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Medicare rebates now available for breast MRI and PET services

08/11/2019

An expansion of the Medicare rebate codes for MRI and PET scans for breast imaging came into effect from 1 November, reducing the cost of these scans for patients.

These new codes have improved access to breast MRI for patients who have a diagnosis of breast cancer and where the results of a breast MRI may alter treatment planning.

A second code has been made available for MRI of the breasts where the patient has a breast lesion and the results of conventional imaging are inconclusive and biopsy has not been possible.

There are also two new Medicare rebates for PET scans for the assessment of stage three, metastatic and locally recurrent breast cancer.

Cabrini patients are already receiving the rebates.

Cabrini Radiologist Dr Bronwen Slater said the changes had reduced costs for patients needing an MRI or PET scan.

“With breast cancer, you can have significant out-of-pocket costs, particularly for scans, so this will reduce that financial burden for patients,” Dr Slater said.

“Previously, patients had to cover the entire cost of $600 for MRI and $870 for PET scan because there was no Medicare rebate. This is a big saving for those patients.”

In order to receive the rebate, patients must be referred by a treating specialist or surgeon.

Normal out-of-pocket costs will apply after the rebate.

Dr Slater said the rebates would make the process more streamlined for patients and would provide treating surgeons with the most accurate information.

“MRI is one of the most expensive but most valuable tools we have available to treat patients with breast cancer,” Dr Slater said.

“MRI allows us to make a more accurate diagnosis following other screening tests, such as mammograms and ultrasounds, which can be inconclusive in their findings.

“MRI also provides a better overview of a patient’s tumour, meaning that the entire tumour can be removed in one operation, without them requiring additional surgery.”

Dr Slater said the rebates would make these scans more accessible for patients.

“There are patients who, in the past, did not have an MRI because of the extra cost. These changes make MRI accessible to more patients who need it.”

Cabrini’s MRI service