Medicare Benefits Schedule - Note IN.0.5

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Category 5 - DIAGNOSTIC IMAGING SERVICES

IN.0.5

Capital Sensitivity Diagnostic Imaging Equipment

Except where there is an exemption in force, Medicare benefits are not payable for diagnostic imaging services rendered using equipment, other than positron emission tomography (PET), that has exceeded its ‘effective life age’ for new equipment or ‘maximum extended life age’ for upgraded equipment as shown in the table below.

This is known as capital sensitivity and is intended to ensure that patients have access to quality diagnostic imaging services by encouraging providers to upgrade and replace aged equipment as appropriate. 

Life ages of diagnostic imaging equipment

Type of Equipment Definition of type of equipment Effective life age for new equipment (years) Maximum extended life age (years)
Ultrasound Equipment primarily used in carrying out a diagnostic imaging procedure used in rendering a service to which an item in Group I1 applies 10 15
CT Equipment primarily used in carrying out a diagnostic imaging procedure used in rendering a service to which an item in Group I2 applies 10 15
Mammography Equipment primarily used in carrying out a diagnostic imaging procedure used in rendering a service to which an item in Subgroup 10 of Group I3 applies 10 15
Angiography Equipment primarily used in carrying out a diagnostic imaging procedure used in rendering a service to which an item in Subgroup 13 of Group I3 applies 10 15
Other diagnostic radiology Equipment primarily used in carrying out a diagnostic imaging procedure used in rendering a service to which an item in Subgroups 1 to 9, 12, 14, 15 or 17 of Group I3 applies 15 20
Nuclear medicine imaging  (other than for PET) Equipment primarily used in carrying out a diagnostic imaging procedure used in rendering a service to which an item in Group I4 applies (other than items 61523 to 61647) 10 15
MRI Equipment primarily used in carrying out a diagnostic imaging procedure used in rendering a service to which an item in Group I5 applies 10 20


Capital sensitivity exemptions

An exemption is available for practices where they have not been able to replace or upgrade equipment due to delays beyond the control of the practice. 

For full details about the rules for capital sensitivity, how to apply for an exemption and the definition of upgrade, providers should access the Department of Health's website at www.health.gov.au/capitalsensitivity or send an email enquiry to capsens@health.gov.au.


Legend

  • Assist - Addition/Deletion of (Assist.)
  • Amend - Amended Description
  • Anaes - Anaesthetic Values Amended
  • Emsn - EMSN Change
  • Fee - Fee Amended
  • Renum - Item Number Change (renumbered)
  • New - New Item
  • NewMin - New Item (previous Ministerial Determination)
  • Qfe - QFE Change