) in Subgroup 5 of this Group applies or a transrectal ultrasonic examination of any of the following:(i) prostate gland;(ii) bladder base;(iii) urethra (NR) | $41.15 75% benefit $30.90 85% benefit $35.00 |
| 55070 | Breast, one, ultrasound scan of (R) | $115.80 75% benefit $86.85 85% benefit $98.45 |
| 55071 | Breast, one, ultrasound scan, in conjunction with a surgical procedure using interventional techniques, if:(a) the request for the scan indicates that an ultrasound-guided breast intervention be performed; and(b) the service is not performed in conjunction with a service to which any other item in this Group applies (other than item 55066, 55070, 55073, 55076, 55079 or 55812) (R) | $244.25 75% benefit $183.20 85% benefit $207.65 |
| 55073 | Breast, one, ultrasound scan of (NR) | $40.05 75% benefit $30.05 85% benefit $34.05 |
| 55076 | Breasts, both, ultrasound scan of, including an ultrasound scan for post mastectomy surveillance (R) | $128.60 75% benefit $96.45 85% benefit $109.35 |
| 55079 | Breasts, both, ultrasound scan of, including an ultrasound scan for post mastectomy surveillance (NR) | $44.55 75% benefit $33.45 85% benefit $37.90 |
| 55080 | Pelvis, ultrasound scan of, by any or all approaches (including transvaginal), if: (a) the patient is known to have, or the requesting practitioner suspects, a complex gynaecological condition; and (b) the service is considered a complex investigation requiring a minimum of 30 minutes scanning time; and (c) within 24 hours of the service, a service mentioned in item 55038, 55065, 55700, 55704, 55736, or 55739 is not performed on the same patient. (R) | $261.65 75% benefit $196.25 85% benefit $222.45 |
| 55084 | Urinary bladder, ultrasound scan of, by any or all approaches, if within 24 hours of the service, a service mentioned in item 11917, 55036, 55038, 55065, 55600 or 55603 is not performed on the same patient by the providing practitioner (R) | $115.80 75% benefit $86.85 85% benefit $98.45 |
| 55085 | Urinary bladder, ultrasound scan of, by any or all approaches, if within 24 hours of the service, a service mentioned in item 11917, 55037, 55039, 55068, 55600 or 55603 is not performed on the same patient by the providing practitioner (NR) | $40.05 75% benefit $30.05 85% benefit $34.05 |
| 55118 | Heart, two‑dimensional or three‑dimensional real time transoesophageal examination of, from at least 2 levels, and in more than one plane at each level, if: (a) the service includes: (i) real time colour flow mapping and, if indicated, pulsed wave Doppler examination; and (ii) recordings on digital media; and (b) the service is not: (i) an intra‑operative service; or (ii) a service associated with a service to which an item in Subgroup 3 of this Group applies (R) (H) (Anaes.) | $324.50 75% benefit $243.40 |
| 55126 | Note: the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: IR.1.2 Initial real time transthoracic echocardiographic examination of the heart with real time colour flow mapping from at least 3 acoustic windows, with recordings on digital media, if the service: (a) is for the investigation of any of the following: (i) symptoms or signs of cardiac failure; (ii) suspected or known ventricular hypertrophy or dysfunction; (iii) pulmonary hypertension; (iv) valvular, aortic, pericardial, thrombotic or embolic disease; (v) heart tumour; (vi) symptoms or signs of congenital heart disease; (vii) other rare indications; and (b) is not associated with a service to which: (i) another item in this Subgroup applies (except items 55137, 55141, 55143, 55145 and 55146); or (ii) an item in Subgroup 2 applies (except items 55118 and 55130); or (iii) an item in Subgroup 3 applies Applicable not more than once in a 24 month period (R) | $271.80 75% benefit $203.85 85% benefit $231.05 |
| 55127 | Note: the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: IR.1.2 Repeat serial real time transthoracic echocardiographic examination of the heart with real time colour flow mapping from at least 3 acoustic windows, with recordings on digital media, if the service: (a) is for the investigation of known valvular dysfunction; and (b) is requested by a specialist or consultant physician; and (c) is not associated with a service to which: (i) another item in this Subgroup applies (except items 55137, 55141, 55143, 55145 and 55146); or (ii) an item in Subgroup 2 applies (except items 55118 and 55130); or (iii) an item in Subgroup 3 applies (R) | $271.80 75% benefit $203.85 85% benefit $231.05 |
| 55128 | Note: the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: IR.1.2 Repeat serial real time transthoracic echocardiographic examination of the heart with real time colour flow mapping from at least 3 acoustic windows, with recordings on digital media, if the service: (a) is for the investigation of known valvular dysfunction; and (b) is requested by a medical practitioner (other than a specialist or consultant physician) at, or from, a practice located in a Modified Monash 3, 4, 5, 6 or 7 area; and (c) is not associated with a service to which: (i) another item in this Subgroup applies (except items 55137, 55141, 55143, 55145 and 55146); or (ii) an item in Subgroup 2 applies (except items 55118 and 55130); or (iii) an item in Subgroup 3 applies (R) | $271.80 75% benefit $203.85 85% benefit $231.05 |
| 55129 | Note: the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: IR.1.2 Repeat serial real time transthoracic echocardiographic examination of the heart with real time colour flow mapping from at least 3 acoustic windows, with recordings on digital media, if: (a) valvular dysfunction is not the primary issue for the patient (although it may be a secondary issue); and (b) the service is for the investigation of any of the following: (i) symptoms or signs of cardiac failure; (ii) suspected or known ventricular hypertrophy or dysfunction; (iii) pulmonary hypertension; (iv) aortic, thrombotic, embolic disease or pericardial disease (excluding isolated pericardial effusion or pericarditis); (v) heart tumour; (vi) structural heart disease; (vii) other rare indications; and (c) the service is requested by a specialist or consultant physician; and (d) the service is not associated with a service to which: (i) another item in this Subgroup applies (except items 55137, 55141, 55143, 55145 and 55146); or (ii) an item in Subgroup 2 applies (except items 55118 and 55130); or (iii) an item in Subgroup 3 applies (R) | $271.80 75% benefit $203.85 85% benefit $231.05 |
| 55130 | Intraoperative two-dimensional or three-dimensional real time transoesophageal echocardiography, if the service: (a) includes Doppler techniques with colour flow mapping and recordings on digital media; and (b) is performed during cardiac surgery; and (c) incorporates sequential assessment of cardiac function before and after the surgical procedure; and (d) is not associated with a service to which item 55135, or an item in Subgroup 3, applies (R) (H) (Anaes.) | $200.20 75% benefit $150.15 |
| 55132 | Note: the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: IR.1.2 Serial real time transthoracic echocardiographic examination of the heart with real time colour flow mapping from at least 4 acoustic windows, with recordings on digital media, if the service: (a) is for the investigation of a patient who: (i) is under 17 years of age; or (ii) has complex congenital heart disease; and (b) is performed by a specialist or consultant physician practising in the speciality of cardiology; and (c) is not associated with a service to which: (i) another item in this Subgroup applies (except items 55137, 55141, 55143, 55145 and 55146); or (ii) an item in Subgroup 2 applies (except items 55118 and 55130); or (iii) an item in Subgroup 3 applies (R) | $271.80 75% benefit $203.85 85% benefit $231.05 |
| 55133 | Frequent repetition serial real time transthoracic echocardiographic examination of the heart with real time colour flow mapping from at least 3 acoustic windows, with recordings on digital media, if the service: (a) is for the investigation of a patient who: (i) has an isolated pericardial effusion or pericarditis; or (ii) has commenced medication that has cardiotoxic side effects and is a pharmaceutical benefit (within the meaning of Part VII of the National Health Act 1953) for the writing of a prescription for the supply of which under that Part an echocardiogram is required; and (b) is not associated with a service to which: (i) another item in this Subgroup applies (except items 55137, 55141, 55143, 55145 and 55146); or (ii) an item in Subgroup 2 applies (except items 55118 and 55130); or (iii) an item in Subgroup 3 applies (R) | $244.60 75% benefit $183.45 85% benefit $207.95 |
| 55134 | Note: the service only applies if the patient meets one or more of the following and the requirements of Note: IR.1.2 Repeat real time transthoracic echocardiographic examination of the heart with real time colour flow mapping from at least 3 acoustic windows, with recordings on digital media, for the investigation of rare cardiac pathologies, if the service: (a) is requested by a specialist or consultant physician; and (b) is not associated with a service to which: (i) another item in this Subgroup applies (except items 55137, 55141, 55143, 55145 and 55146); or (ii) an item in Subgroup 2 applies (except items 55118 and 55130); or (iii) an item in Subgroup 3 applies (R) | $271.80 75% benefit $203.85 85% benefit $231.05 |
| 55135 | Intraoperative two-dimensional or three-dimensional real time transoesophageal echocardiography, if the service: (a) is provided on the same day as a service to which item 38477, 38484, 38499, 38516 or 38517 applies; and (b) includes Doppler techniques with colour flow mapping and recordings on digital media; and (c) is performed during cardiac valve surgery (replacement or repair); and (d) incorporates sequential assessment of cardiac function and valve competence before and after the surgical procedure; and (e) is not associated with a service to which item 22054, 55130, or an item in Subgroup 3, applies (R) (H) (Anaes.) | $416.55 75% benefit $312.45 |
| 55137 | Note: the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: IR.1.2 Serial real time transthoracic echocardiographic examination of the heart with real time colour flow mapping from at least 4 acoustic windows, with recordings on digital media, if the service: (a) is for the investigation of a fetus with suspected or confirmed: (i) complex congenital heart disease; or (ii) functional heart disease; or (iii) fetal cardiac arrhythmia; or (iv) cardiac structural abnormality requiring confirmation; and (b) is performed by a specialist or consultant physician practising in the speciality of cardiology with advanced training and expertise in fetal cardiac imaging; and (c) is not associated with a service to which: (i) an item in Subgroup 2 applies (except items 55118 and 55130); or (ii) an item in Subgroup 3 applies (R) | $271.80 75% benefit $203.85 85% benefit $231.05 |
| 55141 | Note: the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: IR.0.1 and IR.1.2 and does not apply to a service provided to a patient if, in the previous 24 months, a service associated with a service to which item 55143, 55145 or 55146 applies has been provided to the patient. Exercise stress echocardiography focused study, other than a service associated with a service to which: (a) item 11704, 11705, 11707, 11714, 11729 or 11730 applies; or (b) an item in Subgroup 3 applies Applicable not more than once in a 24 month period (R) | $484.50 75% benefit $363.40 85% benefit $411.85 |
| 55143 | Note: the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: IR.0.1, IR.1.1 and IR.1.2 Repeat pharmacological or exercise stress echocardiography if: (a) a service to which item 55141, 55145, 55146, or this item, applies has been performed on the patient in the previous 24 months; and (b) the patient has symptoms of ischaemia that have evolved and are not adequately controlled with optimal medical therapy; and (c) the service is requested by a specialist or a consultant physician; and (d) the service is not associated with a service to which: (i) item 11704, 11705, 11707, 11714, 11729 or 11730 applies; or (ii) an item in Subgroup 3 applies Applicable not more than once in a 12 month period (R) | $484.50 75% benefit $363.40 85% benefit $411.85 |
| 55145 | Note: the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: IR.0.1 and IR.1.2 Pharmacological stress echocardiography, other than a service associated with a service to which: (a) item 11704, 11705, 11707, 11714, 11729 or 11730 applies; or (b) an item in Subgroup 3 applies Applicable not more than once in a 24 month period (R) Note: this item does not apply to a service provided to a patient if, in the previous 24 months, a service associated with a service to which item 55141, 55143 or 55146 applies has been provided to the patient. | $561.55 75% benefit $421.20 85% benefit $477.35 |
| 55146 | Note: the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: IR.0.1 and IR.1.2 Pharmacological stress echocardiography if: (a) a service to which item 55141 applies has been performed on the patient in the previous 4 weeks, and the test has failed due to an inadequate heart rate response; and (b) the service is not associated with a service to which: (i) item 11704, 11705, 11707, 11714, 11729 or 11730 applies; or (ii) an item in Subgroup 3 applies Applicable not more than once in a 24 month period (R) Note: this item does not apply to a service provided to a patient if, in the previous 24 months, a service associated with a service to which item 55143 or 55145 applies has been provided to the patient. | $561.55 75% benefit $421.20 85% benefit $477.35 |
| 55238 | Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of arteries or bypass grafts in the lower limb or of arteries and bypass grafts in the lower limb, below the inguinal ligament, not being a service associated with any of the following:(a) a service to which an item in Subgroup 4 applies;(b) a service to which item 55880, 55881, 55882, 55883, 55884, 55885, 55886, 55887, 55888, 55889, 55890, 55891, 55892, 55893, 55894 or 55895 applies (R) | $199.70 75% benefit $149.80 85% benefit $169.75 |
| 55244 | Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of veins in the lower limb, below the inguinal ligament, for acute venous thrombosis, not being a service associated with any of the following:(a) a service to which item 55246 applies;(b) a service to which an item in Subgroup 4 applies;(c) a service to which item 55880, 55881, 55882, 55883, 55884, 55885, 55886, 55887, 55888, 55889, 55890, 55891, 55892, 55893, 55894 or 55895 applies (R) | $199.70 75% benefit $149.80 85% benefit $169.75 |
| 55246 | Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of veins in the lower limb, below the inguinal ligament, for chronic venous disease, not being a service associated with any of the following:(a) a service to which item 55244 applies;(b) a service to which an item in Subgroup 4 applies;(c) a service to which item 55880, 55881, 55882, 55883, 55884, 55885, 55886, 55887, 55888, 55889, 55890, 55891, 55892, 55893, 55894 or 55895 applies (R) | $199.70 75% benefit $149.80 85% benefit $169.75 |
| 55248 | Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of arteries or bypass grafts in the upper limb or of arteries and bypass grafts in the upper limb, not being a service associated with a service to which an item in Subgroup 4 applies (R) | $199.70 75% benefit $149.80 85% benefit $169.75 |
| 55252 | Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of veins in the upper limb, not being a service associated with a service to which an item in Subgroup 4 applies (R). | $199.70 75% benefit $149.80 85% benefit $169.75 |
| 55274 | Duplex scanning, bilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of extra cranial bilateral carotid and vertebral vessels, with or without subclavian and innominate vessels, with or without oculoplethysmography or peri orbital Doppler examination, not being a service associated with a service to which an item in Subgroup 4 applies (R). | $199.70 75% benefit $149.80 85% benefit $169.75 |
| 55276 | Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of intra‑abdominal, aorta and iliac arteries or inferior vena cava and iliac veins or of intra‑abdominal, aorta and iliac arteries and inferior vena cava and iliac veins, excluding pregnancy related studies, not being a service associated with a service to which an item in Subgroup 4 applies (R) | $199.70 75% benefit $149.80 85% benefit $169.75 |
| 55278 | Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of renal or visceral vessels or of renal and visceral vessels, including aorta, inferior vena cava and iliac vessels as required excluding pregnancy related studies, not being a service associated with a service to which an item in Subgroup 4 applies (R) | $199.70 75% benefit $149.80 85% benefit $169.75 |
| 55280 | Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of intra cranial vessels, not being a service associated with a service to which an item in Subgroup 4 applies (R) | $199.70 75% benefit $149.80 85% benefit $169.75 |
| 55282 | Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements:(a) by spectral analysis of cavernosal artery of the penis following intracavernosal administration of a vasoactive agent; and(b) performed during the period of pharmacological activity of the injected agent, to confirm a diagnosis of vascular aetiology for impotence; and(c) if a specialist in diagnostic radiology, nuclear medicine, sexual health medicine, urology, general surgery (sub-specialising in vascular surgery) or a consultant physician in nuclear medicine attends the patient in person at the practice location where the service is performed, immediately before or for a period during the performance of the service; and(d) if the specialist or consultant physician interprets the results and prepares a report, not being a service associated with a service to which an item in Subgroup 4 applies (R) | $199.70 75% benefit $149.80 85% benefit $169.75 |
| 55284 | Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements: (a) by spectral analysis of cavernosal tissue of the penis to confirm a diagnosis; and (b) if indicated, assess the progress and management of: (i) priapism; or (ii) fibrosis of any type; or (iii) fracture of the tunica; or (iv) arteriovenous malformations; and (c) if a specialist in diagnostic radiology, nuclear medicine, sexual health medicine, urology, general surgery (sub-specialising in vascular surgery) or a consultant physician in nuclear medicine attends the patient in person at the practice location where the service is performed, immediately before or for a period during the performance of the service; and (d) if the specialist or consultant physician interprets the results and prepares a report, not being a service associated with a service to which an item in Subgroup 4 applies (R) | $199.70 75% benefit $149.80 85% benefit $169.75 |
| 55292 | Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of surgically created arteriovenous fistula or surgically created arteriovenous access grafts in the upper or lower limbs, not being a service associated with a service to which an item in Subgroup 4 applies (R) | $199.70 75% benefit $149.80 85% benefit $169.75 |
| 55294 | Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of arteries or veins, or both, including any associated skin marking, for mapping of bypass conduit before vascular surgery, not being a service associated with any of the following:(a) a service to which an item in Subgroup 3 or 4 applies; (b) a service to which item 55880, 55881, 55882, 55883, 55884, 55885, 55886, 55887, 55888, 55889, 55890, 55891, 55892, 55893, 55894 or 55895 applies (R) | $199.70 75% benefit $149.80 85% benefit $169.75 |
| 55296 | Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow spectral analysis and marking of veins in the lower limbs below the inguinal ligament before varicose vein surgery, including any associated skin marking, not being a service associated with any of the following:(a) a service to which an item in Subgroup 3 or 4 applies;(b) a service to which item 55880, 55881, 55882, 55883, 55884, 55885, 55886, 55887, 55888, 55889, 55890, 55891, 55892, 55893, 55894 or 55895 applies (R) | $130.75 75% benefit $98.10 85% benefit $111.15 |
| 55600 | Prostate, bladder base and urethra, ultrasound scan of, if performed:(a) personally by a medical practitioner (not being the medical practitioner who assessed the patient as specified in paragraph (c)) using one or more transducer probes that can obtain both axial and sagittal scans in 2 planes at right angles; and(b) after a digital rectal examination of the prostate by that medical practitioner; and(c) on a patient who has been assessed by:(i) a specialist in urology, radiation oncology or medical oncology; or(ii) a consultant physician in medical oncology; who has:(iii) examined the patient in the 60 days before the scan; and(iv) recommended the scan for the management of the patient’s current prostatic disease(R) | $128.60 75% benefit $96.45 85% benefit $109.35 |
