Medicare Benefits Schedule - Note IN.0.2

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What is a Diagnostic Imaging Service and who may provide a service

What is a diagnostic imaging service

A diagnostic imaging service is defined in the Act as "an R-type diagnostic imaging service or an NR-type diagnostic imaging service to which an item in the DIST applies". 

A diagnostic imaging service includes the diagnostic imaging procedure, which is defined in the Act as 'a procedure for the production of images (for example x-rays, computerised tomography scans, ultrasound scans, magnetic resonance imaging scans and nuclear scans) for use in the rendering of diagnostic imaging services as well as the report'. 

The Schedule fee for each diagnostic imaging service described in the DIST covers both the diagnostic imaging procedure and the reading and report on that procedure by the diagnostic imaging service provider.  Exceptions to the reporting requirement are as follows: 

-          where the service is provided in conjunction with a surgical procedure, the findings may be noted on the operation record (items 55054, 55130, 55135, 55848, 57341, 59312, 59314, 60506, 60509 and 61109);

-          where a service is provided in preparation of a radiological procedure (items 60918 and 60927). 

As for all Medicare services, diagnostic imaging services have to be clinically relevant before they are eligible for Medicare benefits.  A clinically relevant service is a service that is generally accepted by the profession as being necessary for the appropriate treatment of the patient. 

For R-type services rendered at the request of another practitioner, responsibility for determining the clinical relevance of the service lies with the requesting practitioner. For NR-type services (and R-type services provided without a request under the exemption provisions - see IN.0.6 - 'Exemptions from the written request requirements for R-type diagnostic imaging services'), the clinical relevance of the service is determined by the providing practitioner. 

Who may provide a diagnostic imaging service

Unless otherwise stated, a diagnostic imaging service specified in the DIST may be provided by: 

a) a medical practitioner; or 

b) a person, other than a medical practitioner, who provides the service under the supervision of a medical practitioner in accordance with accepted medical practice. 

For the purposes of Medicare, however, the rendering practitioner is the medical practitioner who provides the report. 

Medicare benefits are not payable, for example, when a medical practitioner refers patients to self-employed paramedical personnel, such as radiographers or other persons, who either bill the patient or the practitioner requesting the service. 

Reports provided by practitioners located outside Australia 

Under the Act, Medicare benefits are only payable for services rendered in Australia. Where a service consists of a number of components, such as a diagnostic imaging service, all components need to be rendered in Australia in order to qualify for Medicare benefits. For diagnostic imaging services, this means that all elements of the service, including the preparation of report on the procedure, would need to be rendered in Australia. 

Related Items: 57341

Related Items



57341 - Additional Information

Item Start Date:
Description Updated:
Schedule Fee Updated:

Computed tomography, in conjunction with a surgical procedure using interventional techniques (R) 


Fee: $509.20 Benefit: 75% = $381.90 85% = $432.85

(See para IN.0.2, IN.0.19 of explanatory notes to this Category)


  • 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