Bulk Billed MRI, CT & Ultrasound Explained

Bulk billing is when a healthcare provider accepts the Medicare benefit as full payment for a service. This means you pay nothing out of pocket - the clinic bills Medicare directly.

For medical imaging, bulk billing means you can have your X-ray, ultrasound, CT scan, or other imaging done at no cost to you, as long as you have a valid referral and a Medicare card.

Most imaging types can potentially be bulk-billed, but the likelihood varies:

• X-rays: Very commonly bulk-billed. Most clinics bulk-bill all X-rays with a valid referral. • Ultrasound: Frequently bulk-billed, especially for pregnancy scans. Some clinics bulk-bill all ultrasounds; others only for concession holders. • CT scan: Often bulk-billed for concession card holders. Some clinics bulk-bill all CT scans. • Mammography: Screening is free through BreastScreen Australia for eligible women (no referral needed). Diagnostic mammograms may be bulk-billed. • MRI: Rarely bulk-billed due to limited Medicare licensing. Some clinics bulk-bill MRI for concession holders at Medicare-licensed sites. • DEXA scan: Sometimes bulk-billed if you meet Medicare eligibility criteria.

Bulk billing is at the clinic's discretion - not all clinics offer it, and policies can change.

You need:

1. A valid Medicare card 2. A valid referral from a doctor (GP or specialist)

Some clinics bulk-bill everyone. Others only bulk-bill certain groups:

• Pensioner Concession Card holders • Healthcare Card holders • DVA (Department of Veterans' Affairs) card holders • Children under 16 • Aged care residents

When booking, always ask the clinic whether they'll bulk-bill your particular scan. Some clinics advertise bulk billing for specific scan types but charge a gap for others.

Finding a bulk-billing clinic is easier than you think:

• Book a bulk billed MRI near you or book an ultrasound on Radly and filter by bulk billing • Ask your GP - they often know which local clinics bulk-bill • Call the clinic directly and ask before booking - "Will this scan be bulk-billed?" • Check the clinic's website - many list their billing policies

Remember: you're not locked into the clinic your doctor suggests. You can take your referral anywhere. Shopping around can save you hundreds of dollars.

If a clinic doesn't bulk-bill, you'll pay a gap fee - the difference between what the clinic charges and what Medicare rebates.

Example: • Clinic charges $250 for a CT scan • Medicare rebates $180 • You pay $70 out of pocket

You can either pay this upfront and claim your Medicare rebate (via the Medicare app or myGov), or many clinics will process your Medicare claim on the spot so you only pay the gap.

Always ask for the total cost and likely out-of-pocket amount before your scan. Clinics are required to inform you of costs before proceeding.