| 55603 | Prostate, bladder base and urethra, ultrasound scan of, if performed:(a) personally by a medical practitioner who made the assessment mentioned in paragraph (c) using one or more transducer probes that can obtain both axial and sagittal scans in 2 planes at right angles; and(b) after a digital rectal examination of the prostate by that medical practitioner; and(c) on a patient who has been assessed by:(i) a specialist in urology, radiation oncology or medical oncology; or(ii) a consultant physician in medical oncology; who has:(iii) examined the patient in the 60 days before the scan; and(iv) recommended the scan for the management of the patient’s current prostatic disease(R) | $128.60 75% benefit $96.45 85% benefit $109.35 |
| 55700 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, ultrasound (the current ultrasound) scan of, by any or all approaches, for determining the gestation, location, viability or number of fetuses, if: (a) the dating of the pregnancy (as confirmed by the current ultrasound) is less than 12 weeks of gestation; and (b) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55704, 55705, 55707, 55708, 55740, 55741, 55742 or 55743 (R) | $70.65 75% benefit $53.00 85% benefit $60.10 |
| 55703 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, ultrasound (the current ultrasound) scan of, by any or all approaches, for determining the gestation, location, viability or number of fetuses, if: (a) the dating of the pregnancy (as confirmed by the current ultrasound) is less than 12 weeks of gestation; and (b) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55704, 55705, 55707, 55708, 55740, 55741, 55742 or 55743 (NR) | $41.15 75% benefit $30.90 85% benefit $35.00 |
| 55704 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, for determining the structure, gestation, location, viability or number of fetuses, if: (a) the dating of the pregnancy (as confirmed by the current ultrasound) is 12 to 16 weeks of gestation; and (b) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in another item in this Subgroup (R) | $82.50 75% benefit $61.90 85% benefit $70.15 |
| 55705 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, for determining the structure, gestation, location, viability or number of fetuses, if: (a) the dating of the pregnancy (as confirmed by the current ultrasound) is 12 to 16 weeks of gestation; and (b) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in another item in this Subgroup (NR) | $41.15 75% benefit $30.90 85% benefit $35.00 |
| 55706 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, with measurement of all parameters for dating purposes, if: (a) the dating for the pregnancy (as confirmed by the current ultrasound) is 17 to 22 weeks of gestation; and (b) the current ultrasound: (i) is not performed in the same pregnancy as item 55709; and (ii) is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (R) | $117.85 75% benefit $88.40 85% benefit $100.20 |
| 55707 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, if: (a) the pregnancy (as confirmed by the current ultrasound) is dated by a fetal crown rump length of 45 to 84 mm; and (b) nuchal translucency measurement is performed to assess the risk of fetal abnormality; and (c) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in another item in this Subgroup (R) | $82.50 75% benefit $61.90 85% benefit $70.15 |
| 55708 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, if: (a) the pregnancy (as confirmed by the current ultrasound) is dated by a crown rump length of 45 to 84 mm; and (b) nuchal translucency measurement is performed to assess the risk of fetal abnormality; and (c) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in another item in this Subgroup (NR) | $41.15 75% benefit $30.90 85% benefit $35.00 |
| 55709 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, with measurement of all parameters for dating purposes, if: (a) the dating of the pregnancy (as confirmed by the current ultrasound) is 17 to 22 weeks of gestation; and (b) the current ultrasound: (i) is not performed in the same pregnancy as item 55706; and (ii) is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (NR) | $44.70 75% benefit $33.55 85% benefit $38.00 |
| 55712 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, with measurement of all parameters for dating purposes, if: (a) the current ultrasound is requested by a medical practitioner who: (i) is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists; or (ii) has a Diploma of Obstetrics; or (iii) has a qualification recognised by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists as being equivalent to a Diploma of Obstetrics; or (iv) has obstetric privileges at a non‑metropolitan hospital; and (b) the dating of the pregnancy (as confirmed by the current ultrasound) is 17 to 22 weeks of gestation; and (c) further examination is clinically indicated after performance, in the same pregnancy, of a scan mentioned in item 55706 or 55709; and (d) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (R) | $135.45 75% benefit $101.60 85% benefit $115.15 |
| 55715 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, with measurement of all parameters for dating purposes, performed by or on behalf of a medical practitioner who is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, if: (a) the dating of the pregnancy (as confirmed by the current ultrasound) is 17 to 22 weeks of gestation; and (b) further examination is clinically indicated after performance, in the same pregnancy, of a scan mentioned in item 55706 or 55709; and (c) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (NR) | $47.10 75% benefit $35.35 85% benefit $40.05 |
| 55718 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, if: (a) the dating of the pregnancy (as confirmed by the current ultrasound) is after 22 weeks of gestation; and (b) the current ultrasound: (i) is not performed in the same pregnancy as item 55723; and (ii) is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (R) | $117.85 75% benefit $88.40 85% benefit $100.20 |
| 55721 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, if: (a) the current ultrasound is requested by a medical practitioner who: (i) is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists; or (ii) has a Diploma of Obstetrics; or (iii) has a qualification recognised by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists as being equivalent to a Diploma of Obstetrics; or (iv) has obstetric privileges at a non‑metropolitan hospital; and (b) the dating of the pregnancy (as confirmed by current ultrasound) is after 22 weeks of gestation; and (c) further examination is clinically indicated in the same pregnancy to which item 55718 or 55723 applies; and (d) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (R) | $135.45 75% benefit $101.60 85% benefit $115.15 |
| 55723 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, if: (a) the dating of the pregnancy (as confirmed by the current ultrasound) is after 22 weeks of gestation; and (b) the current ultrasound: (i) is not performed in the same pregnancy as item 55718; and (ii) is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (NR) | $44.70 75% benefit $33.55 85% benefit $38.00 |
| 55725 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, performed by or on behalf of a medical practitioner who is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, if: (a) the dating of the pregnancy (as confirmed by the current ultrasound) is after 22 weeks of gestation; and (b) further examination is clinically indicated in the same pregnancy to which item 55718 or 55723 applies; and (c) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (NR) | $47.10 75% benefit $35.35 85% benefit $40.05 |
| 55729 | Duplex scanning, if:(a) the service involves:(i) B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of the umbilical artery; and(ii) measured assessment of amniotic fluid volume after the 24th week of gestation; and(b) there is reason to suspect intrauterine growth retardation or a significant risk of fetal death;—examination and report (R) | $32.10 75% benefit $24.10 85% benefit $27.30 |
| 55736 | Pelvis, ultrasound scan of, in association with saline infusion of the endometrial cavity, by any or all approaches, if a previous transvaginal ultrasound has revealed an abnormality of the uterus or fallopian tube (R) | $149.60 75% benefit $112.20 85% benefit $127.20 |
| 55739 | Pelvis, ultrasound scan of, in association with saline infusion of the endometrial cavity, by any or all approaches, if a previous transvaginal ultrasound has revealed an abnormality of the uterus or fallopian tube (NR) | $67.15 75% benefit $50.40 85% benefit $57.10 |
| 55740 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, for determining the structure, gestation, location, viability or number of fetuses, if: (a) an ultrasound of the same pregnancy confirms a multiple pregnancy; and (b) the dating of the pregnancy (as confirmed by the current ultrasound) is 12 to 16 weeks of gestation; and (c) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in another item in this Subgroup (R) | $122.60 75% benefit $91.95 85% benefit $104.25 |
| 55741 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, for determining the structure, gestation, location, viability or number of fetuses, if: (a) an ultrasound of the same pregnancy confirms a multiple pregnancy; and (b) the dating of the pregnancy (as confirmed by the current ultrasound) is 12 to 16 weeks of gestation; and (c) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in another item in this Subgroup (NR) | $61.25 75% benefit $45.95 85% benefit $52.10 |
| 55742 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, if: (a) an ultrasound of the same pregnancy confirms a multiple pregnancy; and (b) the pregnancy (as confirmed by the current ultrasound) is dated by a fetal crown rump length of 45 to 84 mm; and (c) nuchal translucency measurement is performed to assess the risk of fetal abnormality; and (d) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in another item in this Subgroup (R) | $122.60 75% benefit $91.95 85% benefit $104.25 |
| 55743 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, if: (a) an ultrasound of the same pregnancy confirms a multiple pregnancy; and (b) the pregnancy (as confirmed by the current ultrasound) is dated by a fetal crown rump length of 45 to 84 mm; and (c) nuchal translucency measurement is performed to assess the risk of fetal abnormality; and (d) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in another item in this Subgroup (NR) | $61.25 75% benefit $45.95 85% benefit $52.10 |
| 55757 | Pelvis or abdomen, ultrasound (the current ultrasound) scan of, for cervical length assessment for risk of preterm labour, by any or all approaches, if: (a) the dating of the pregnancy (as confirmed by the current ultrasound) is between 14 and 30 weeks of gestation; and (b) any of the following apply: (i) the patient has a history indicating high risk of preterm labour or birth or second trimester fetal loss; (ii) the patient has symptoms suggestive of threatened preterm labour or second trimester fetal loss; (iii) the patient’s cervical length is less than 25 mm on an ultrasound before 28 weeks gestation; and (c) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in another item in this Subgroup (R) | $58.40 75% benefit $43.80 85% benefit $49.65 |
| 55758 | Pelvis or abdomen, ultrasound (the current ultrasound) scan of, for cervical length assessment for risk of preterm labour, by any or all approaches, if: (a) the dating of the pregnancy (as confirmed by the current ultrasound) is between 14 and 30 weeks of gestation; and (b) any of the following apply: (i) the patient has a history indicating high risk of preterm labour or birth or second trimester fetal loss; (ii) the patient has symptoms suggestive of threatened preterm labour or second trimester fetal loss; (iii) the patient’s cervical length is less than 25 mm on an ultrasound before 28 weeks gestation; and (c) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in another item in this Subgroup (NR) | $22.15 75% benefit $16.65 85% benefit $18.85 |
| 55759 | Pelvis or abdomen, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, with measurement of all parameters for dating purposes, if: (a) an ultrasound of the same pregnancy confirms a multiple pregnancy; and (b) the dating of the pregnancy (as confirmed by the current ultrasound) is 17 to 22 weeks gestation; and (c) the service mentioned in item 55706, 55709, 55712, 55715 or 55762 is not performed in conjunction with the current ultrasound during the same pregnancy; and (d) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (R) | $176.70 75% benefit $132.55 85% benefit $150.20 |
| 55762 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, with measurement of all parameters for dating purposes, if: (a) an ultrasound of the same pregnancy confirms a multiple pregnancy; and (b) the dating of the pregnancy (as confirmed by the current ultrasound) is 17 to 22 weeks gestation; and (c) the service mentioned in item 55706, 55709, 55712, 55715 or 55759 is not performed in conjunction with the current ultrasound during the same pregnancy; and (d) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (NR) | $70.65 75% benefit $53.00 85% benefit $60.10 |
| 55764 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, with measurement of all parameters for dating purposes, if: (a) the service is requested by a medical practitioner who: (i) is a Member or Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists; or (ii) has a Diploma of Obstetrics; or (iii) has a qualification recognised by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists as equivalent to a Diploma of Obstetrics; or (iv) has obstetric privileges at a non‑metropolitan hospital; and (b) an ultrasound of the same pregnancy confirms a multiple pregnancy; and (c) the dating of the pregnancy (as confirmed by the current ultrasound) is 17 to 22 weeks gestation; and (d) further examination is clinically indicated in the same pregnancy in which item 55759 or 55762 has been performed; and (e) the service mentioned in item 55706, 55709, 55712 or 55715 is not performed in conjunction with the current ultrasound during the same pregnancy; and (f) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (R) | $188.40 75% benefit $141.30 85% benefit $160.15 |
| 55766 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, with measurement of all parameters for dating purposes, performed by or on behalf of a medical practitioner, who is a Member or Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, if: (a) an ultrasound of the same pregnancy confirms a multiple pregnancy; and (b) the dating of the pregnancy (as confirmed by the current ultrasound) is 17 to 22 weeks of gestation; and (c) further examination is clinically indicated in the same pregnancy in which item 55759 or 55762 has been performed; and (d) the service mentioned in item 55706, 55709, 55712 or 55715 is not performed in conjunction with the current ultrasound during the same pregnancy; and (e) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (NR) | $76.55 75% benefit $57.45 85% benefit $65.10 |
| 55768 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, if: (a) dating of the pregnancy (as confirmed by the current ultrasound) is after 22 weeks of gestation; and (b) an ultrasound confirms a multiple pregnancy; and (c) the service is not performed in the same pregnancy as item 55770; and (d) the service mentioned in item 55718, 55721, 55723 or 55725 is not performed in conjunction with the current ultrasound during the same pregnancy; and (e) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (R) | $176.70 75% benefit $132.55 85% benefit $150.20 |
| 55770 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, if: (a) dating of the pregnancy (as confirmed by the current ultrasound) is after 22 weeks of gestation; and (b) an ultrasound confirms a multiple pregnancy; and (c) the service is not performed in the same pregnancy as item 55768; and (d) the service mentioned in item 55718, 55721, 55723 or 55725 is not performed in conjunction with the current ultrasound during the same pregnancy; and (e) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (NR) | $70.65 75% benefit $53.00 85% benefit $60.10 |
| 55772 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, if: (a) dating of the pregnancy as confirmed by the current ultrasound is after 22 weeks of gestation; and (b) the service is requested by a medical practitioner who: (i) is a Member or Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists; or (ii) has a Diploma of Obstetrics; or (iii) has a qualification recognised by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists as equivalent to a Diploma of Obstetrics; or (iv) has obstetric privileges at a non‑metropolitan hospital; and (c) further examination is clinically indicated in the same pregnancy to which item 55768 or 55770 has been performed; and (d) the pregnancy as confirmed by an ultrasound is a multiple pregnancy; and (e) the service mentioned in item 55718, 55721, 55723 or 55725 is not performed in conjunction with the current ultrasound during the same pregnancy; and (f) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (R) | $188.40 75% benefit $141.30 85% benefit $160.15 |
| 55774 | Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, performed by or on behalf of a medical practitioner who is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, if: (a) dating of the pregnancy as confirmed by the current ultrasound is after 22 weeks of gestation; and (b) further examination is clinically indicated in the same pregnancy to which item 55768 or 55770 has been performed; and (c) the pregnancy as confirmed by an ultrasound is a multiple pregnancy; and (d) the service mentioned in item 55718, 55721, 55723 or 55725 is not performed in conjunction with the current ultrasound during the same pregnancy; and (e) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (NR) | $76.55 75% benefit $57.45 85% benefit $65.10 |
| 55812 | Chest or abdominal wall, one or more areas, ultrasound scan of (R) | $128.60 75% benefit $96.45 85% benefit $109.35 |
| 55814 | Chest or abdominal wall, one or more areas, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55070, 55073, 55076 or 55079 (NR) | $44.55 75% benefit $33.45 85% benefit $37.90 |
| 55844 | Assessment of a mass associated with the skin or subcutaneous structures, not being a part of the musculoskeletal system, one or more areas, ultrasound scan of (R) | $102.85 75% benefit $77.15 85% benefit $87.45 |
| 55846 | Assessment of a mass associated with the skin or subcutaneous structures, not being a part of the musculoskeletal system, one or more areas, ultrasound scan of (NR) | $44.55 75% benefit $33.45 85% benefit $37.90 |
| 55848 | Musculoskeletal ultrasound, in conjunction with a surgical procedure using interventional techniques, not being a service associated with a service to which any other item in this group applies, and not performed in conjunction with a service mentioned in item 55054 (R) | $161.00 75% benefit $120.75 85% benefit $136.85 |
| 55850 | Musculoskeletal ultrasound, in conjunction with a surgical procedure using interventional techniques, inclusive of a diagnostic musculoskeletal ultrasound service, if:(a) the medical practitioner or nurse practitioner has indicated on a request for a musculoskeletal ultrasound that an ultrasound guided intervention be performed if clinically indicated; and(b) the service is not performed in conjunction with a service mentioned in item 55054 or any other item in this Subgroup (R) | $212.45 75% benefit $159.35 85% benefit $180.60 |
| 55852 | Paediatric spine, spinal cord and overlying subcutaneous tissues, ultrasound scan of (R) | $128.60 75% benefit $96.45 85% benefit $109.35 |
| 55854 | Paediatric spine, spinal cord and overlying subcutaneous tissues, ultrasound scan of (NR) | $44.55 75% benefit $33.45 85% benefit $37.90 |
| 55856 | Hand or wrist or both, left or right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55858 (R) | $128.60 75% benefit $96.45 85% benefit $109.35 |
| 55857 | Hand or wrist, or both, left or right, ultrasound scan of, if the service is not performed in conjunction with item 55859 (NR) | $44.55 75% benefit $33.45 85% benefit $37.90 |
| 55858 | Hand or wrist, or both, left and right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55856 (R) | $142.65 75% benefit $107.00 85% benefit $121.30 |
| 55859 | Hand or wrist, or both, left and right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55857 (NR) | $49.55 75% benefit $37.20 85% benefit $42.15 |
| 55860 | Forearm or elbow, or both, left or right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55862 (R) | $128.60 75% benefit $96.45 85% benefit $109.35 |
| 55861 | Forearm or elbow, or both, left or right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55863 (NR) | $44.55 75% benefit $33.45 85% benefit $37.90 |
| 55862 | Forearm or elbow, or both, left and right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55860 (R) | $142.65 75% benefit $107.00 85% benefit $121.30 |
| 55863 | Forearm or elbow, or both, left and right, ultrasound scan of, if the service is not performed in conjunction with item 55861 (NR) | $49.55 75% benefit $37.20 85% benefit $42.15 |
