Medicare and Patient Billing Information
Medicare & Patient Billing Information
Affordable & Accessible Care
Bulk Billed* X-Ray, Ultrasound and CT examinations & Image Guided Injections
Bulk Billed Medicare Eligible Examinations
At CLARITY we are committed to providing affordable and accessible healthcare for all. Wherever possible we provide Bulk Billed medical imaging for our community.
Various procedures require specific indications or criteria in order to attract a Medicare rebate- this is know as Medicare Eligible. Please see a summary and some FAQ’s below as a guide.
We are unable to bulk bill examinations or referrals that do meet the Medicare eligible criteria and out-of-pocket fees may apply. If you have any questions about the eligibility of a request please contact our reception staff during business hours on 02 4990 2655.
FAQs
In order for your examination to be bulk billed you must as a minimum have:
- A valid Australian Medicare card
- A valid referral from a registered Practitioner with a Medicare issued Provider number (referral restrictions apply for some practitioners and allied healthcare professionals).
- The examination requested meets the relevant Medicare criteria*.
*Medicare eligibility can vary depending on the referring practitioner and clinical indication provided.
Most referrals for X-ray, Ultrasound, CT and Injections written by a GP or Specialists with a valid Medicare provider number, will be Medicare eligible.
Allied Healthcare Professionals such as Podiatrists, Physiotherapists, Chiropractors, and Osteopaths are largely restricted in the examinations they can request. They cannot request most Ultrasound, any CT or guided injections. Please find a summary of Medicare eligible examinations from allied health professionals below:
Podiatrists: X-Rays of the foot; ankle; leg; knee or femur only. Ultrasound of the ankle, foot or skin/lump
Physiotherapists/ Chiropractors and Osteopaths: X-Rays of the hip, pelvis, cervical, thoracic, lumbosacral spine.
Unfortunately, there are many varied and complex exceptions and we are unable to list them all here.
The main exceptions apply to:
- some pregnancy scans, in particular those not referred by an Obstetrician.
- referrals from allied healthcare professionals such as Podiatrists, Physiotherapists, Chiropractors, and Osteopaths.
- bilateral (right + left) musculoskeletal ultrasounds and CT
- Multiple spine regions for CT
- Some multiple examinations
Our staff can advise you on the any out-of-pocket costs that may apply if your examination/s are not Medicare eligible.
Unfortunately, the Federal Government restricts access to Medicare Funded MRI services through a “MRI licencing” system. Meaning only select MRI’s and locations can receive Medicare rebates. This is not in any way related to the MRI technology, quality of service or standard of care at the location. Therefore “licenced MRIs’ are not “better” in any way. There have not been any new MRI licences offered in Newcastle in 10 years. As a result we do not receive any Medicare funding or rebates for any MRI services at CLARITY, and are regretfully unable to bulk bill.
This is all set to change in 2027 when the licencing system is set to be revoked. Until then we will offer low out of pocket costs for our MRI services with no referral restrictions. We do offer a comprehensive range of services for Worker’s Compensation and third party claims at no out of pocket cost for approved claims. Please contact our reception team for more information on MRI fees and insurance approvals.
CLARITY is committed to providing affordable care for our community. Unlike some other Radiology companies, we are locally and independently owned. We do not have to pay wages for a large management team or a board of directors. Nor do we have profit focused shareholders. Just our small team that delivers high quality care at affordable Medicare rebates.
The information provided here is intended as a guide only. Medicare criteria can be complex to navigate and exceptions may apply. Determining the eligibility of a referral is one of the expertise of our trained reception staff. If you have any questions regarding the Medicare eligibility of your referral please call us during business hours on 02 4990 2655.