| 55864 | Shoulder or upper arm, or both, left or right, ultrasound scan of, if:(a) the service is used for the assessment of one or more of the following suspected or known conditions:(i) an injury to a muscle, tendon or muscle/tendon junction;(ii) rotator cuff tear, calcification or tendinosis (biceps, subscapular, supraspinatus or infraspinatus);(iii) biceps subluxation;(iv) capsulitis and bursitis;(v) a mass, including a ganglion;(vi) an occult fracture;(vii) acromioclavicular joint pathology; and(b) the service is not performed in conjunction with a service mentioned in item 55866 (R) | $128.60 75% benefit $96.45 85% benefit $109.35 |
| 55865 | Shoulder or upper arm, or both, left or right, ultrasound scan of, if:(a) the service is used for the assessment of one or more of the following suspected or known conditions:(i) an injury to a muscle, tendon or muscle/tendon junction;(ii) rotator cuff tear, calcification or tendinosis (biceps, subscapular, supraspinatus or infraspinatus);(iii) biceps subluxation;(iv) capsulitis and bursitis;(v) a mass, including a ganglion;(vi) an occult fracture;(vii) acromioclavicular joint pathology; and(b) the service is not performed in conjunction with a service mentioned in item 55867 (NR) | $44.55 75% benefit $33.45 85% benefit $37.90 |
| 55866 | Shoulder or upper arm, or both, left and right, ultrasound scan of, if:(a) the service is used for the assessment of one or more of the following suspected or known conditions:(i) an injury to a muscle, tendon or muscle/tendon junction;(ii) rotator cuff tear, calcification or tendinosis (biceps, subscapular, supraspinatus or infraspinatus);(iii) biceps subluxation;(iv) capsulitis and bursitis;(v) a mass, including a ganglion;(vi) an occult fracture;(vii) acromioclavicular joint pathology; and(b) the service is not performed in conjunction with a service mentioned in item 55864 (R) | $142.65 75% benefit $107.00 85% benefit $121.30 |
| 55867 | Shoulder or upper arm, or both, left and right, ultrasound scan of, if:(a) the service is used for the assessment of one or more of the following suspected or known conditions:(i) an injury to a muscle, tendon or muscle/tendon junction;(ii) rotator cuff tear, calcification or tendinosis (biceps, subscapular, supraspinatus or infraspinatus);(iii) biceps subluxation;(iv) capsulitis and bursitis;(v) a mass, including a ganglion;(vi) an occult fracture;(vii) acromioclavicular joint pathology; and(b) the service is not performed in conjunction with a service mentioned in item 55865 (NR) | $49.55 75% benefit $37.20 85% benefit $42.15 |
| 55868 | Hip or groin, or both, left or right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55870 (R) | $128.60 75% benefit $96.45 85% benefit $109.35 |
| 55869 | Hip or groin, or both, left or right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55871 (NR) | $44.55 75% benefit $33.45 85% benefit $37.90 |
| 55870 | Hip or groin, or both, left and right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55868 (R) | $142.65 75% benefit $107.00 85% benefit $121.30 |
| 55871 | Hip or groin, or both, left and right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55869 (NR) | $49.55 75% benefit $37.20 85% benefit $42.15 |
| 55872 | Paediatric hip examination for dysplasia, left or right, ultrasound scan of, if the service is not performed in conjunction with item 55874 (R) | $128.60 75% benefit $96.45 85% benefit $109.35 |
| 55873 | Paediatric hip examination for dysplasia, left or right, ultrasound scan of, if the service is not performed in conjunction with item 55875 (NR) | $44.55 75% benefit $33.45 85% benefit $37.90 |
| 55874 | Paediatric hip examination for dysplasia, left and right, ultrasound scan of, if the service is not performed in conjunction with item 55872 (R) | $142.65 75% benefit $107.00 85% benefit $121.30 |
| 55875 | Paediatric hip examination for dysplasia, left and right, ultrasound scan of, if the service is not performed in conjunction with item 55873 (NR) | $49.55 75% benefit $37.20 85% benefit $42.15 |
| 55876 | Buttock or thigh, or both, left or right, ultrasound scan of, if the service is not performed in conjunction with item 55878 (R) | $128.60 75% benefit $96.45 85% benefit $109.35 |
| 55877 | Buttock or thigh or both, left or right, ultrasound scan of, if the service is not performed in conjunction with item 55879 (NR) | $44.55 75% benefit $33.45 85% benefit $37.90 |
| 55878 | Buttock or thigh, or both, left and right, ultrasound scan of, if the service is not performed in conjunction with item 55876 (R) | $142.65 75% benefit $107.00 85% benefit $121.30 |
| 55879 | Buttock or thigh, or both, left and right, ultrasound scan of, if the service is not performed in conjunction with item 55877 (NR) | $49.55 75% benefit $37.20 85% benefit $42.15 |
| 55880 | Knee, left or right, ultrasound scan of, if: (a) the service is used for the assessment of one or more of the following suspected or known conditions:(i) abnormality of tendons or bursae about the knee;(ii) a meniscal cyst, popliteal fossa cyst, mass or pseudomass;(iii) a nerve entrapment or a nerve or nerve sheath tumour;(iv) an injury of collateral ligaments; and (b) the service is not performed in conjunction with item 55882 (R) | $128.60 75% benefit $96.45 85% benefit $109.35 |
| 55881 | Knee, left or right, ultrasound scan of, if:(a) the service is used for the assessment of one or more of the following suspected or known conditions: (i) abnormality of tendons or bursae about the knee;(ii) a meniscal cyst, popliteal fossa cyst, mass or pseudomass;(iii) a nerve entrapment or a nerve or nerve sheath tumour;(iv) an injury of collateral ligaments; and(b) the service is not performed in conjunction with item 55883 (NR) | $44.55 75% benefit $33.45 85% benefit $37.90 |
| 55882 | Knee, left and right, ultrasound scan of, if:(a) the service is used for the assessment of one or more of the following suspected or known conditions:(i) abnormality of tendons or bursae about the knee;(ii) a meniscal cyst, popliteal fossa cyst, mass or pseudomass;(iii) a nerve entrapment or a nerve or nerve sheath tumour;(iv) an injury of collateral ligaments; and(b) the service is not performed in conjunction with a service mentioned in item 55880 (R) | $142.65 75% benefit $107.00 85% benefit $121.30 |
| 55883 | Knee, left and right, ultrasound scan of, if:(a) the service is used for the assessment of one or more of the following suspected or known conditions: (i) abnormality of tendons or bursae about the knee;(ii) a meniscal cyst, popliteal fossa cyst, mass or pseudomass;(iii) a nerve entrapment or a nerve or nerve sheath tumour;(iv) an injury of collateral ligaments; and(b) the service is not performed in conjunction with item 55881 (NR) | $49.55 75% benefit $37.20 85% benefit $42.15 |
| 55884 | Lower leg, left or right, ultrasound scan of, if the service is not performed in conjunction with item 55886 (R) | $128.60 75% benefit $96.45 85% benefit $109.35 |
| 55885 | Lower leg, left or right, ultrasound scan of, if the service is not performed in conjunction with item 55887 (NR) | $44.55 75% benefit $33.45 85% benefit $37.90 |
| 55886 | Lower leg, left and right, ultrasound scan of, if the service is not performed in conjunction with item 55884 (R) | $142.65 75% benefit $107.00 85% benefit $121.30 |
| 55887 | Lower leg, left and right, ultrasound scan of, if the service is not performed in conjunction with item 55885 (NR) | $49.55 75% benefit $37.20 85% benefit $42.15 |
| 55888 | Ankle or hind foot, or both, left or right, ultrasound scan of, if the service is not performed in conjunction with item 55890 (R) | $128.60 75% benefit $96.45 85% benefit $109.35 |
| 55889 | Ankle or hind foot, or both, left or right, ultrasound scan of, if the service is not performed in conjunction with item 55891 (NR) | $44.55 75% benefit $33.45 85% benefit $37.90 |
| 55890 | Ankle or hind foot, or both, left and right, ultrasound scan of, if the service is not performed in conjunction with item 55888 (R) | $142.65 75% benefit $107.00 85% benefit $121.30 |
| 55891 | Ankle or hind foot, or both, left and right, ultrasound scan of, if the service is not performed in conjunction with item 55889 (NR) | $49.55 75% benefit $37.20 85% benefit $42.15 |
| 55892 | Mid foot or fore foot, or both, left or right, ultrasound scan of, if the service is not performed in conjunction with item 55894 (R) | $128.60 75% benefit $96.45 85% benefit $109.35 |
| 55893 | Mid foot or fore foot, or both, left or right, ultrasound scan of, if the service is not performed in conjunction with item 55895 (NR) | $44.55 75% benefit $33.45 85% benefit $37.90 |
| 55894 | Mid foot or fore foot, or both, left and right, ultrasound scan of, if the service is not performed in conjunction with item 55892 (R) | $142.65 75% benefit $107.00 85% benefit $121.30 |
| 55895 | Mid foot or fore foot, or both, left and right, ultrasound scan of, if the service is not performed in conjunction with item 55893 (NR) | $49.55 75% benefit $37.20 85% benefit $42.15 |
I2 Computed Tomography
54 items
| Item | Description | Fee and benefits |
|---|---|---|
| 56001 | Computed tomography—scan of brain without intravenous contrast medium, not being a service to which item 57001 applies (R) (Anaes.) | $225.20 75% benefit $168.90 85% benefit $191.45 |
| 56007 | Computed tomography—scan of brain with intravenous contrast medium and with any scans of the brain before intravenous contrast injection, when performed, not being a service to which item 57007 applies (R) (Anaes.) | $288.65 75% benefit $216.50 85% benefit $245.40 |
| 56010 | Computed tomography—scan of pituitary fossa with or without intravenous contrast medium and with or without brain scan when performed (R) (Anaes.) | $291.10 75% benefit $218.35 85% benefit $247.45 |
| 56013 | COMPUTED TOMOGRAPHY - scan of orbits with or without intravenous contrast medium and with or without brain scan when undertaken (R) (Anaes.) | $288.65 75% benefit $216.50 85% benefit $245.40 |
| 56016 | Computed tomography—scan of petrous bones in axial and coronal planes in 1 mm or 2 mm sections, with or without intravenous contrast medium, with or without scan of brain (R) (Anaes.) | $334.80 75% benefit $251.10 85% benefit $284.60 |
| 56022 | Computed tomography—scan of facial bones, para nasal sinuses or both without intravenous contrast medium (R) (Anaes.) | $259.80 75% benefit $194.85 85% benefit $220.85 |
| 56028 | Computed tomography—scan of facial bones, para nasal sinuses or both with intravenous contrast medium and with any scans of the facial bones, para nasal sinuses or both before intravenous contrast injection, when performed (R) (Anaes.) | $388.80 75% benefit $291.60 85% benefit $330.50 |
| 56030 | Computed tomography—scan of facial bones, para nasal sinuses or both, with scan of brain, without intravenous contrast medium (R) (Anaes.) | $259.80 75% benefit $194.85 85% benefit $220.85 |
| 56036 | Computed tomography—scan of facial bones, para nasal sinuses or both, with scan of brain, with intravenous contrast medium, if:(a) a scan without intravenous contrast medium has been performed; and(b) the service is required because the result of the scan mentioned in paragraph (a) is abnormal (R) (Anaes.) | $388.80 75% benefit $291.60 85% benefit $330.50 |
| 56101 | Computed tomography—scan of soft tissues of neck, including larynx, pharynx, upper oesophagus and salivary glands (not associated with cervical spine) without intravenous contrast medium, not being a service to which item 56801 applies (R) (Anaes.) | $265.50 75% benefit $199.15 85% benefit $225.70 |
| 56107 | Computed tomography—scan of soft tissues of neck, including larynx, pharynx, upper oesophagus and salivary glands (not associated with cervical spine)—with intravenous contrast medium and with any scans of soft tissues of neck, including larynx, pharynx, upper oesophagus and salivary glands (not associated with cervical spine) before intravenous contrast injection, when undertaken, not being a service associated with a service to which item 56807 applies (R) (Anaes.) | $392.50 75% benefit $294.40 85% benefit $333.65 |
| 56219 | Computed tomography—scan of spine, one or more regions with intrathecal contrast medium, including the preparation for intrathecal injection of contrast medium and any associated plain X rays, not being a service to which item 59724 applies (R) (Anaes.) | $376.60 75% benefit $282.45 85% benefit $320.15 |
| 56220 | Computed tomography—scan of spine, cervical region, without intravenous contrast medium (R) (Anaes.) | $277.10 75% benefit $207.85 85% benefit $235.55 |
| 56221 | Computed tomography—scan of spine, thoracic region, without intravenous contrast medium (R) (Anaes.) | $277.10 75% benefit $207.85 85% benefit $235.55 |
| 56223 | Computed tomography—scan of spine, lumbosacral region, without intravenous contrast medium (R) (Anaes.) | $277.10 75% benefit $207.85 85% benefit $235.55 |
| 56224 | Computed tomography—scan of spine, cervical region, with intravenous contrast medium and with any scans of the cervical region of the spine before intravenous contrast injection when undertaken (R) (Anaes.) | $405.60 75% benefit $304.20 85% benefit $344.80 |
| 56225 | Computed tomography—scan of spine, thoracic region, with intravenous contrast medium and with any scans of the thoracic region of the spine before intravenous contrast injection when undertaken (R) (Anaes.) | $405.60 75% benefit $304.20 85% benefit $344.80 |
| 56226 | Computed tomography—scan of spine, lumbosacral region, with intravenous contrast medium and with any scans of the lumbosacral region of the spine prior to intravenous contrast injection when undertaken (R) (Anaes.) | $405.60 75% benefit $304.20 85% benefit $344.80 |
| 56233 | Computed tomography—scan of spine, 2 examinations of the kind referred to in items 56220, 56221 and 56223, without intravenous contrast medium (R) (Anaes.) | $277.10 75% benefit $207.85 85% benefit $235.55 |
| 56234 | Computed tomography—scan of spine, 2 examinations of the kind referred to in items 56224, 56225 and 56226, with intravenous contrast medium and with any scans of these regions of the spine before intravenous contrast injection when undertaken (R) (Anaes.) | $405.60 75% benefit $304.20 85% benefit $344.80 |
| 56237 | Computed tomography—scan of spine, 3 regions cervical, thoracic and lumbosacral, without intravenous contrast medium (R) (Anaes.) | $277.10 75% benefit $207.85 85% benefit $235.55 |
| 56238 | Computed tomography—scan of spine, 3 regions, cervical, thoracic and lumbosacral, with intravenous contrast medium and with any scans of these regions of the spine before intravenous contrast injection when undertaken (R) (Anaes.) | $405.60 75% benefit $304.20 85% benefit $344.80 |
| 56301 | Computed tomography—scan of chest, including lungs, mediastinum, chest wall and pleura, with or without scans of the upper abdomen, without intravenous contrast medium, not being a service to which item 56801 or 57001 applies and not including a study performed to exclude coronary artery calcification or image the coronary arteries (R) (Anaes.) | $340.65 75% benefit $255.50 85% benefit $289.60 |
| 56307 | Computed tomography—scan of chest, including lungs, mediastinum, chest wall and pleura, with or without scans of the upper abdomen, with intravenous contrast medium and with any scans of the chest, including lungs, mediastinum, chest wall or pleura and upper abdomen before intravenous contrast injection, when undertaken, not being a service to which item 56807 or 57007 applies and not including a study performed to exclude coronary artery calcification or image the coronary arteries (R) (Anaes.) | $461.80 75% benefit $346.35 85% benefit $392.55 |
| 56401 | Computed tomography—scan of upper abdomen only (diaphragm to iliac crest) without intravenous contrast medium, not being a service to which item 56301, 56501, 56801 or 57001 applies (R) (Anaes.) | $288.65 75% benefit $216.50 85% benefit $245.40 |
| 56407 | Computed tomography—scan of upper abdomen only (diaphragm to iliac crest), with intravenous contrast medium, and with any scans of upper abdomen (diaphragm to iliac crest) before intravenous contrast injection, when undertaken, not being a service to which item 56307, 56507, 56807 or 57007 applies (R) (Anaes.) | $415.70 75% benefit $311.80 85% benefit $353.35 |
| 56409 | Computed tomography—scan of pelvis only (iliac crest to pubic symphysis) without intravenous contrast medium not being a service associated with a service to which item 56401 applies (R) (Anaes.) | $288.65 75% benefit $216.50 85% benefit $245.40 |
| 56412 | Computed tomography—scan of pelvis only (iliac crest to pubic symphysis), with intravenous contrast medium and with any scans of pelvis (iliac crest to pubic symphysis) before intravenous contrast injection, when undertaken, not being a service to which item 56407 applies (R) (Anaes.) | $415.70 75% benefit $311.80 85% benefit $353.35 |
| 56501 | Computed tomography—scan of upper abdomen and pelvis without intravenous contrast medium, not for the purposes of virtual colonoscopy and not being a service to which item 56801 or 57001 applies(R) (Anaes.) | $444.35 75% benefit $333.30 85% benefit $377.70 |
| 56507 | Computed tomography—scan of upper abdomen and pelvis with intravenous contrast medium and with any scans of upper abdomen and pelvis before intravenous contrast injection, when performed, not for the purposes of virtual colonoscopy and not being a service to which item 56807 or 57007 applies (R) (Anaes.) | $554.25 75% benefit $415.70 85% benefit $471.15 |
| 56553 | Computed tomography—scan of colon for exclusion or diagnosis of colorectal neoplasia in a symptomatic or high risk patient if:(a) one or more of the following applies:(i) the patient has had an incomplete colonoscopy in the 3 months before the scan;(ii) there is a high grade colonic obstruction;(iii) the service is requested by a specialist or consultant physician who performs colonoscopies in the practice of the specialist’s or consultant physician’s speciality; and(b) the service is not a service to which item 56301, 56307, 56401, 56407, 56409, 56412, 56501, 56507, 56801, 56807 or 57001 applies (R) (Anaes.) | $600.30 75% benefit $450.25 85% benefit $510.30 |
| 56620 | Computed tomography—scan of knee, without intravenous contrast medium, not being a service to which item 56622 or 56629 applies (R) (Anaes.) | $254.00 75% benefit $190.50 85% benefit $215.90 |
| 56622 | Computed tomography—scan of lower limb, left or right or both, one region (other than knee), or more than one region (which may include knee), without intravenous contrast medium, not being a service to which item 56620 applies (R) (Anaes.) | $254.00 75% benefit $190.50 85% benefit $215.90 |
| 56623 | Computed tomography—scan of lower limb, left or right or both, one region (other than knee), or more than one region (which may include knee), with intravenous contrast medium and with any scans of the lower limb before intravenous contrast injection, when performed, not being a service to which item 56626 applies (R) (Anaes.) | $386.40 75% benefit $289.80 85% benefit $328.45 |
| 56626 | Computed tomography—scan of knee, with intravenous contrast medium and with any scans of the knee before intravenous contrast injection, when performed, not being a service to which items 56623 or 56630 apply (R) (Anaes.) | $386.40 75% benefit $289.80 85% benefit $328.45 |
| 56627 | Computed tomography—scan of upper limb, left or right or both, any one region, or more than one region, without intravenous contrast medium (R) (Anaes.) | $254.00 75% benefit $190.50 85% benefit $215.90 |
| 56628 | Computed tomography—scan of upper limb, left or right or both, any one region, or more than one region, with intravenous contrast medium and with any scans of the upper limb before intravenous contrast injection, when performed (R) (Anaes.) | $386.40 75% benefit $289.80 85% benefit $328.45 |
| 56629 | Computed tomography—scan of upper limb and lower limb, left or right or both, any one region (other than knee), or more than one region (which may include knee) without intravenous contrast medium not being a service to which item 56620 applies (R) (Anaes.) | $254.00 75% benefit $190.50 85% benefit $215.90 |
| 56630 | Computed tomography—scan of upper limb and lower limb, left or right or both, any one region (other than knee), or more than one region (which may include knee) with intravenous contrast medium with any scans of the limbs before intravenous contrast injection, when performed, not being a service to which item 56626 applies (R) (Anaes.) | $386.40 75% benefit $289.80 85% benefit $328.45 |
| 56801 | Computed tomography—scan of chest, abdomen and pelvis with or without scans of soft tissues of neck without intravenous contrast medium, not including a study performed to exclude coronary artery calcification or image the coronary arteries (R) (Anaes.) | $538.65 75% benefit $404.00 85% benefit $457.90 |
| 56807 | Computed tomography—scan of chest, abdomen and pelvis with or without scans of soft tissues of neck with intravenous contrast medium and with any scans of chest, abdomen and pelvis with or without scans of soft tissue of neck before intravenous contrast injection, when performed, not including a study performed to exclude coronary artery calcification or image the coronary arteries (R) (Anaes.) | $646.55 75% benefit $484.95 85% benefit $549.60 |
| 57001 | Computed tomography—scan of brain and chest with or without scans of upper abdomen without intravenous contrast medium, not including a study performed to exclude coronary artery calcification or image the coronary arteries (R) (Anaes.) | $538.75 75% benefit $404.10 85% benefit $457.95 |
| 57007 | Computed tomography—scan of brain and chest with or without scans of upper abdomen with intravenous contrast medium and with any scans of brain and chest and upper abdomen before intravenous contrast injection, when performed, not including a study performed to exclude coronary artery calcification or image the coronary arteries (R) (Anaes.) | $655.40 75% benefit $491.55 85% benefit $557.10 |
| 57201 | Computed tomography—pelvimetry (R) (Anaes.) | $179.20 75% benefit $134.40 85% benefit $152.35 |
| 57341 | Computed tomography, in conjunction with a surgical procedure using interventional techniques (R) (Anaes.) | $542.60 75% benefit $406.95 85% benefit $461.25 |
| 57352 | Computed tomography—angiography with intravenous contrast medium of any or all, or any part, of: (a) the arch of the aorta; or (b) the carotid arteries; or (c) the vertebral arteries and their branches (head and neck); including any scans performed before intravenous contrast injection—one or more data acquisitions, including image editing, and maximum intensity projections or 3 dimensional surface shaded display, with hardcopy or digital recording of multiple projections, if: (d) either: (i) the service is requested by a specialist or consultant physician; or (ii) the service is requested by a medical practitioner (other than a specialist or consultant physician) and the request indicates that the patient’s case has been discussed with a specialist or consultant physician; and (e) the service is not a service to which another item in this group applies; and (f) the service is performed for the exclusion of arterial stenosis, occlusion, aneurysm or embolism; and (g) the service is not a study performed to image the coronary arteries (R) (Anaes.) | $588.75 75% benefit $441.60 85% benefit $500.45 |
| 57353 | Computed tomography—angiography with intravenous contrast medium of any or all, or any part, of: (a) the ascending and descending aorta; or (b) the common iliac and abdominal branches including upper limbs (chest, abdomen and upper limbs); including any scans performed before intravenous contrast injection—one or more data acquisitions, including image editing, and maximum intensity projections or 3 dimensional surface shaded display, with hardcopy or digital recording of multiple projections, if: (c) either: (i) the service is requested by a specialist or consultant physician; or (ii) the service is requested by a medical practitioner (other than a specialist or consultant physician) and the request indicates that the patient’s case has been discussed with a specialist or consultant physician; and (d) the service is not a service to which another item in this group applies; and (e) the service is performed for the exclusion of arterial stenosis, occlusion, aneurysm or embolism; and (f) the service is not a study performed to image the coronary arteries (R) (Anaes.) | $588.75 75% benefit $441.60 85% benefit $500.45 |
| 57354 | Computed tomography—angiography with intravenous contrast medium of any or all, or any part, of: (a) the descending aorta; or (b) the pelvic vessels (aorto‑iliac segment) and lower limbs; including any scans performed before intravenous contrast injection—one or more data acquisitions, including image editing, and maximum intensity projections or 3 dimensional surface shaded display, with hardcopy or digital recording of multiple projections, if: (c) either: (i) the service is requested by a specialist or consultant physician; or (ii) the service is requested by a medical practitioner (other than a specialist or consultant physician) and the request indicates that the patient’s case has been discussed with a specialist or consultant physician; and (d) the service is not a service to which another item in this group applies; and (e) the service is performed for the exclusion of arterial stenosis, occlusion, aneurysm or embolism; and (f) the service is not a study performed to image the coronary arteries (R) (Anaes.) | $588.75 75% benefit $441.60 85% benefit $500.45 |
| 57357 | Computed tomography—angiography with intravenous contrast medium of any or all, or any part, of the pulmonary arteries and their branches, including any scans performed before intravenous contrast injection—one or more data acquisitions, including image editing, and maximum intensity projections or 3 dimensional surface shaded display, with hardcopy or digital recording of multiple projections, if: the service is not a service to which another item in this group applies; and the service is not a study performed to image the coronary arteries; and the service is:(i) performed for the exclusion of pulmonary arterial stenosis, occlusion, aneurysm or embolism and is requested by a specialist or consultant physician; or(ii) performed for the exclusion of pulmonary arterial stenosis, occlusion or aneurysm and is requested by a medical practitioner (other than a specialist or consultant physician) and the request indicates that the patient’s case has been discussed with a specialist or consultant physician; or (iii) for the exclusion of pulmonary embolism and is requested be a medical practitioner (other than a specialist or consultant physician) (R) (Anaes.) | $588.75 75% benefit $441.60 85% benefit $500.45 |
| 57360 | New 85% benefit on 1 November 2026Computed tomography of the coronary arteries performed on a minimum of a 64 slice (or equivalent) scanner if: (a) the request is made by a specialist or consultant physician; and (b) the patient has stable or acute symptoms consistent with coronary ischaemia; and (c) the patient is at low to intermediate risk of an acute coronary event, including having no significant cardiac biomarker elevation and no electrocardiogram changes indicating acute ischaemia (R) Note: See explanatory note IN.2.2 for claiming restrictions for this item. (Anaes.) | $808.10 75% benefit $606.10 85% benefit $699.60 was $703.60 |
| 57362 | Cone beam computed tomography—dental and temporo mandibular joint imaging (without contrast medium) for diagnosis and management of any of the following:(a) mandibular and dento alveolar fractures;(b) dental implant planning;(c) orthodontics;(d) endodontic conditions;(e) periodontal conditions;(f) temporo mandibular joint conditionsApplicable once per patient per day, not being for a service to which any of items 57960 to 57969 apply, and not being a service associated with another service in Group I2 (R) (Anaes.) | $130.65 75% benefit $98.00 85% benefit $111.10 |
| 57364 | New 85% benefit on 1 November 2026Note: the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.3 (item 38247), TR.8.2 (item 38249) or item 38252 if subclause (iv) applies. Computed tomography of the coronary arteries performed on a minimum of a 64 slice (or equivalent) scanner, if: (a) the service is requested by a specialist or consultant physician; and (b) at least one of the following apply to the patient: (i) the patient has stable symptoms and newly recognised left ventricular systolic dysfunction of unknown aetiology; (ii) the patient requires exclusion of coronary artery anomaly or fistula; (iii) the patient will be undergoing non-coronary cardiac surgery; (iv) the patient meets the criteria to be eligible for a service to which item 38247, 38249 or 38252 applies, but as an alternative to selective coronary angiography will require an assessment of the patency of one or more bypass grafts (R) (Anaes.) | $808.10 75% benefit $606.10 85% benefit $699.60 was $703.60 |
| 57410 | Low-dose computed tomography (low-dose CT) scan of chest for the National Lung Cancer Screening Program, without intravenous contrast medium, where: (a) the request states that the patient’s eligibility to participate in the National Lung Cancer Screening Program has been assessed and confirmed; and (b) the service utilises the agreed nodule management protocol for standardised lung nodule identification, classification and reporting; and (c) the service is bulk-billed (R) (Anaes.) | $347.55 75% benefit $260.70 85% benefit $295.45 |
| 57413 | Low-dose computed tomography (low-dose CT) scan of chest for the National Lung Cancer Screening Program, without intravenous contrast medium, where: (a) the service is: (i) performed as a clinical follow-up within 2 years of a screening low-dose CT scan of MBS item 57410; or (ii) performed as a clinical follow-up to a previous interval low-dose CT scan of MBS item 57413 linked to MBS item 57410; and (b) the service utilises the agreed nodule management protocol for standardised lung nodule identification, classification and reporting; and (c) the service is bulk-billed (R) (Anaes.) | $347.55 75% benefit $260.70 85% benefit $295.45 |
I3 Diagnostic Radiology
124 items
| Item | Description | Fee and benefits |
|---|---|---|
| 57506 | Hand, wrist, forearm, elbow or humerus (NR) | $35.05 75% benefit $26.30 85% benefit $29.80 |
| 57509 | Hand, wrist, forearm, elbow or humerus (R) | $46.80 75% benefit $35.10 85% benefit $39.80 |
| 57512 | Hand and wrist, or hand, wrist and forearm, or wrist and forearm, or forearm and elbow, or elbow and humerus (NR) | $47.65 75% benefit $35.75 85% benefit $40.55 |
| 57515 | Hand and wrist, or hand, wrist and forearm, or wrist and forearm, or forearm and elbow, or elbow and humerus (R) | $63.60 75% benefit $47.70 85% benefit $54.10 |
| 57518 | Foot, ankle, leg or femur (NR) | $38.35 75% benefit $28.80 85% benefit $32.60 |
| 57521 | Foot, ankle, leg or femur (R) | $51.15 75% benefit $38.40 85% benefit $43.50 |
| 57522 | Knee (NR) | $38.35 75% benefit $28.80 85% benefit $32.60 |
| 57523 | Knee (R) | $51.15 75% benefit $38.40 85% benefit $43.50 |
| 57524 | Foot and ankle, or ankle and leg, or leg and knee, or knee and femur (NR) | $58.15 75% benefit $43.65 85% benefit $49.45 |
| 57527 | Foot and ankle, or ankle and leg, or leg and knee, or knee and femur (R) | $77.45 75% benefit $58.10 85% benefit $65.85 |
| 57541 | Fee for a service rendered using first eligible x-ray procedure carried out during attendance at a residential aged care facility, where the service has been requested by a medical practitioner or a participating nurse practitioner who has attended the patient in person and the request identifies one or more of the following indications: the patient has experienced a fall and one or more of the following items apply to the service 57509, 57515, 57521, 57527, 57703, 57709, 57712, 57715, 58521, 58524, 58527; or pneumonia or heart failure is suspected and item 58503 applies to the service; or acute abdomen or bowel obstruction is suspected and item 58903 applies to the service. This call-out fee can be claimed once only per visit at a residential aged care facility irrespective of the number of patients attended. NOTE: If the service is bulked billed 95% of the fee is payable. The multiple services rule does not apply to this item. (R) | $86.75 85% benefit $73.75 |
| 57700 | Shoulder or scapula (NR) | $47.65 75% benefit $35.75 85% benefit $40.55 |
| 57703 | Shoulder or scapula (R) | $63.60 75% benefit $47.70 85% benefit $54.10 |
| 57706 | Clavicle (NR) | $38.35 75% benefit $28.80 85% benefit $32.60 |
| 57709 | Clavicle (R) | $51.15 75% benefit $38.40 85% benefit $43.50 |
| 57712 | Hip joint (R) | $55.50 75% benefit $41.65 85% benefit $47.20 |
| 57715 | Pelvic girdle (R) | $71.75 75% benefit $53.85 85% benefit $61.00 |
| 57721 | Femur, internal fixation of neck or intertrochanteric (pertrochanteric) fracture (R) | $116.90 75% benefit $87.70 85% benefit $99.40 |
| 57901 | Skull, not in association with item 57902 (R) | $76.00 75% benefit $57.00 85% benefit $64.60 |
| 57902 | Cephalometry, not in association with item 57901 (R) | $76.00 75% benefit $57.00 85% benefit $64.60 |
| 57905 | Mastoids or petrous temporal bones (R) | $76.00 75% benefit $57.00 85% benefit $64.60 |
| 57907 | Sinuses or facial bones – orbit, maxilla or malar, any or all (R) | $55.70 75% benefit $41.80 85% benefit $47.35 |
| 57915 | Mandible, not by orthopantomography technique (R) | $55.50 75% benefit $41.65 85% benefit $47.20 |
| 57918 | Salivary calculus (R) | $55.50 75% benefit $41.65 85% benefit $47.20 |
| 57921 | Nose (R) | $55.50 75% benefit $41.65 85% benefit $47.20 |
| 57924 | Eye (R) | $55.50 75% benefit $41.65 85% benefit $47.20 |
| 57927 | Temporo mandibular joints (R) | $58.50 75% benefit $43.90 85% benefit $49.75 |
| 57930 | Teeth—single area (R) | $38.85 75% benefit $29.15 85% benefit $33.05 |
| 57933 | Teeth - full mouth (R) | $92.15 75% benefit $69.15 85% benefit $78.35 |
| 57939 | Palato pharyngeal studies with fluoroscopic screening (R) | $76.00 75% benefit $57.00 85% benefit $64.60 |
| 57942 | Palato pharyngeal studies without fluoroscopic screening (R) | $58.50 75% benefit $43.90 85% benefit $49.75 |
| 57945 | Larynx, lateral airways and soft tissues of the neck, not being a service associated with a service to which item 57939 or 57942 applies (R) | $51.15 75% benefit $38.40 85% benefit $43.50 |
| 57960 | Orthopantomography for diagnosis or management (or both) of trauma, infection, tumour or a congenital or surgical condition of the teeth or maxillofacial region (R) | $55.90 75% benefit $41.95 85% benefit $47.55 |
| 57963 | Orthopantomography for diagnosis or management (or both) of any of the following conditions, if the signs and symptoms of the condition is present:(a) impacted teeth;(b) caries;(c) periodontal pathology;(d) periapical pathology (R) | $55.90 75% benefit $41.95 85% benefit $47.55 |
| 57966 | Orthopantomography for diagnosis or management (or both) of missing or crowded teeth, or developmental anomalies of the teeth or jaws (R) | $55.90 75% benefit $41.95 85% benefit $47.55 |
| 57969 | Orthopantomography for diagnosis or management (or both) of temporo mandibular joint arthroses or dysfunction (R) | $55.90 75% benefit $41.95 85% benefit $47.55 |
| 58100 | Spine—cervical (R) | $79.05 75% benefit $59.30 85% benefit $67.20 |
| 58103 | Spine—thoracic (R) | $64.95 75% benefit $48.75 85% benefit $55.25 |
| 58106 | Spine—lumbosacral (R) | $90.65 75% benefit $68.00 85% benefit $77.10 |
| 58108 | Spine—4 regions, cervical, thoracic, lumbosacral and sacrococcygeal (R) | $129.55 75% benefit $97.20 85% benefit $110.15 |
| 58109 | Spine—sacrococcygeal (R) | $55.35 75% benefit $41.55 85% benefit $47.05 |
| 58112 | Spine—2 examinations of the kind mentioned in items 58100, 58103, 58106 and 58109 (R) | $114.55 75% benefit $85.95 85% benefit $97.40 |
| 58115 | Spine—3 examinations of the kind mentioned in items 58100, 58103, 58106 and 58109 (R) | $129.55 75% benefit $97.20 85% benefit $110.15 |
| 58120 | Spine—4 regions, cervical, thoracic, lumbosacral and sacrococcygeal, if the service to which item 58120 or 58121 applies has not been performed on the same patient within the same calendar year (R) | $129.55 75% benefit $97.20 85% benefit $110.15 |
| 58121 | Spine—3 examinations of the kind mentioned in items 58100, 58103, 58106 and 58109, if the service to which item 58120 or 58121 applies has not been performed on the same patient within the same calendar year (R) | $129.55 75% benefit $97.20 85% benefit $110.15 |
| 58300 | Bone age study (R) | $47.20 75% benefit $35.40 85% benefit $40.15 |
| 58306 | Skeletal survey (R) | $105.30 75% benefit $79.00 85% benefit $89.55 |
| 58500 | Chest (lung fields) by direct radiography (NR) | $41.65 75% benefit $31.25 85% benefit $35.45 |
| 58503 | Chest (lung fields) by direct radiography (R) | $55.50 75% benefit $41.65 85% benefit $47.20 |
| 58506 | Chest (lung fields) by direct radiography with fluoroscopic screening (R) | $71.60 75% benefit $53.70 85% benefit $60.90 |
| 58509 | Thoracic inlet or trachea (R) | $46.80 75% benefit $35.10 85% benefit $39.80 |
| 58521 | Left ribs, right ribs or sternum (R) | $51.15 75% benefit $38.40 85% benefit $43.50 |
| 58524 | Left and right ribs, left ribs and sternum, or right ribs and sternum (R) | $66.55 75% benefit $49.95 85% benefit $56.60 |
| 58527 | Left ribs, right ribs and sternum (R) | $81.75 75% benefit $61.35 85% benefit $69.50 |
| 58700 | Plain renal only (R) | $54.20 75% benefit $40.65 85% benefit $46.10 |
| 58706 | Intravenous pyelography, with or without preliminary plain films and with or without tomography (R) | $186.00 75% benefit $139.50 85% benefit $158.10 |
| 58715 | Antegrade or retrograde pyelography with or without preliminary plain films and with preparation and contrast injection, one side (R) | $178.60 75% benefit $133.95 85% benefit $151.85 |
| 58718 | Retrograde cystography or retrograde urethrography with or without preliminary plain films and with preparation and contrast injection (R) (Anaes.) | $148.55 75% benefit $111.45 85% benefit $126.30 |
| 58721 | Retrograde micturating cysto urethrography, with preparation and contrast injection (R) (Anaes.) | $162.85 75% benefit $122.15 85% benefit $138.45 |
| 58900 | Plain abdominal only, not being a service associated with a service to which item 58909, 58912 or 58915 applies (NR) | $42.10 75% benefit $31.60 85% benefit $35.80 |
| 58903 | Plain abdominal only, not being a service associated with a service to which item 58909, 58912 or 58915 applies (R) | $56.10 75% benefit $42.10 85% benefit $47.70 |
| 58909 | Barium or other opaque meal of one or more of pharynx, oesophagus, stomach or duodenum, with or without preliminary plain films of pharynx, chest or duodenum, not being a service associated with a service to which item 57939, 57942 or 57945 applies (R) | $105.90 75% benefit $79.45 85% benefit $90.05 |
| 58912 | Barium or other opaque meal of oesophagus, stomach, duodenum and follow through to colon, with or without screening of chest and with or without preliminary plain film (R) | $129.90 75% benefit $97.45 85% benefit $110.45 |
| 58915 | Barium or other opaque meal, small bowel series only, with or without preliminary plain film (R) | $93.05 75% benefit $69.80 85% benefit $79.10 |
| 58916 | Small bowel enema, barium or other opaque study of the small bowel, including duodenal intubation, with or without preliminary plain films, not being a service associated with a service to which item 30488 applies (R) (Anaes.) | $163.20 75% benefit $122.40 85% benefit $138.75 |
| 58921 | Opaque enema, with or without air contrast study and with or without preliminary plain films (R) | $159.40 75% benefit $119.55 85% benefit $135.50 |
| 58927 | Cholegraphy direct, with or without preliminary plain films and with preparation and contrast injection, not being a service associated with a service to which item 30439 applies (R) | $90.05 75% benefit $67.55 85% benefit $76.55 |
| 58933 | Cholegraphy, percutaneous transhepatic, with or without preliminary plain films and with preparation and contrast injection (R) | $242.25 75% benefit $181.70 85% benefit $205.95 |
| 58936 | Cholegraphy, drip infusion, with or without preliminary plain films, with preparation and contrast injection and with or without tomography (R) | $230.85 75% benefit $173.15 85% benefit $196.25 |
| 58939 | Defaecogram (R) | $164.10 75% benefit $123.10 85% benefit $139.50 |
| 59103 | Localisation of foreign body, if provided in conjunction with a service described in Subgroups 1 to 12 of Group I3 (R) | $25.05 75% benefit $18.80 85% benefit $21.30 |
| 59300 | Mammography of both breasts if there is reason to suspect the presence of malignancy because of:(a) the past occurrence of breast malignancy in the patient; or(b) significant history of breast or ovarian malignancy in the patient’s family; or(c) symptoms or indications of breast disease found on examination of the patient by a medical practitioner (R) (Note: These items are intended for use in the investigation of a clinical abnormality of the breast/s and NOT for individual, group or opportunistic screening of asymptomatic patients) | $105.40 75% benefit $79.05 85% benefit $89.60 |
| 59302 | Three dimensional tomosynthesis of both breasts, if there is reason to suspect the presence of breast malignancy because of: (a) the past occurrence of breast malignancy in the patient; or(b) significant history of breast or ovarian malignancy in the patient’s family; or(c) symptoms or signs found on examination of the patient by a medical practitioner; not being a service to which item 59300 applies (R) | $238.00 75% benefit $178.50 85% benefit $202.30 |
| 59303 | Mammography of one breast if: (a) the service is specifically requested for a unilateral mammogram; and(b) there is reason to suspect the presence of malignancy because of:(i) the past occurrence of breast malignancy in the patient; or(ii) significant history of breast or ovarian malignancy in the patient’s family; or(iii) symptoms or indications of breast disease found on examination of the patient by a medical practitioner (R) | $63.55 75% benefit $47.70 85% benefit $54.05 |
| 59305 | Three dimensional tomosynthesis of one breast, if there is reason to suspect the presence of breast malignancy because of: (a) the past occurrence of breast malignancy in the patient; or(b) significant history of breast or ovarian malignancy in the patient’s family; or(c) symptoms or signs found on examination of the patient by a medical practitioner; not being a service to which item 59303 applies (R) | $134.20 75% benefit $100.65 85% benefit $114.10 |
| 59312 | Radiographic examination of both breasts, in conjunction with a surgical procedure on each breast, using interventional techniques (R) | $102.50 75% benefit $76.90 85% benefit $87.15 |
| 59314 | Radiographic examination of one breast, in conjunction with a surgical procedure using interventional techniques (R) | $61.85 75% benefit $46.40 85% benefit $52.60 |
| 59318 | Radiographic examination of excised breast tissue to confirm satisfactory excision of one or more lesions in one breast or both following pre-operative localisation in conjunction with a service under item 31536 (R) | $55.40 75% benefit $41.55 85% benefit $47.10 |
| 59700 | Discography, each disc, with or without preliminary plain films and with preparation and contrast injection (R) (Anaes.) | $113.75 75% benefit $85.35 85% benefit $96.70 |
| 59703 | Dacryocystography, one side, with or without preliminary plain film and with preparation and contrast injection (R) | $89.45 75% benefit $67.10 85% benefit $76.05 |
| 59712 | Hysterosalpingography, with or without preliminary plain films and with preparation and contrast injection (R) (Anaes.) | $133.90 75% benefit $100.45 85% benefit $113.85 |
| 59715 | Bronchography, one side, with or without preliminary plain films and with preparation and contrast injection, on a person under 16 years of age (R) (Anaes.) | $169.10 75% benefit $126.85 85% benefit $143.75 |
| 59718 | Phlebography, one side, with or without preliminary plain films and with preparation and contrast injection (R) (Anaes.) | $158.60 75% benefit $118.95 85% benefit $134.85 |
| 59724 | Myelography, one or more regions, with or without preliminary plain films and with preparation and contrast injection, not being a service associated with a service to which item 56219 applies (R) (Anaes.) | $266.75 75% benefit $200.10 85% benefit $226.75 |
| 59733 | Sialography, one side, with preparation and contrast injection, not being a service associated with a service to which item 57918 applies (R) | $126.90 75% benefit $95.20 85% benefit $107.90 |
| 59739 | Sinogram or fistulogram, one or more regions, with or without preliminary plain films and with preparation and contrast injection (R) | $86.85 75% benefit $65.15 85% benefit $73.85 |
| 59751 | Arthrography, each joint, excluding the facet (zygapophyseal) joints of the spine, single or double contrast study, with or without preliminary plain films and with preparation and contrast injection (R) | $163.95 75% benefit $123.00 85% benefit $139.40 |
| 59754 | Lymphangiography, one or both sides, with preliminary plain films and follow-up radiography and with preparation and contrast injection (R) | $258.40 75% benefit $193.80 85% benefit $219.65 |
| 59763 | Air insufflation during video—fluoroscopic imaging including associated consultation (R) | $157.65 75% benefit $118.25 85% benefit $134.05 |
| 59970 | Angiography or digital subtraction angiography, or both, with fluoroscopy and image acquisition, using a mobile image intensifier, including any preliminary plain films, preparation and contrast injection—one or more regions (R) (H) (Anaes.) | $198.25 75% benefit $148.70 |
| 60000 | Digital subtraction angiography, examination of head and neck with or without arch aortography—1 to 3 data acquisition runs (R) (H) (Anaes.) | $664.50 75% benefit $498.40 |
| 60003 | Digital subtraction angiography, examination of head and neck with or without arch aortography—4 to 6 data acquisition runs (R) (H) (Anaes.) | $974.35 75% benefit $730.80 |
| 60006 | Digital subtraction angiography, examination of head and neck with or without arch aortography—7 to 9 data acquisition runs (R) (H) (Anaes.) | $1,385.50 75% benefit $1,039.15 |
| 60009 | Digital subtraction angiography, examination of head and neck with or without arch aortography—10 or more data acquisition runs (R) (H) (Anaes.) | $1,621.35 75% benefit $1,216.05 |
| 60012 | Digital subtraction angiography, examination of thorax—1 to 3 data acquisition runs (R) (H) (Anaes.) | $664.50 75% benefit $498.40 |
| 60015 | Digital subtraction angiography, examination of thorax—4 to 6 data acquisition runs (R) (H) (Anaes.) | $974.35 75% benefit $730.80 |
| 60018 | Digital subtraction angiography, examination of thorax—7 to 9 data acquisition runs (R) (H) (Anaes.) | $1,385.50 75% benefit $1,039.15 |
| 60021 | Digital subtraction angiography, examination of thorax—10 or more data acquisition runs (R) (H) (Anaes.) | $1,621.35 75% benefit $1,216.05 |
| 60024 | Digital subtraction angiography, examination of abdomen—1 to 3 data acquisition runs (R) (H) (Anaes.) | $664.50 75% benefit $498.40 |
| 60027 | Digital subtraction angiography, examination of abdomen—4 to 6 data acquisition runs (R) (H) (Anaes.) | $974.35 75% benefit $730.80 |
| 60030 | Digital subtraction angiography, examination of abdomen—7 to 9 data acquisition runs (R) (H) (Anaes.) | $1,385.50 75% benefit $1,039.15 |
| 60033 | Digital subtraction angiography, examination of abdomen—10 or more data acquisition runs (R) (H) (Anaes.) | $1,621.35 75% benefit $1,216.05 |
| 60036 | Digital subtraction angiography, examination of upper limb or limbs—1 to 3 data acquisition runs (R) (H) (Anaes.) | $664.50 75% benefit $498.40 |
| 60039 | Digital subtraction angiography, examination of upper limb or limbs—4 to 6 data acquisition runs (R) (H) (Anaes.) | $974.35 75% benefit $730.80 |
| 60042 | Digital subtraction angiography, examination of upper limb or limbs—7 to 9 data acquisition runs (R) (H) (Anaes.) | $1,385.50 75% benefit $1,039.15 |
| 60045 | Digital subtraction angiography, examination of upper limb or limbs—10 or more data acquisition runs (R) (H) (Anaes.) | $1,621.35 75% benefit $1,216.05 |
| 60048 | Digital subtraction angiography, examination of lower limb or limbs—1 to 3 data acquisition runs (R) (H) (Anaes.) | $664.50 75% benefit $498.40 |
| 60051 | Digital subtraction angiography, examination of lower limb or limbs—4 to 6 data acquisition runs (R) (H) (Anaes.) | $974.35 75% benefit $730.80 |
| 60054 | Digital subtraction angiography, examination of lower limb or limbs—7 to 9 data acquisition runs (R) (H) (Anaes.) | $1,385.50 75% benefit $1,039.15 |
| 60057 | Digital subtraction angiography, examination of lower limb or limbs—10 or more data acquisition runs (R) (H) (Anaes.) | $1,621.35 75% benefit $1,216.05 |
| 60060 | Digital subtraction angiography, examination of aorta and lower limb or limbs—1 to 3 data acquisition runs (R) (H) (Anaes.) | $664.50 75% benefit $498.40 |
| 60063 | Digital subtraction angiography, examination of aorta and lower limb or limbs—4 to 6 data acquisition runs (R) (H) (Anaes.) | $974.35 75% benefit $730.80 |
| 60066 | Digital subtraction angiography, examination of aorta and lower limb or limbs—7 to 9 data acquisition runs (R) (H) (Anaes.) | $1,385.50 75% benefit $1,039.15 |
| 60069 | Digital subtraction angiography, examination of aorta and lower limb or limbs—10 or more data acquisition runs (R) (H) (Anaes.) | $1,621.35 75% benefit $1,216.05 |
| 60072 | Selective arteriography or selective venography by digital subtraction angiography technique—one vessel (NR) (H) (Anaes.) | $56.65 75% benefit $42.50 |
| 60075 | Selective arteriography or selective venography by digital subtraction angiography technique—2 vessels (NR) (H) (Anaes.) | $113.25 75% benefit $84.95 |
| 60078 | Selective arteriography or selective venography by digital subtraction angiography technique—3 or more vessels (NR) (H) (Anaes.) | $169.90 75% benefit $127.45 |
| 60500 | Fluoroscopy, with general anaesthesia (not being a service associated with a radiographic examination) (R) (H) (Anaes.) | $51.15 75% benefit $38.40 |
| 60503 | Fluoroscopy, without general anaesthesia (not being a service associated with a radiographic examination) (R) | $35.05 75% benefit $26.30 85% benefit $29.80 |
| 60506 | Fluoroscopy, using a mobile image intensifier, that: (a) lasts less than 1 hour; and (b) is in conjunction with a surgical procedure; not being a service associated with a service to which another item in this Group applies (R) (H) | $75.10 75% benefit $56.35 |
| 60509 | Fluoroscopy, using a mobile image intensifier, that: (a) lasts 1 hour or more; and (b) is in conjunction with a surgical procedure; not being a service associated with a service to which another item in this Group applies (R) (H) | $116.50 75% benefit $87.40 |
| 60918 | Arteriography (peripheral) or phlebography—one vessel, when used in association with a service to which item 59970 applies, not being a service associated with a service to which any of items 60000 to 60078 apply (NR) (Anaes.) | $55.50 75% benefit $41.65 85% benefit $47.20 |
| 60927 | Selective arteriogram or phlebogram, when used in association with a service to which item 59970 applies, not being a service associated with a service to which any of items 60000 to 60078 apply (NR) (Anaes.) | $44.75 75% benefit $33.60 85% benefit $38.05 |
| 61109 | Fluoroscopy in an angiography suite with image intensification, in conjunction with a surgical procedure using interventional techniques, not being a service associated with a service to which another item in this Group applies (R) (H) | $305.00 75% benefit $228.75 |
I4 Nuclear Medicine Imaging
102 items
| Item | Description | Fee and benefits |
|---|---|---|
| 61310 | Myocardial infarct avid study (R) | $399.35 75% benefit $299.55 85% benefit $339.45 |
| 61313 | Gated cardiac blood pool study, (equilibrium) (R) | $329.85 75% benefit $247.40 85% benefit $280.40 |
| 61314 | Gated cardiac blood pool study, with or without intervention, and first pass blood flow or cardiac shunt study (R) | $456.70 75% benefit $342.55 85% benefit $388.20 |
| 61321 | Single rest myocardial perfusion study for the assessment of the extent and severity of viable and non‑viable myocardium, with single photon emission tomography, with or without planar imaging, if: (a) the patient has left ventricular systolic dysfunction and probable or confirmed coronary artery disease; and (b) the service uses a single rest technetium‑99m (Tc‑99m) protocol; and (c) the service is requested by a specialist or a consultant physician; and (d) the service is not associated with a service to which item 11704, 11705, 11707, 11714, 11729, 11730, 61325, 61329, 61345, 61398 or 61406 applies; and (e) if the patient is 17 years or older—a service to which this item, or item 61325, 61329, 61345, 61398 or 61406 applies has not been provided to the patient in the previous 24 months (R) | $357.70 75% benefit $268.30 85% benefit $304.05 |
| 61324 | New 85% benefit on 1 November 2026Single stress myocardial perfusion study, with single photon emission tomography, with or without planar imaging, if: (a) the patient has symptoms of cardiac ischaemia; and (b) at least one of the following applies: (i) the patient has body habitus or other physical conditions (including heart rhythm disturbance) to the extent that a stress echocardiography would not provide adequate information; (ii) the patient is unable to exercise to the extent required for a stress echocardiography to provide adequate information; (iii) the patient has had a failed stress echocardiography provided in a service to which item 55141, 55143, 55145 or 55146 applies; and (c) the service includes resting ECG, continuous ECG monitoring during exercise (with recording), blood pressure monitoring and the recording of other parameters (including heart rate); and (d) the service is requested by a specialist or consultant physician; and (e) the service is not associated with a service to which item 11704, 11705, 11707, 11714, 11729, 11730, 61321, 61325, 61329, 61345, 61357, 61394, 61398, 61406 or 61414 applies; and (f) if the patient is 17 years or older—a service to which this item, or item 61329, 61345, 61357, 61394, 61398, 61406, 61410 or 61414, applies has not been provided to the patient in the previous 24 months (R) | $710.10 75% benefit $532.60 85% benefit $603.60 was $605.60 |
| 61325 | New 85% benefit on 1 November 2026Single rest myocardial perfusion study for the assessment of the extent and severity of viable and non‑viable myocardium, with single photon emission tomography, with or without planar imaging, if: (a) the patient has left ventricular systolic dysfunction and probable or confirmed coronary artery disease; and (b) the service uses: (i) an initial rest study followed by a redistribution study on the same day; and (ii) a thallous chloride‑201 (Tl‑201) protocol; and (c) the service is requested by a specialist or a consultant physician; and (d) the service is not associated with a service to which item 11704, 11705, 11707, 11714, 11729, 11730, 61321, 61329, 61345, 61398 or 61406 applies; and (e) if the patient is 17 years or older: (i) a service to which item 61321, 61329, 61345, 61398 or 61406 applies has not been provided to the patient in the previous 24 months; and (ii) the service is applicable only twice each 24 months (R) | $1,949.45 75% benefit $1,462.10 85% benefit $1,840.95 was $1,844.95 |
| 61328 | Lung perfusion study (R) | $247.50 75% benefit $185.65 85% benefit $210.40 |
| 61329 | New 85% benefit on 1 November 2026Combined stress and rest, stress and re‑injection or rest and redistribution myocardial perfusion study, including delayed imaging or re‑injection protocol on a subsequent occasion, with single photon emission tomography, with or without planar imaging, if: (a) the patient has symptoms of cardiac ischaemia; and (b) at least one of the following applies: (i) the patient has body habitus or other physical conditions (including heart rhythm disturbance) to the extent that a stress echocardiography would not provide adequate information; (ii) the patient is unable to exercise to the extent required for a stress echocardiography to provide adequate information; (iii) the patient has had a failed stress echocardiography provided in a service to which item 55141, 55143, 55145 or 55146 applies; and (c) the service includes resting electrocardiograph, continuous electrocardiograph monitoring during exercise (with recording), blood pressure monitoring and the recording of other parameters (including heart rate); and (d) the service is requested by a medical practitioner (other than a specialist or consultant physician); and (e) the service is not associated with a service to which item 11704, 11705, 11707, 11714, 11729, 11730, 61321, 61324, 61325, 61345, 61357, 61394, 61398, 61406 or 61414 applies; and (f) if the patient is 17 years or older—a service to which this item, or item 61321, 61324, 61325, 61345, 61357, 61394, 61398, 61406 or 61414, applies has not been provided to the patient in the previous 24 months (R) | $1,067.85 75% benefit $800.90 85% benefit $959.35 was $963.35 |
| 61333 | Lung ventilation study using Galligas and lung perfusion study using gallium-68 macro aggregated albumin (68Ga-MAA), with PET, if the service is performed because the service to which item 61348 applies cannot be performed due to unavailability of technetium-99m (R) | $443.35 75% benefit $332.55 85% benefit $376.85 |
| 61336 | Cerebral study, with PET, if the service is performed because the service to which item 61402 applies cannot be performed due to unavailability of technetium-99m (R) | $605.05 75% benefit $453.80 85% benefit $514.30 |
| 61340 | Lung ventilation study using aerosol, technegas or xenon gas (R) | $275.10 75% benefit $206.35 85% benefit $233.85 |
| 61341 | Bone study – whole body with PET, with delayed imaging when undertaken, if the service is performed because the services to which item 61421 or 61425 apply cannot be performed due to unavailability of technetium-99m (R) | $600.70 75% benefit $450.55 85% benefit $510.60 |
| 61345 | New 85% benefit on 1 November 2026Combined stress and rest, stress and re‑injection or rest and redistribution myocardial perfusion study, including delayed imaging or re‑injection protocol on a subsequent occasion, with single photon emission tomography, with or without planar imaging, if: (a) the patient has symptoms of cardiac ischaemia; and (b) at least one of the following applies: (i) the patient has body habitus or other physical conditions (including heart rhythm disturbance) to the extent that a stress echocardiography would not provide adequate information; (ii) the patient is unable to exercise to the extent required for a stress echocardiography to provide adequate information; (iii) the patient has had a failed stress echocardiography provided in a service to which item 55141, 55143, 55145 or 55146 applies; and (c) the service includes resting electrocardiograph, continuous electrocardiograph monitoring during exercise (with recording), blood pressure monitoring and the recording of other parameters (including heart rate); and (d) the service is requested by a specialist or consultant physician; and (e) the service is not associated with a service to which item 11704, 11705, 11707, 11714, 11729, 11730, 61321, 61324, 61325, 61329, 61357, 61394, 61398, 61406 or 61414 applies (R); and (f) if the patient is 17 years or older—a service to which this item, or item 61321, 61324, 61325, 61329, 61357, 61394, 61398, 61406 or 61414, applies has not been provided to the patient in the previous 24 months (R) | $1,067.85 75% benefit $800.90 85% benefit $959.35 was $963.35 |
| 61348 | Lung perfusion study and lung ventilation study using aerosol, technegas or xenon gas (R) | $482.05 75% benefit $361.55 85% benefit $409.75 |
| 61349 | New 85% benefit on 1 November 2026Repeat combined stress and rest, stress and re‑injection or rest and redistribution myocardial perfusion study, including delayed imaging or re‑injection protocol on a subsequent occasion, with single photon emission tomography, with or without planar imaging, if: (a) both: (i) a service has been provided to the patient in the previous 24 months to which this item, or item 61324, 61329, 61345, 61357, 61394, 61398, 61406, 61410 or 61414 applies; and (ii) the patient has subsequently undergone a revascularisation procedure; and (b) the patient has one or more symptoms of cardiac ischaemia that have evolved and are not adequately controlled with optimal medical therapy; and (c) at least one of the following applies: (i) the patient has body habitus or other physical conditions (including heart rhythm disturbance) to the extent that a stress echocardiography would not provide adequate information; (ii) the patient is unable to exercise to the extent required for a stress echocardiography to provide adequate information; (iii) the patient has had a failed stress echocardiography provided in a service to which item 55141, 55143, 55145 or 55146 applies; and (d) the service is requested by a specialist or a consultant physician; and (e) the service is not associated with a service to which item 11704, 11705, 11707, 11714, 11729, 11730 or 61410 applies; and (f) if the patient is 17 years or older—a service to which this item, or item 61410, applies has not been provided to the patient in the previous 12 months (R) | $1,067.85 75% benefit $800.90 85% benefit $959.35 was $963.35 |
| 61353 | Liver and spleen study (colloid) (R) | $420.40 75% benefit $315.30 85% benefit $357.35 |
| 61356 | Red blood cell spleen or liver study (R) | $427.10 75% benefit $320.35 85% benefit $363.05 |
| 61357 | New 85% benefit on 1 November 2026Single stress myocardial perfusion study, with single photon emission tomography, with or without planar imaging, if: (a) the patient has symptoms of cardiac ischaemia; and (b) at least one of the following applies: (i) the patient has body habitus or other physical conditions (including heart rhythm disturbance) to the extent that a stress echocardiography would not provide adequate information; (ii) the patient is unable to exercise to the extent required for a stress echocardiography to provide adequate information; (iii) the patient has had a failed stress echocardiography provided in a service to which items 55141, 55143, 55145 or 55146 applies; and (c) the service includes resting electrocardiograph, continuous electrocardiograph monitoring during exercise (with recording), blood pressure monitoring and the recording of other parameters (including heart rate); and (d) the service is requested by a medical practitioner (other than a specialist or consultant physician); and (e) the service is not associated with a service to which item 11704, 11705, 11707, 11714, 11729, 11730, 61321, 61324, 61325, 61329, 61345, 61394, 61398, 61406 or 61414 applies; and (f) if the patient is 17 years or older—a service to which this item, or item 61324, 61329, 61345, 61394, 61398, 61406, or 61414, applies has not been provided to the patient in the previous 24 months (R) | $710.10 75% benefit $532.60 85% benefit $603.60 was $605.60 |
| 61360 | Hepatobiliary study, including morphine administration or pre-treatment with a cholagogue when performed (R) | $438.55 75% benefit $328.95 85% benefit $372.80 |
| 61361 | Hepatobiliary study with formal quantification following baseline imaging, using a cholagogue (R) | $501.70 75% benefit $376.30 85% benefit $426.45 |
| 61364 | Bowel haemorrhage study (R) | $540.40 75% benefit $405.30 85% benefit $459.35 |
| 61368 | Meckel’s diverticulum study (R) | $242.60 75% benefit $181.95 85% benefit $206.25 |
| 61369 | New 85% benefit on 1 November 2026Indium-labelled octreotide study (including single photon emission tomography when undertaken), if:(a) a gastro-entero-pancreatic endocrine tumour is suspected on the basis of biochemical evidence with negative or equivocal conventional imaging; or(b) both:(i) a surgically amenable gastro-entero-pancreatic endocrine tumour has been identified on the basis of conventional techniques; and(ii) the study is to exclude additional disease sites (R) | $2,191.90 75% benefit $1,643.95 85% benefit $2,083.40 was $2,087.40 |
| 61372 | Salivary study (R) | $242.60 75% benefit $181.95 85% benefit $206.25 |
| 61373 | Gastro-oesophageal reflux study, including delayed imaging on a separate occasion when performed (R) | $532.50 75% benefit $399.40 85% benefit $452.65 |
| 61376 | Oesophageal clearance study (R) | $155.85 75% benefit $116.90 85% benefit $132.50 |
| 61381 | Gastric emptying study, using single tracer (R) | $624.55 75% benefit $468.45 85% benefit $530.90 |
| 61383 | Combined solid and liquid gastric emptying study using dual isotope technique or the same isotope on separate days (R) | $679.50 75% benefit $509.65 85% benefit $577.60 |
| 61384 | New 85% benefit on 1 November 2026Radionuclide colonic transit study (R) | $747.80 75% benefit $560.85 85% benefit $639.30 was $643.30 |
| 61386 | Renal study, including perfusion and renogram images and computer analysis or cortical study with planar imaging (R) | $361.55 75% benefit $271.20 85% benefit $307.35 |
| 61387 | Renal cortical study, with single photon emission tomography and planar quantification (R) | $468.40 75% benefit $351.30 85% benefit $398.15 |
| 61389 | Single renal study with pre-procedural administration of a diuretic or angiotensin converting enzyme (ACE) inhibitor (R) | $402.90 75% benefit $302.20 85% benefit $342.50 |
| 61390 | Renal study with diuretic administration after a baseline study (R) | $445.80 75% benefit $334.35 85% benefit $378.95 |
| 61393 | Combined examination involving a renal study following angiotensin converting enzyme (ACE) inhibitor provocation and a baseline study, in either order and related to a single referral episode (R) | $658.45 75% benefit $493.85 85% benefit $559.70 |
| 61394 | New 85% benefit on 1 November 2026Single stress myocardial perfusion study, with single photon emission tomography, with or without planar imaging, if: (a) the patient has symptoms of cardiac ischaemia; and (b) the service is provided at, or from, a practice located in a Modified Monash 3, 4, 5, 6 or 7 area; and (c) a stress echocardiography service is not available in the Modified Monash area where the service is provided; and (d) the service includes resting electrocardiograph, continuous electrocardiograph monitoring during exercise (with recording), blood pressure monitoring and the recording of other parameters (including heart rate); and (e) the service is requested by a specialist or consultant physician; and (f) the service is not associated with a service to which item 11704, 11705, 11707, 11714, 11729, 11730, 61321, 61324, 61325, 61329, 61345, 61357, 61398, 61406 or 61414 applies; and (g) if the patient is 17 years or older—a service to which this item, or item 61324, 61329, 61345, 61357, 61398, 61406 or 61414, applies has not been provided to the patient in the previous 24 months (R) | $710.10 75% benefit $532.60 85% benefit $603.60 was $605.60 |
| 61397 | Cystoureterogram (R) | $268.45 75% benefit $201.35 85% benefit $228.20 |
| 61398 | New 85% benefit on 1 November 2026Combined stress and rest, stress and re‑injection or rest and redistribution myocardial perfusion study, including delayed imaging or re‑injection protocol on a subsequent occasion, with single photon emission tomography, with or without planar imaging, if: (a) the patient has symptoms of cardiac ischaemia; and (b) the service is provided at, or from, a practice located in a Modified Monash 3, 4, 5, 6 or 7 area; and (c) a stress echocardiography service is not available in the Modified Monash area where the services is provided; and (d) the service includes resting electrocardiograph, continuous electrocardiograph monitoring during exercise (with recording), blood pressure monitoring and the recording of other parameters (including heart rate); and (e) the service is requested by a medical practitioner (other than a specialist or consultant physician); and (f) the service is not associated with a service to which item 11704, 11705, 11707, 11714, 11729, 11730, 61321, 61324, 61325, 61329, 61345, 61357, 61394, 61406 or 61414 applies; and (g) if the patient is 17 years or older—a service to which this item, or item 61321, 61324, 61325, 61329, 61345, 61357, 61394, 61406 or 61414, applies has not been provided to the patient in the previous 24 months (R) | $1,067.85 75% benefit $800.90 85% benefit $959.35 was $963.35 |
| 61402 | Cerebral perfusion study, with single photon emission tomography and with planar imaging when performed (R) | $657.95 75% benefit $493.50 85% benefit $559.30 |
| 61406 | New 85% benefit on 1 November 2026Combined stress and rest, stress and re‑injection or rest and redistribution myocardial perfusion study, including delayed imaging or re‑injection protocol on a subsequent occasion, with single photon emission tomography, with or without planar imaging, if: (a) the patient has symptoms of cardiac ischaemia; and (b) the service is provided at, or from, a practice located in a Modified Monash 3, 4, 5, 6 or 7 area; and (c) a stress echocardiography service is not available in the Modified Monash area where the service is provided; and (d) the service includes resting electrocardiograph, continuous electrocardiograph monitoring during exercise (with recording), blood pressure monitoring and the recording of other parameters (including heart rate); and (e) the service is requested by a specialist or consultant physician; and (f) the service is not associated with a service to which item 11704, 11705, 11707, 11714, 11729, 11730, 61321, 61324, 61325, 61329, 61345, 61357, 61394, 61398 or 61414 applies; and (g) if the patient is 17 years or older—a service to which this item, or item 61321, 61324, 61325, 61329, 61345, 61357, 61394, 61398 or 61414, applies has not been provided to the patient in the previous 24 months (R) | $1,067.85 75% benefit $800.90 85% benefit $959.35 was $963.35 |
| 61409 | New 85% benefit on 1 November 2026Cerebro-spinal fluid transport study using technetium 99m, with imaging on 2 or more separate occasions (R) | $949.80 75% benefit $712.35 85% benefit $841.30 was $845.30 |
| 61410 | New 85% benefit on 1 November 2026Repeat combined stress and rest, stress and re‑injection or rest and redistribution myocardial perfusion study, including delayed imaging or re‑injection protocol on a subsequent occasion, with single photon emission tomography, with or without planar imaging, if: (a) both: (i) a service has been provided to the patient in the previous 24 months to which this item, or item 61324, 61329, 61345, 61349, 61357, 61394, 61398, 61406 or 61414 applies; and (ii) the patient has subsequently undergone a revascularisation procedure; and (b) the patient has one or more symptoms of cardiac ischaemia that have evolved and are not adequately controlled with optimal medical therapy; and (c) the service is provided at, or from, a practice located in a Modified Monash 3, 4, 5, 6 or 7 area; and (d) a stress echocardiography service is not available in the Modified Monash area where the service is provided; and (e) the service is not associated with a service to which item 11704, 11705, 11707, 11714, 11729 or 11730 applies; and (f) if the patient is 17 years or older—a service to which item 61349 applies has not been provided to the patient in the previous 12 months | $1,067.85 75% benefit $800.90 85% benefit $959.35 was $963.35 |
| 61413 | Cerebro spinal fluid shunt patency study (R) | $245.70 75% benefit $184.30 85% benefit $208.85 |
| 61414 | New 85% benefit on 1 November 2026Single stress myocardial perfusion study, with single photon emission tomography, with or without planar imaging, if: (a) the patient has symptoms of cardiac ischaemia; and (b) the service is provided at, or from, a practice located in a Modified Monash 3, 4, 5, 6 or 7 area; and (c) a stress echocardiography service is not available in the Modified Monash area where the service is provided; and (d) the service includes resting electrocardiograph, continuous electrocardiograph monitoring during exercise (with recording), blood pressure monitoring and the recording of other parameters (including heart rate); and (e) the service is requested by a medical practitioner (other than a specialist or consultant physician); and (f) the service is not associated with a service to which item 11704, 11705, 11707, 11714, 11729, 11730, 61321, 61324, 61325, 61329, 61345, 61357, 61394, 61398 or 61406 applies; and (g) if the patient is 17 years or older—a service to which this item, or item 61324, 61329, 61345, 61357, 61398 or 61406, applies has not been provided to the patient in the previous 24 months (R) | $710.10 75% benefit $532.60 85% benefit $603.60 was $605.60 |
| 61421 | Bone study—whole body, with, when undertaken, blood flow, blood pool and delayed imaging on a separate occasion (R) | $521.70 75% benefit $391.30 85% benefit $443.45 |
| 61425 | Bone study—whole body and single photon emission tomography, with, when undertaken, blood flow, blood pool and delayed imaging on a separate occasion (R) | $653.15 75% benefit $489.90 85% benefit $555.20 |
| 61426 | Whole body study using iodine (R) | $603.30 75% benefit $452.50 85% benefit $512.85 |
| 61429 | New 85% benefit on 1 November 2026Whole body study using gallium (R) | $1,636.50 75% benefit $1,227.40 85% benefit $1,528.00 was $1,532.00 |
| 61430 | New 85% benefit on 1 November 2026Whole body study using gallium, with single photon emission tomography (R) | $1,763.20 75% benefit $1,322.40 85% benefit $1,654.70 was $1,658.70 |
| 61433 | Whole body study using cells labelled with technetium (R) | $540.40 75% benefit $405.30 85% benefit $459.35 |
| 61434 | Whole body study using cells labelled with technetium, with single photon emission tomography (R) | $669.20 75% benefit $501.90 85% benefit $568.85 |
| 61438 | New 85% benefit on 1 November 2026Whole body study using thallium (R) | $2,323.50 75% benefit $1,742.65 85% benefit $2,215.00 was $2,219.00 |
| 61441 | Bone marrow study—whole body using technetium labelled bone marrow agents (R) | $532.50 75% benefit $399.40 85% benefit $452.65 |
| 61442 | New 85% benefit on 1 November 2026Whole body study, using gallium—with single photon emission tomography of 2 or more body regions acquired separately (R) | $1,864.20 75% benefit $1,398.15 85% benefit $1,755.70 was $1,759.70 |
| 61445 | Bone marrow study—localised using technetium labelled agent (R) | $311.85 75% benefit $233.90 85% benefit $265.10 |
| 61446 | Regional scintigraphic study, using an approved bone scanning agent, including when undertaken, blood flow imaging, blood pool imaging and repeat imaging on a separate occasion (R) | $362.70 75% benefit $272.05 85% benefit $308.30 |
| 61449 | Regional scintigraphic study, using an approved bone scanning agent and single photon emission tomography, including when undertaken, blood flow imaging, blood pool imaging and repeat imaging on a separate occasion (R) | $496.05 75% benefit $372.05 85% benefit $421.65 |
| 61450 | New 85% benefit on 1 November 2026Localised study using gallium (R) | $1,478.30 75% benefit $1,108.75 85% benefit $1,369.80 was $1,373.80 |
| 61453 | New 85% benefit on 1 November 2026Localised study using gallium, with single photon emission tomography (R) | $1,605.75 75% benefit $1,204.35 85% benefit $1,497.25 was $1,501.25 |
| 61454 | Localised study using cells labelled with technetium (R) | $378.55 75% benefit $283.95 85% benefit $321.80 |
| 61457 | Localised study using cells labelled with technetium, with single photon emission tomography (R) | $511.55 75% benefit $383.70 85% benefit $434.85 |
| 61461 | New 85% benefit on 1 November 2026Localised study using thallium (R) | $2,165.70 75% benefit $1,624.30 85% benefit $2,057.20 was $2,061.20 |
| 61462 | Repeat planar and single photon emission tomography imaging, or repeat planar imaging or single photon emission tomography imaging on an occasion subsequent to the performance of item 61364, 61426, 61429, 61430, 61442, 61450, 61453, 61469 or 61485, if there is no additional administration of radiopharmaceutical and if the previous radionuclide scan was abnormal or equivocal (R) | $140.25 75% benefit $105.20 85% benefit $119.25 |
| 61466 | New 85% benefit on 1 November 2026Cerebro-spinal fluid transport study using indium-111, with imaging on 2 or more separate occasions (R) | $5,100.85 75% benefit $3,825.65 85% benefit $4,992.35 was $4,996.35 |
| 61469 | Lymphoscintigraphy (R) | $378.55 75% benefit $283.95 85% benefit $321.80 |
| 61473 | Thyroid study (R) | $190.75 75% benefit $143.10 85% benefit $162.15 |
| 61480 | Parathyroid study (R) | $420.65 75% benefit $315.50 85% benefit $357.60 |
| 61485 | New 85% benefit on 1 November 2026Adrenal study, with single photon emission tomography (R) | $3,658.00 75% benefit $2,743.50 85% benefit $3,549.50 was $3,553.50 |
| 61495 | Tear duct study (R) | $242.60 75% benefit $181.95 85% benefit $206.25 |
| 61499 | Particle perfusion study (infra arterial) or Le Veen shunt study (R) | $275.10 75% benefit $206.35 85% benefit $233.85 |
| 61505 | CT scan performed at the same time and covering the same body area as single photon emission tomography or positron emission tomography for the purpose of anatomic localisation or attenuation correction if no separate diagnostic CT report is issued and performed in association with a service to which an item in Subgroup 1 or 2 of Group I4 applies (R) | $100.00 75% benefit $75.00 85% benefit $85.00 |
| 61523 | New 85% benefit on 1 November 2026Whole body FDG PET study, performed for evaluation of a solitary pulmonary nodule where the lesion is considered unsuitable for transthoracic fine needle aspiration biopsy, or for which an attempt at pathological characterisation has failed.(R) | $953.00 75% benefit $714.75 85% benefit $844.50 was $848.50 |
| 61524 | New 85% benefit on 1 November 2026Whole body FDG PET study, performed for the staging of locally advanced (Stage III) breast cancer, for a patient who is considered suitable for active therapy (R) (Anaes.) | $953.00 75% benefit $714.75 85% benefit $844.50 was $848.50 |
| 61525 | New 85% benefit on 1 November 2026Whole body FDG PET study, performed for the evaluation of suspected metastatic or suspected locally or regionally recurrent breast carcinoma, for a patient who is considered suitable for active therapy (R) (Anaes.) | $953.00 75% benefit $714.75 85% benefit $844.50 was $848.50 |
| 61527 | New 85% benefit on 1 November 2026Whole body study using PET, if the service is performed because the services to which items 61429, 61430, 61442, 61450 or 61453 apply cannot be performed due to unavailability of gallium-67 (R) | $752.35 75% benefit $564.30 85% benefit $643.85 was $647.85 |
| 61528 | New 85% benefit on 1 November 2026Whole body PSMA PET study, performed for the assessment of suitability for Lutetium 177 PSMA therapy in a patient with metastatic castrate resistant prostate cancer, after progressive disease has developed while undergoing prior treatment with at least one taxane chemotherapy and at least one androgen receptor signalling inhibitor. (R) (Anaes.) | $1,300.00 75% benefit $975.00 85% benefit $1,191.50 was $1,195.50 |
| 61529 | New 85% benefit on 1 November 2026Whole body FDG PET study, performed for the staging of proven non-small cell lung cancer, where curative surgery or radiotherapy is planned (R) | $953.00 75% benefit $714.75 85% benefit $844.50 was $848.50 |
| 61530 | New 85% benefit on 1 November 2026Whole body 68Ga-DOTA-somatostatin receptor agonist PET study for: a) staging of histologically confirmed neuroendocrine neoplasm (NEN) considered surgically incurable on conventional imaging, orb) evaluation of somatostatin receptor expression of histologically confirmed and inoperable NEN, either locally advanced or metastatic, under consideration for peptide receptor radionuclide therapy (PRRT); orc) evaluation of response to PRRT therapy; ord) evaluation of suspected recurrent or metastatic disease in known somatostatin receptor positive NEN. (R) (Anaes.) | $953.00 75% benefit $714.75 85% benefit $844.50 was $848.50 |
| 61538 | New 85% benefit on 1 November 2026FDG PET study of the brain for evaluation of suspected residual or recurrent malignant brain tumour based on anatomical imaging findings, after definitive therapy (or during ongoing chemotherapy) in patients who are considered suitable for further active therapy. (R) | $901.00 75% benefit $675.75 85% benefit $792.50 was $796.50 |
| 61541 | New 85% benefit on 1 November 2026Whole body FDG PET study, following initial therapy, for the evaluation of suspected residual, metastatic or recurrent colorectal carcinoma in patients considered suitable for active therapy (R) | $953.00 75% benefit $714.75 85% benefit $844.50 was $848.50 |
| 61553 | New 85% benefit on 1 November 2026Whole body FDG PET study, following initial therapy, performed for the evaluation of suspected metastatic or recurrent malignant melanoma in patients considered suitable for active therapy (R) | $999.00 75% benefit $749.25 85% benefit $890.50 was $894.50 |
| 61559 | New 85% benefit on 1 November 2026FDG PET study of the brain, performed for the evaluation of refractory epilepsy which is being evaluated for surgery (R) | $918.00 75% benefit $688.50 85% benefit $809.50 was $813.50 |
| 61560 | FDG PET study of the brain, performed for the diagnosis of Alzheimer’s disease, if: clinical evaluation of the patient by a specialist, or in consultation with a specialist, is equivocal; and the service includes a quantitative comparison of the results of the study with the results of an FDG PET study of a normal brain from a reference database; and a service to which this item applies has not been performed on the patient in the previous 12 months; and a service to which item 61402 applies has not been performed on the patient in the previous 12 months for the diagnosis or management of Alzheimer’s disease Applicable not more than 3 times per lifetime (R) | $605.05 75% benefit $453.80 85% benefit $514.30 |
| 61563 | New 85% benefit on 1 November 2026Whole body prostate-specific membrane antigen PET study performed for the initial staging of intermediate to high-risk prostate adenocarcinoma, for a previously untreated patient who is considered suitable for locoregional therapy with curative intent Applicable once per lifetime (R) | $1,300.00 75% benefit $975.00 85% benefit $1,191.50 was $1,195.50 |
| 61564 | New 85% benefit and new wording on 1 November 2026Whole body prostate-specific membrane antigen PET study performed for the restaging of recurrent prostate adenocarcinoma, for a patient who:(a) has undergone prior locoregional therapy; and(b) is considered suitable for further locoregional therapy to determine appropriate therapeutic pathways and timing of treatment initiationApplicable once in any 12 month period (R) | $1,300.00 75% benefit $975.00 85% benefit $1,191.50 was $1,195.50 |
| 61565 | New 85% benefit on 1 November 2026Whole body FDG PET study, following initial therapy, performed for the evaluation of suspected residual, metastatic or recurrent ovarian carcinoma in patients considered suitable for active therapy. (R) | $953.00 75% benefit $714.75 85% benefit $844.50 was $848.50 |
| 61571 | New 85% benefit on 1 November 2026Whole body FDG PET study, for the further primary staging of patients with histologically proven carcinoma of the uterine cervix, at FIGO stage IB2 or greater by conventional staging, prior to planned radical radiation therapy or combined modality therapy with curative intent. (R) | $953.00 75% benefit $714.75 85% benefit $844.50 was $848.50 |
| 61575 | New 85% benefit on 1 November 2026Whole body FDG PET study, for the further staging of patients with confirmed local recurrence of carcinoma of the uterine cervix considered suitable for salvage pelvic chemoradiotherapy or pelvic exenteration with curative intent. (R) | $953.00 75% benefit $714.75 85% benefit $844.50 was $848.50 |
| 61577 | New 85% benefit on 1 November 2026Whole body FDG PET study, performed for the staging of proven oesophageal or GEJ carcinoma, in patients considered suitable for active therapy (R). | $953.00 75% benefit $714.75 85% benefit $844.50 was $848.50 |
| 61598 | New 85% benefit on 1 November 2026Whole body FDG PET study performed for the staging of biopsy-proven newly diagnosed or recurrent head and neck cancer (R). | $953.00 75% benefit $714.75 85% benefit $844.50 was $848.50 |
| 61604 | New 85% benefit on 1 November 2026Whole body FDG PET study performed for the evaluation of patients with suspected residual head and neck cancer after definitive treatment, and who are suitable for active therapy (R). | $953.00 75% benefit $714.75 85% benefit $844.50 was $848.50 |
| 61610 | New 85% benefit on 1 November 2026Whole body FDG PET study performed for the evaluation of metastatic squamous cell carcinoma of unknown primary site involving cervical nodes (R). | $953.00 75% benefit $714.75 85% benefit $844.50 was $848.50 |
| 61612 | New 85% benefit on 1 November 2026Whole body FDG PET study for the initial staging of cancer, for a patient who is considered suitable for active therapy, if:(a) the cancer is a typically FDG-avid cancer; and(b) there is at least 10% likelihood that a PET study result will inform a significant change in management for the patientApplicable once per cancer diagnosis (R) | $953.00 75% benefit $714.75 85% benefit $844.50 was $848.50 |
| 61614 | New 85% benefit on 1 November 2026Whole body FDG PET study, following initial therapy, performed for the evaluation of suspected residual, metastatic or recurrent cancer in a patient who is undergoing, or is suitable for, active therapy, if the cancer is a typically FGD-avid cancer (R) | $953.00 75% benefit $714.75 85% benefit $844.50 was $848.50 |
| 61620 | New 85% benefit on 1 November 2026Whole body FDG PET study for the initial staging of newly diagnosed or previously untreated Hodgkin or non-Hodgkin lymphoma (R) | $953.00 75% benefit $714.75 85% benefit $844.50 was $848.50 |
| 61622 | New 85% benefit on 1 November 2026Whole body FDG PET study to assess response to first line therapy either during treatment or within three months of completing definitive first line treatment for Hodgkin or non-Hodgkin lymphoma (R) | $953.00 75% benefit $714.75 85% benefit $844.50 was $848.50 |
| 61628 | New 85% benefit on 1 November 2026Whole body FDG PET study for restaging following confirmation of recurrence of Hodgkin or non-Hodgkin lymphoma (R) | $953.00 75% benefit $714.75 85% benefit $844.50 was $848.50 |
| 61632 | New 85% benefit on 1 November 2026Whole body FDG PET study to assess response to second-line chemotherapy if haemopoietic stem cell transplantation is being considered for Hodgkin or non-Hodgkin lymphoma (R) | $953.00 75% benefit $714.75 85% benefit $844.50 was $848.50 |
| 61640 | New 85% benefit on 1 November 2026Whole body FDG PET study for initial staging of patients with biopsy-proven bone or soft tissue sarcoma (excluding gastrointestinal stromal tumour) considered by conventional staging to be potentially curable. (R) | $999.00 75% benefit $749.25 85% benefit $890.50 was $894.50 |
| 61644 | Single rest myocardial perfusion study for the assessment of the extent and severity of non‑viable myocardium, with PET, if: (a) the service is performed because the service to which item 61325 applies cannot be performed due to unavailability of thallous chloride 201 (Tl-201); and (b) the patient has left ventricular systolic dysfunction and probable or confirmed coronary artery disease; and (c) the service is performed in conjunction with a rest myocardial perfusion study using technetium-99m; and (d) the service is requested by a specialist or a consultant physician; and (e) the service is not associated with a service to which item 11704, 11705, 11707, 11714, 11729 or 11730 applies; and (f) this service and item 61325 are applicable only twice each 24 months (R) | $329.00 75% benefit $246.75 85% benefit $279.65 |
| 61646 | New 85% benefit on 1 November 2026Whole body FDG PET study for the evaluation of patients with suspected residual or recurrent sarcoma (excluding gastrointestinal stromal tumour) after the initial course of definitive therapy to determine suitability for subsequent therapy with curative intent. (R) | $999.00 75% benefit $749.25 85% benefit $890.50 was $894.50 |
| 61647 | New 85% benefit on 1 November 2026Whole body 68Ga DOTA peptide PET study, if:(a) a gastro entero pancreatic neuroendocrine tumour is suspected on the basis of biochemical evidence with negative or equivocal conventional imaging; or(b) both:(i) a surgically amenable gastro entero pancreatic neuroendocrine tumour has been identified on the basis of conventional techniques; and(ii) the study is for excluding additional disease sites (R) | $953.00 75% benefit $714.75 85% benefit $844.50 was $848.50 |
| 61650 | New 85% benefit on 1 November 2026LeukoScan study of the long bones and feet for suspected osteomyelitis, if:(a) the patient does not have access to ex vivo white blood cell scanning; and(b) the patient is not being investigated for other sites of infection (R) | $955.50 75% benefit $716.65 85% benefit $847.00 was $851.00 |
I5 Magnetic Resonance Imaging
120 items
| Item | Description | Fee and benefits |
|---|---|---|
| 63001 | MRI—scan of head (including MRA, if performed) for tumour of the brain or meninges (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63004 | MRI—scan of head (including MRA, if performed) for inflammation of brain or meninges (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63007 | MRI—scan of head (including MRA, if performed) for skull base or orbital tumour (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63010 | MRI—scan of head (including MRA, if performed) for stereotactic scan of brain, with fiducials in place, for the sole purpose of allowing planning for stereotactic neurosurgery (R) (Contrast) (Anaes.) | $386.55 75% benefit $289.95 85% benefit $328.60 |
| 63019 | MRI—scan of head (including MRA if performed) for the assessment of suitability for the treatment of medically refractory essential tremor with magnetic resonance imaging‑guided focused ultrasound Applicable once per patient per lifetime (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63020 | MRI—scan of head (including MRA if performed) for the post‑procedure assessment of the patient following magnetic resonance imaging‑guided focused ultrasound for the treatment of medically refractory essential tremor Applicable once per patient per lifetime (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63040 | MRI—scan of head (including MRA, if performed) for acoustic neuroma (R) (Contrast) (Anaes.) | $386.55 75% benefit $289.95 85% benefit $328.60 |
| 63043 | MRI—scan of head (including MRA, if performed) for pituitary tumour (R) (Contrast) (Anaes.) | $412.25 75% benefit $309.20 85% benefit $350.45 |
| 63046 | MRI—scan of head (including MRA, if performed) for toxic or metabolic or ischaemic encephalopathy (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63049 | MRI—scan of head (including MRA, if performed) for demyelinating disease of the brain (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63052 | MRI—scan of head (including MRA, if performed) for congenital malformation of the brain or meninges (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63055 | MRI—scan of head (including MRA, if performed) for venous sinus thrombosis (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63058 | MRI—scan of head (including MRA, if performed) for head trauma (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63061 | MRI—scan of head (including MRA, if performed) for epilepsy (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63064 | MRI—scan of head (including MRA, if performed) for stroke (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63067 | MRI—scan of head (including MRA, if performed) for carotid or vertebral artery dissection (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63070 | MRI—scan of head (including MRA, if performed) for intracranial aneurysm (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63073 | MRI—scan of head (including MRA, if performed) for intracranial arteriovenous malformation (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63101 | MRI and MRA of extracranial or intracranial circulation (or both)—scan of head and neck vessels for stroke (R) (Contrast) (Anaes.) | $566.90 75% benefit $425.20 85% benefit $481.90 |
| 63111 | MRI—scan of head and cervical spine (including MRA, if performed) for tumour of the central nervous system or meninges (R) (Contrast) (Anaes.) | $566.90 75% benefit $425.20 85% benefit $481.90 |
| 63114 | MRI—scan of head and cervical spine (including MRA, if performed) for inflammation of the central nervous system or meninges (R) (Contrast) (Anaes.) | $566.90 75% benefit $425.20 85% benefit $481.90 |
| 63125 | MRI—scan of head and cervical spine (including MRA, if performed) for demyelinating disease of the central nervous system (R) (Contrast) (Anaes.) | $566.90 75% benefit $425.20 85% benefit $481.90 |
| 63128 | MRI—scan of head and cervical spine (including MRA, if performed) for congenital malformation of the central nervous system or meninges (R) (Contrast) (Anaes.) | $566.90 75% benefit $425.20 85% benefit $481.90 |
| 63131 | MRI—scan of head and cervical spine (including MRA, if performed) for syrinx (congenital or acquired) (R) (Contrast) (Anaes.) | $566.90 75% benefit $425.20 85% benefit $481.90 |
| 63151 | MRI—scan of one region or 2 contiguous regions of the spine for infection (R) (Contrast) (Anaes.) | $412.25 75% benefit $309.20 85% benefit $350.45 |
| 63154 | MRI—scan of one region or 2 contiguous regions of the spine for tumour (R) (Contrast) (Anaes.) | $412.25 75% benefit $309.20 85% benefit $350.45 |
| 63161 | MRI—scan of one region or 2 contiguous regions of the spine for demyelinating disease (R) (Contrast) (Anaes.) | $412.25 75% benefit $309.20 85% benefit $350.45 |
| 63164 | MRI—scan of one region or 2 contiguous regions of the spine for congenital malformation of the spinal cord or the cauda equina or the meninges (R) (Contrast) (Anaes.) | $412.25 75% benefit $309.20 85% benefit $350.45 |
| 63167 | MRI—scan of one region or 2 contiguous regions of the spine for myelopathy (R) (Contrast) (Anaes.) | $412.25 75% benefit $309.20 85% benefit $350.45 |
| 63170 | MRI—scan of one region or 2 contiguous regions of the spine for syrinx (congenital or acquired) (R) (Contrast) (Anaes.) | $412.25 75% benefit $309.20 85% benefit $350.45 |
| 63173 | MRI—scan of one region or 2 contiguous regions of the spine for cervical radiculopathy (R) (Contrast) (Anaes.) | $412.25 75% benefit $309.20 85% benefit $350.45 |
| 63176 | MRI—scan of one region or 2 contiguous regions of the spine for sciatica (R) (Contrast) (Anaes.) | $412.25 75% benefit $309.20 85% benefit $350.45 |
| 63179 | MRI—scan of one region or 2 contiguous regions of the spine for spinal canal stenosis (R) (Contrast) (Anaes.) | $412.25 75% benefit $309.20 85% benefit $350.45 |
| 63182 | MRI—scan of one region or 2 contiguous regions of the spine for previous spinal surgery (R) (Contrast) (Anaes.) | $412.25 75% benefit $309.20 85% benefit $350.45 |
| 63185 | MRI—scan of one region or 2 contiguous regions of the spine for trauma (R) (Anaes.) | $412.25 75% benefit $309.20 85% benefit $350.45 |
| 63201 | MRI—scan of 3 contiguous or 2 non contiguous regions of the spine for infection (R) (Contrast) (Anaes.) | $515.30 75% benefit $386.50 85% benefit $438.05 |
| 63204 | MRI—scan of 3 contiguous or 2 non contiguous regions of the spine for tumour (R) (Contrast) (Anaes.) | $515.30 75% benefit $386.50 85% benefit $438.05 |
| 63219 | MRI—scan of 3 contiguous or 2 non contiguous regions of the spine for demyelinating disease (R) (Contrast) (Anaes.) | $515.30 75% benefit $386.50 85% benefit $438.05 |
| 63222 | MRI—scan of 3 contiguous or 2 non contiguous regions of the spine for congenital malformation of the spinal cord or the cauda equina or the meninges (R) (Contrast) (Anaes.) | $515.30 75% benefit $386.50 85% benefit $438.05 |
| 63225 | MRI—scan of 3 contiguous or 2 non contiguous regions of the spine for myelopathy (R) (Contrast) (Anaes.) | $515.30 75% benefit $386.50 85% benefit $438.05 |
| 63228 | MRI—scan of 3 contiguous or 2 non contiguous regions of the spine for syrinx (congenital or acquired) (R) (Contrast) (Anaes.) | $515.30 75% benefit $386.50 85% benefit $438.05 |
| 63231 | MRI—scan of 3 contiguous or 2 non contiguous regions of the spine for cervical radiculopathy (R) (Contrast) (Anaes.) | $515.30 75% benefit $386.50 85% benefit $438.05 |
| 63234 | MRI—scan of 3 contiguous or 2 non contiguous regions of the spine for sciatica (R) (Contrast) (Anaes.) | $515.30 75% benefit $386.50 85% benefit $438.05 |
| 63237 | MRI—scan of 3 contiguous or 2 non contiguous regions of the spine for spinal canal stenosis (R) (Contrast) (Anaes.) | $515.30 75% benefit $386.50 85% benefit $438.05 |
| 63240 | MRI—scan of 3 contiguous or 2 non contiguous regions of the spine for previous spinal surgery (R) (Contrast) (Anaes.) | $515.30 75% benefit $386.50 85% benefit $438.05 |
| 63243 | MRI—scan of 3 contiguous or 2 non contiguous regions of the spine for trauma (R) (Anaes.) | $515.30 75% benefit $386.50 85% benefit $438.05 |
| 63271 | MRI—scan of cervical spine and brachial plexus for tumour (R) (Contrast) (Anaes.) | $566.90 75% benefit $425.20 85% benefit $481.90 |
| 63274 | MRI—scan of cervical spine and brachial plexus for trauma (R) (Contrast) (Anaes.) | $566.90 75% benefit $425.20 85% benefit $481.90 |
| 63277 | MRI—scan of cervical spine and brachial plexus for cervical radiculopathy (R) (Contrast) (Anaes.) | $566.90 75% benefit $425.20 85% benefit $481.90 |
| 63280 | MRI—scan of cervical spine and brachial plexus for previous surgery (R) (Contrast) (Anaes.) | $566.90 75% benefit $425.20 85% benefit $481.90 |
| 63301 | MRI—scan of musculoskeletal system for tumour arising in bone or musculoskeletal system, excluding tumours arising in breast, prostate or rectum (R) (Contrast) (Anaes.) | $438.05 75% benefit $328.55 85% benefit $372.35 |
| 63304 | MRI—scan of musculoskeletal system for infection arising in bone or musculoskeletal system, excluding infection arising in breast, prostate or rectum (R) (Contrast) (Anaes.) | $438.05 75% benefit $328.55 85% benefit $372.35 |
| 63307 | MRI—scan of musculoskeletal system for osteonecrosis (R) (Contrast) (Anaes.) | $438.05 75% benefit $328.55 85% benefit $372.35 |
| 63322 | MRI—scan of musculoskeletal system for derangement of hip or its supporting structures (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63325 | MRI—scan of musculoskeletal system for derangement of shoulder or its supporting structures (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63328 | MRI—scan of musculoskeletal system for derangement of knee or its supporting structures (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63331 | MRI—scan of musculoskeletal system for derangement of ankle or foot (or both) or its supporting structures (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63334 | MRI—scan of musculoskeletal system for derangement of one or both temporomandibular joints or their supporting structures (R) (Contrast) (Anaes.) | $386.55 75% benefit $289.95 85% benefit $328.60 |
| 63337 | MRI—scan of musculoskeletal system for derangement of wrist or hand (or both) or its supporting structures (R) (Contrast) (Anaes.) | $515.30 75% benefit $386.50 85% benefit $438.05 |
| 63340 | MRI—scan of musculoskeletal system for derangement of elbow or its supporting structures (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63361 | MRI—scan of musculoskeletal system for Gaucher disease (R) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63385 | MRI—scan of cardiovascular system for congenital disease of the heart or a great vessel (R) (Contrast) (Anaes.) | $515.30 75% benefit $386.50 85% benefit $438.05 |
| 63388 | MRI—scan of cardiovascular system for tumour of the heart or a great vessel (R) (Contrast) (Anaes.) | $515.30 75% benefit $386.50 85% benefit $438.05 |
| 63390 | MRI—scan of cardiovascular system for assessment of myocardial structure, function and characterisation, if the request for the scan indicates that the patient has: (a) acute onset (less than 3 months) heart failure caused by suspected myocarditis which would otherwise require endomyocardial biopsy to confirm the diagnosis of myocarditis; or (b) unexplained arrhythmia caused by suspected myocarditis which would otherwise require endomyocardial biopsy to confirm the diagnosis of myocarditis; or (c) suspected drug-induced myocarditis, if the results from all of the following examinations are inconclusive to form a diagnosis: (i) troponin; (ii) chest X-ray; (iii) transthoracic echocardiogram. (R) (Contrast) (Anaes.) | $632.65 75% benefit $474.50 85% benefit $537.80 |
| 63391 | MRI—scan of cardiovascular system for abnormality of thoracic aorta (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63395 | New 85% benefit on 1 November 2026MRI—scan of cardiovascular system for assessment of myocardial structure and function involving:(a) dedicated right ventricular views; and(b) 3D volumetric assessment of the right ventricle; and(c) reporting of end diastolic and end systolic volumes, ejection fraction and BSA indexed values;if the request for the scan indicates that:(d) the patient presented with symptoms consistent with arrhythmogenic right ventricular cardiomyopathy (ARVC); or(e) investigative findings in relation to the patient are consistent with ARVC(R) (Contrast) (Anaes.) | $983.75 75% benefit $737.85 85% benefit $875.25 was $879.25 |
| 63397 | New 85% benefit on 1 November 2026MRI—scan of cardiovascular system for assessment of myocardial structure and function involving: (a) dedicated right ventricular views; and(b) 3D volumetric assessment of the right ventricle; and(c) reporting of end diastolic and end systolic volumes, ejection fraction and BSA indexed values;if the request for the scan indicates that the patient:(d) is asymptomatic; and(e) has one or more first degree relatives diagnosed with confirmed arrhythmogenic right ventricular cardiomyopathy (ARVC)(R) (Contrast) (Anaes.) | $983.75 75% benefit $737.85 85% benefit $875.25 was $879.25 |
| 63401 | MRA—if the request for the scan specifically identifies the clinical indication for the scan—scan of cardiovascular system for vascular abnormality in a patient with a previous anaphylactic reaction to an iodinated contrast medium (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63404 | MRA—if the request for the scan specifically identifies the clinical indication for the scan—scan of cardiovascular system for obstruction of the superior vena cava, inferior vena cava or a major pelvic vein (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63416 | MRA—scan of person under the age of 16 for the vasculature of limbs prior to limb or digit transfer surgery in congenital limb deficiency syndrome (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63425 | MRI—scan of person under the age of 16 for post inflammatory or post traumatic physeal fusion (R) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63428 | MRI—scan of person under the age of 16 for Gaucher disease (R) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63440 | MRI—scan of person under the age of 16 for pelvic or abdominal mass (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63443 | MRI—scan of person under the age of 16 for mediastinal mass (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63446 | MRI—scan of person under the age of 16 for congenital uterine or anorectal abnormality (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63454 | New 85% benefit on 1 November 2026MRI scan of the pelvis or abdomen, for a patient who is pregnant, if: (a) the pregnancy is at, or after, 18 weeks gestation; and (b) fetal abnormality is suspected; and (c) an ultrasound has been performed and is provided by, or on behalf of, or at the request of, a specialist who is practising in the specialty of obstetrics; and (d) the diagnosis of fetal abnormality as a result of the ultrasound is indeterminate or requires further examination; and (e) the MRI service is requested by a specialist practising in the specialty of obstetrics (R) (Contrast) (Anaes.) | $1,380.40 75% benefit $1,035.30 85% benefit $1,271.90 was $1,275.90 |
| 63461 | MRI—scan of the body for adrenal mass in a patient with a malignancy that is otherwise resectable (R) (Anaes.) | $412.25 75% benefit $309.20 85% benefit $350.45 |
| 63464 | New 85% benefit on 1 November 2026MRI—scan of both breasts for the detection of cancer in a patient, if: (a) a dedicated breast coil is used; and (b) the request for the scan identifies that the patient is asymptomatic and is younger than 60 years of age; and (c) the request for the scan identifies that the patient is at high risk of developing breast cancer due to one or more of the following: (i) genetic testing has identified the presence of a high risk breast cancer gene mutation in the patient or in a first degree relative of the patient; (ii) both: (A) one of the patient’s first or second degree relatives was diagnosed with breast cancer at age 45 years or younger; and (B) another first or second degree relative on the same side of the patient’s family was diagnosed with bone or soft tissue sarcoma at age 45 years or younger; (iii) the patient has a personal history of breast cancer before the age of 50 years; (iv) the patient has a personal history of mantle radiation therapy; (v) the patient has a lifetime risk estimation greater than 30% or a 10 year absolute risk estimation greater than 5% using a clinically relevant risk evaluation algorithm Applicable not more than once in a 12 month period (R) (Contrast) (Anaes.) | $793.75 75% benefit $595.35 85% benefit $685.25 was $689.25 |
| 63467 | New 85% benefit on 1 November 2026MRI—scan of both breasts for the detection of cancer, if:(a) a dedicated breast coil is used; and(b) the person has had an abnormality detected as a result of a service mentioned in item 63464 performed in the previous 12 months (R) (Anaes.) | $793.75 75% benefit $595.35 85% benefit $685.25 was $689.25 |
| 63470 | MRI—scan of the pelvis for the staging of histologically diagnosed cervical cancer at FIGO stage 1B or greater, if the request for scan identifies that: (a) a histological diagnosis of carcinoma of the cervix has been made; and(b) the patient has been diagnosed with cervical cancer at FIGO stage 1B or greater (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63473 | New 85% benefit on 1 November 2026MRI—scan of the pelvis and upper abdomen, in a single examination, for the staging of histologically diagnosed cervical cancer at FIGO stage 1B or greater, if the request for the scan identifies that: (a) a histological diagnosis of carcinoma of the cervix has been made; and(b) the patient has been diagnosed with cervical cancer at FIGO stage 1B or greater (R) (Contrast) (Anaes.) | $721.50 75% benefit $541.15 85% benefit $613.30 was $617.00 |
| 63476 | MRI—scan of the pelvis for the initial staging, restaging or follow up of rectal cancer, if: (a) a high resolution T2 technique is used; and (b) the request for the scan identifies that the indication is for: (i) the initial staging of rectal cancer (including cancer of the rectosigmoid and anorectum); or (ii) the initial assessment of response to chemotherapy or chemoradiotherapy; or (iii) the assessment of possible recurrent tumour after complete response to neoadjuvant therapy, within an active surveillance program; or (iv) the assessment of recurrent disease prior to treatment planning (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63482 | MRI—scan of pancreas and biliary tree for suspected biliary or pancreatic pathology (R) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63487 | New 85% benefit on 1 November 2026MRI—scan of both breasts, if:(a) a dedicated breast coil is used; and(b) the request for the scan identifies that:(i) the patient has been diagnosed with metastatic cancer restricted to the regional lymph nodes; and(ii) clinical examination and conventional imaging have failed to identify the primary cancer (R) (Anaes.) | $793.75 75% benefit $595.35 85% benefit $685.25 was $689.25 |
| 63489 | New 85% benefit on 1 November 2026MRI—scan of one breast, performed in conjunction with a biopsy procedure on that breast and an ultrasound scan of that breast, if: (a) the request for the MRI scan identifies that the patient has a suspicious lesion seen on MRI but not on conventional imaging; and (b) the ultrasound scan is performed immediately before the MRI scan and confirms that the lesion is not amenable to biopsy guided by conventional imaging; and (c) a dedicated breast coil is used (R) (Anaes.) | $1,159.50 75% benefit $869.65 85% benefit $1,051.00 was $1,055.00 |
| 63491 | NOTE: Benefits in Subgroup 22 are only payable for modifying items where claimed simultaneously with MRI services. Modifiers for sedation and anaesthesia may not be claimed for the same service. MRI or MRA service to which an item in this Group (other than an item in this Subgroup) applies if: (a) the service is performed on a person in accordance with clause 2.5.1; and(b) the item for the service includes in its description ‘(Contrast)’; and(c) the service is performed using a contrast agent | $51.55 75% benefit $38.70 85% benefit $43.85 |
| 63494 | MRI or MRA service to which an item in this Group (other than an item in this Subgroup) applies if: (a) the service is performed on a person in accordance with clause 2.5.1; and(b) the service is performed using intravenous or intra muscular sedation | $51.55 75% benefit $38.70 85% benefit $43.85 |
| 63496 | NOTE: Benefits in Subgroup 22 are only payable for modifying items where claimed simultaneously with MRI services. Modifiers for sedation and anaesthesia may not be claimed for the same service. MRI service to which item 63545 or 63546 applies if: (a) the service is performed on a person under the supervision of an eligible provider; and(b) the service is performed using an hepatobiliary specific contrast agent | $287.55 75% benefit $215.70 85% benefit $244.45 |
| 63497 | MRI or MRA service to which an item in this Group (other than an item in this Subgroup) applies if: (a) the service is performed on a person in accordance with clause 2.5.1; and(b) the service is performed under anaesthetic in the presence of a medical practitioner who is qualified to perform an anaesthetic | $180.35 75% benefit $135.30 85% benefit $153.30 |
| 63498 | MRI service to which item 63501, 63502, 63504 or 63505 applies, if the service is performed on a person using intravenous or intra muscular sedation | $51.55 75% benefit $38.70 85% benefit $43.85 |
| 63499 | MRI service to which item 63501, 63502, 63504 or 63505 applies, if the service is performed on a person under anaesthetic in the presence of a medical practitioner who is qualified to perform an anaesthetic (H) | $180.35 75% benefit $135.30 |
| 63501 | MRI—scan of one or both breasts for the evaluation of implant integrity, if: (a) a dedicated breast coil is used; and (b) the request for the scan identifies that the patient: (i) has or is suspected of having a silicone breast implant manufactured by Poly Implant Prosthese (PIP); and (ii) the result of the scan confirms a loss of integrity of the implant (R) | $575.20 75% benefit $431.40 85% benefit $488.95 |
| 63502 | MRI—scan of one or both breasts for the evaluation of implant integrity, if: (a) a dedicated breast coil is used; and (b) the request for the scan identifies that the patient: (i) has or is suspected of having a silicone breast implant manufactured by Poly Implant Prosthese (PIP); and (ii) the result of the scan does not demonstrate a loss of integrity of the implant (R) | $575.20 75% benefit $431.40 85% benefit $488.95 |
| 63504 | MRI—scan of one or both breasts for the evaluation of implant integrity, if: (a) a dedicated breast coil is used; and (b) the request for the scan identifies that the patient: (i) has or is suspected of having a silicone breast implant manufactured by Poly Implant Prosthese (PIP); and (ii) presents with symptoms where implant rupture is suspected; and (iii) the result of the scan confirms a loss of integrity of the implant (R) | $575.20 75% benefit $431.40 85% benefit $488.95 |
| 63505 | MRI—scan of one or both breasts for the evaluation of implant integrity, if: (a) a dedicated breast coil is used; and (b) the request for the scan identifies that the patient: (i) has or is suspected of having a silicone breast implant manufactured by Poly Implant Prosthese (PIP); and (ii) presents with symptoms where implant rupture is suspected; and (iii) the result of the scan does not demonstrate a loss of integrity of the implant (R) | $575.20 75% benefit $431.40 85% benefit $488.95 |
| 63507 | MRI—scan of head for a patient under 16 years if the service is for:(a) an unexplained seizure; or(b) an unexplained headache if significant pathology is suspected; or(c) paranasal sinus pathology that has not responded to conservative therapy (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63510 | MRI—scan of spine following radiographic examination for a patient under 16 years if the service is for: (a) significant trauma; or(b) unexplained neck or back pain with associated neurological signs; or(c) unexplained back pain if significant pathology is suspected (R) (Contrast) (Anaes.) | $515.30 75% benefit $386.50 85% benefit $438.05 |
| 63513 | MRI—scan of knee for internal joint derangement for a patient under 16 years (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63516 | MRI—scan of hip following radiographic examination for a patient under 16 years if any of the following is suspected: (a) septic arthritis;(b) slipped capital femoral epiphysis;(c) Perthes disease (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63519 | MRI—scan of elbow following radiographic examination for a patient under 16 years if a significant fracture or avulsion injury, which would change the way in which the patient is managed, is suspected (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63522 | MRI—scan of wrist following radiographic examination for a patient under 16 years if a scaphoid fracture is suspected (R) (Contrast) (Anaes.) | $515.30 75% benefit $386.50 85% benefit $438.05 |
| 63531 | New 85% benefit on 1 November 2026MRI—scan of both breasts, if: (a) a dedicated breast coil is used; and(b) the request for the scan identifies that:(i) the patient has a breast lesion; and(ii) the results of conventional imaging are inconclusive for the presence of breast cancer; and(iii) biopsy has not been possible (R) (Contrast) (Anaes.) | $793.75 75% benefit $595.35 85% benefit $685.25 was $689.25 |
| 63533 | New 85% benefit on 1 November 2026MRI—scan of both breasts, if: (a) a dedicated breast coil is used; and(b) the request for the scan identifies that:(i) the patient has been diagnosed with a breast cancer; and(ii) there is a discrepancy between the clinical assessment and the conventional imaging assessment of the extent of the malignancy; and(c) the results of breast MRI imaging may alter treatment planning (R) (Contrast) (Anaes.) | $793.75 75% benefit $595.35 85% benefit $685.25 was $689.25 |
| 63539 | New 85% benefit on 1 November 2026MRI—scan of the abdomen, requested by a specialist or consultant physician, to assess the development or growth of renal tumours in a patient with a confirmed clinical or molecular diagnosis of a genetic disorder associated with an increased risk of developing renal tumours, other than a service to which item 63540 applies Applicable once in any 12 month period (R) (Contrast) (Anaes.) | $721.50 75% benefit $541.15 85% benefit $613.30 was $617.00 |
| 63540 | New 85% benefit on 1 November 2026MRI—scan of the abdomen, requested by a specialist or consultant physician, to assess a patient with one or more known renal tumours and with a confirmed clinical or molecular diagnosis of a genetic disorder associated with an increased risk of developing renal tumours, if the service is performed: (a) to evaluate changes in clinical condition or suspected complications of the known renal tumours; or (b) where a disease specific line of treatment has been initiated and an assessment of patient responsiveness to the treatment is required Applicable once in any 3 month period (R) (Contrast) (Anaes.) | $721.50 75% benefit $541.15 85% benefit $613.30 was $617.00 |
| 63541 | Multiparametric MRI—scan of the prostate for the detection of cancer, requested by a specialist in the speciality of urology, radiation oncology or medical oncology: (a) if the request for the scan identifies that the patient is suspected of developing prostate cancer: (i) on the basis of a digital rectal examination; or (ii) in the circumstances mentioned in clause 2.5.9A; and (b) using a standardised image acquisition protocol involving: (i) T2‑weighted imaging; and (ii) diffusion‑weighted imaging; and (iii) (unless contraindicated) dynamic contrast enhancement (R) Note: See explanatory note IN.5.1 for the meaning of Clause 2.5.9 in the descriptor for this item and the claiming limitations. (Anaes.) | $517.55 75% benefit $388.20 85% benefit $439.95 |
| 63543 | Multiparametric MRI—scan of the prostate for the assessment of cancer, requested by a specialist in the speciality of urology, radiation oncology or medical oncology: (a) if the request for the scan identifies that the patient: (i) is under active surveillance following a confirmed diagnosis of prostate cancer by biopsy histopathology; and (ii) is not undergoing, or planning to undergo, treatment for prostate cancer; and (b) using a standardised image acquisition protocol involving: (i) T2‑weighted imaging; and (ii) diffusion‑weighted imaging; and (iii) (unless contraindicated) dynamic contrast enhancement (R) Note: See explanatory note IN.5.2 for claiming restrictions for this item. (Anaes.) | $517.55 75% benefit $388.20 85% benefit $439.95 |
| 63545 | MRI - multiphase scans of liver (including delayed imaging, if performed) with a contrast agent, for characterisation, or staging where surgical resection or interventional techniques are under consideration, if: (a) the patient has a confirmed extra‑hepatic primary malignancy (other than hepatocellular carcinoma); and (b) computed tomography is negative or inconclusive for hepatic metastatic disease; and (c) the identification of liver metastases would change the patient’s treatment planning Applicable not more than once in a 12 month period (R) (Contrast) (Anaes.) | $632.65 75% benefit $474.50 85% benefit $537.80 |
| 63546 | MRI – multiphase scans of the liver (including delayed imaging, if performed) with a contrast agent, for diagnosis or staging, if: (a) the patient has:(i) known or suspected hepatocellular carcinoma; and(ii) chronic liver disease that has been confirmed by a specialist or consultant physician; and(b) the patient’s liver function has been identified as Child Pugh class A or B; and(c) the patient has an identified hepatic lesion over 10 mm in diameter.For any particular patient—applicable not more than once in a 12 month period (R) (Contrast) (Anaes.) | $632.65 75% benefit $474.50 85% benefit $537.80 |
| 63547 | New 85% benefit on 1 November 2026MRI—scan of both breasts for the detection of cancer, if: (a) a dedicated breast coil is used; and(b) the request for the scan identifies that:(i) the patient has a breast implant in situ; and(ii) anaplastic large cell lymphoma has been diagnosed(R) (Contrast) (Anaes.) | $793.75 75% benefit $595.35 85% benefit $685.25 was $689.25 |
| 63549 | New 85% benefit on 1 November 2026MRI scan of the pelvis or abdomen, for a patient with a multiple pregnancy, if: (a) the multiple pregnancy is at, or after, 18 weeks gestation; and (b) fetal abnormality is suspected; and (c) an ultrasound has been performed and is provided by, or on behalf of, or at the request of, a specialist who is practising in the specialty of obstetrics; and (d) the diagnosis of fetal abnormality as a result of the ultrasound is indeterminate or requires further examination; and (e) the MRI service is requested by a specialist practising in the specialty of obstetrics (R) (Contrast) (Anaes.) | $2,070.50 75% benefit $1,552.90 85% benefit $1,962.00 was $1,966.00 |
| 63551 | MRI - scan of head for a patient 16 years or older, after a request by a medical practitioner (other than a specialist or consultant physician), for any of the following: (a) unexplained seizure(s);(b) unexplained chronic headache with suspected intracranial pathology (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63554 | MRI - scan of spine for a patient 16 years or older, after referral by a medical practitioner (other than a specialist or consultant physician), for suspected cervical radiculopathy (R) (Contrast) (Anaes.) | $412.25 75% benefit $309.20 85% benefit $350.45 |
| 63557 | MRI - scan of spine for a patient 16 years or older, after referral by a medical practitioner (other than a specialist or consultant physician), for suspected cervical spinal trauma (R) (Contrast) (Anaes.) | $566.90 75% benefit $425.20 85% benefit $481.90 |
| 63560 | MRI - scan of knee following acute knee trauma, after referral by a medical practitioner (other than a specialist or consultant physician), for a patient 16 to 49 years with: (a) inability to extend the knee suggesting the possibility of acute meniscal tear; or(b) clinical findings suggesting acute anterior cruciate ligament tear (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63563 | MRI scan of the pelvis or abdomen, if the request for the scan identifies that the investigation is for: (a) sub‑fertility that requires one or more of the following: (i) an investigation of suspected Mullerian duct anomaly seen in pelvic ultrasound or hysterosalpingogram; (ii) an assessment of uterine mass identified on pelvic ultrasound before consideration of surgery; (iii) an investigation of recurrent implantation failure in IVF (2 or more embryo transfer cycles without viable pregnancy); or (b) surgical planning of a patient with known or suspected deep endometriosis involving the bowel, bladder or ureter (or any combination of the bowel, bladder or ureter), where the results of pelvic ultrasound are inconclusive Applicable not more than once in a 2 year period (R) (Contrast) (Anaes.) | $463.80 75% benefit $347.85 85% benefit $394.25 |
| 63564 | New 85% benefit on 1 November 2026Note: the requirements for services provided under item 63564 are detailed under note IN.5.4 MRI – whole body scan for the early detection of cancer: a) requested by a specialist or consultant physician in consultation with a clinical geneticist in a familial cancer or genetic clinic; and b) the request identifies that the patient has a high risk of developing cancer malignancy due to heritable TP53 - related cancer (hTP53rc) syndrome (R) (Anaes.) | $1,698.25 75% benefit $1,273.70 85% benefit $1,589.75 was $1,593.75 |
| 63740 | MRI—scan to evaluate small bowel Crohn’s disease if the service is provided to a patient for: (a) evaluation of disease extent at time of initial diagnosis of Crohn’s disease; or(b) evaluation of exacerbation, or suspected complications, of known Crohn’s disease; or(c) evaluation of known or suspected Crohn’s disease in pregnancy; or(d) assessment of change to therapy in a patient with small bowel Crohn’s disease (R) (Contrast) | $525.90 75% benefit $394.45 85% benefit $447.05 |
| 63741 | MRI—scan with enteroclysis for Crohn’s disease if the service is related to item 63740 (R) | $305.10 75% benefit $228.85 85% benefit $259.35 |
| 63743 | MRI—scan for fistulising perianal Crohn’s disease if the service is provided to a patient for:(a) evaluation of pelvic sepsis and fistulas associated with established or suspected Crohn’s disease; or(b) assessment of change to therapy of pelvis sepsis and fistulas from Crohn’s disease (R) (Contrast) | $463.80 75% benefit $347.85 85% benefit $394.25 |
I6 Management Of Bulk-Billed Services
6 items
| Item | Description | Fee and benefits |
|---|---|---|
| 64990 | A diagnostic imaging service to which an item in this table (other than this item or item 64991, 64992, 64993, 64994 or 64995) applies if: (a) the service is an unreferred service; and (b) the service is provided to a person who is under the age of 16 or is a Commonwealth concession card holder; and (c) the person is not an admitted patient of a hospital; and (d) the service is bulk-billed in respect of the fees for: (i) this item; and (ii) the other item in this table applying to the service | $8.25 85% benefit $7.05 |
| 64991 | A diagnostic imaging service to which an item in this table (other than this item or item 64990, 64992, 64993, 64994 or 64995) applies if: (a) the service is an unreferred service; and (b) the service is provided to a person who is under the age of 16 or is a Commonwealth concession card holder; and (c) the person is not an admitted patient of a hospital; and (d) the service is bulk-billed in respect of the fees for: (i) this item; and (ii) the other item in this table applying to the service; and (e) the service is provided at, or from, a practice location in a Modified Monash 2 area | $12.50 85% benefit $10.65 |
| 64992 | A diagnostic imaging service to which an item in this table (other than this item or item 64990, 64991, 64993, 64994 or 64995) applies if: (a) the service is an unreferred service; and (b) the service is provided to a person who is under the age of 16 or is a Commonwealth concession card holder; and (c) the person is not an admitted patient of a hospital; and (d) the service is bulk-billed in respect of the fees for: (i) this item; and (ii) the other item in this Schedule applying to the service; and (e) the service is provided at, or from, a practice location in: (i) a Modified Monash 3 are; or (ii) a Modified Monash 4 area | $13.30 85% benefit $11.35 |
| 64993 | A diagnostic imaging service to which an item in this table (other than this item or item 64990, 64991, 64992, 64994 or 64995) applies if: (a) the service is an unreferred service; and (b) the service is provided to a person who is under the age of 16 or is a Commonwealth concession card holder; and (c) the person is not an admitted patient of a hospital; and (d) the service is bulk-billed in respect of the fees for: (i) this item; and (ii) the other item in this Schedule applying to the service; and (e) the service is provided at, or from, a practice location in a Modified Monash 5 area | $14.05 85% benefit $11.95 |
| 64994 | A diagnostic imaging service to which an item in this table (other than this item or item 64990, 64991, 64992, 64993 or 64995) applies if: (a) the service is an unreferred service; and (b) the service is provided to a person who is under the age of 16 or is a Commonwealth concession card holder; and (c) the person is not an admitted patient of a hospital; and (d) the service is bulk-billed in respect of the fees for: (i) this item; and (ii) the other item in this Schedule applying to the service; and (e) the service is provided at, or from, a practice location in a Modified Monash 6 area | $15.00 85% benefit $12.75 |
| 64995 | A diagnostic imaging service to which an item in this table (other than this item or item 64990, 64991, 64992, 64993 or 64994) applies if: (a) the service is an unreferred service; and (b) the service is provided to a person who is under the age of 16 or is a Commonwealth concession card holder; and (c) the person is not an admitted patient of a hospital; and (d) the service is bulk-billed in respect of the fees for: (i) this item; and (ii) the other item in this Schedule applying to the service; and (e) the service is provided at, or from, a practice location in a Modified Monash 7 area | $16.35 85% benefit $13.90 |
Check the item before you claim.
An eligibility check tests the patient and each MBS item against Medicare’s rules, so a ‘no’ comes back with the reason before the claim goes in.