Requesting of MRI (magnetic resonance imaging) services

This page describes the MRI services that may be requested by GPs (general practitioners) and the differences between services that can be rebated on full and partial Medicare-eligible MRI units.

Page last updated: 18 March 2020

Who can request MRI scans

The majority of MRI scans listed on the MBS are only eligible for a Medicare rebate if they are requested by a specialist.  This is because, usually, the types of conditions for which MRI scans are needed should be managed by a specialist. 

There are a small set of MRI items under Medicare that can be requested by a GP, which were established based on expert advice on the clinical appropriateness of the items in the general practice setting.  These items are intended to improve patient access to timely MRI services and reduce patient exposure to unnecessary radiation (associated with some types of diagnostic imaging such as CT (computed tomography) scans).

Difference between full and partial Medicare eligibility

Full Medicare-eligible MRI units are able to perform all MRI services listed on the MBS with a Medicare rebate for the patient.

Partial Medicare-eligible MRI units are currently able to perform a limited number of MRI items listed on the MBS.  These items (listed below) include:

  • GP requested items for children under the age of 16 years;
  • GP requested items for patients 16 years and over;
  • a range of cancer staging services such as MRI of the breast; prostate; and pelvis - for cervical and rectal cancer;
  • breast MRI items where conventional imaging has been inconclusive or inconsistent with clinical assessment;
  • MRI of the pancreas and biliary tree for suspected pathologies;
  • cardiomyopathy MRI items;
  • approved Crohn’s disease MRI items; and
  • items to evaluate Poly Implant Prothèse (PIP) breast implant integrity.

Any future MRI items listed on the MBS will be able to be provided on partially eligible MRI units.

MBS items eligible on partially eligible machines

The following two tables contain a summary of items that can be provided on MRI units with either partial (or full) Medicare eligibility.  A full description of these items including the specific clinical indications for each item, can be found on the MBS online website, by clicking on the relevant MBS item number in the tables.

Table 1: General Practitioner requested MRI items

MBS Item

Descriptor Summary

Requestor

Provider

63507

MRI of the head – under 16 years

GP

MRI Specialist

63510

MRI of the spine – under 16 years

GP

MRI Specialist

63513

MRI of the knee – under 16 years

GP

MRI Specialist

63516

MRI of the hip – under 16 years

GP

MRI Specialist

63519

MRI of the elbow – under 16 years

GP

MRI Specialist

63522

MRI of the wrist – under 16 years

GP

MRI Specialist

63551

MRI of the head – 16 years and over

GP

MRI Specialist

63554

MRI of the spine (cervical radiculopathy)

GP

MRI Specialist

63557

MRI of the spine (cervical spine trauma)

GP

MRI Specialist

63560

MRI of the knee - 16 to 49 years

GP

MRI Specialist

Note: An MRI Specialist is a person who is a specialist in diagnostic radiology and a participant in RANZCRs’ Quality and Accreditation Program.

Table 2: Specialist requested MBS items

MBS Item

Descriptor Summary

Requestor

Provider

63464

MRI of both breasts for asymptomatic patients less than 50 years

Specialist

MRI Specialist

63467

MRI of both breasts within 12months of abnormality detected in service 63464

Specialist

MRI Specialist

63470

MRI of the pelvis (cervical cancer)

Specialist

MRI Specialist

63473

MRI of the pelvis and abdomen (cervical cancer)

Specialist

MRI Specialist

63476

MRI of the pelvis (rectal cancer)

Specialist

MRI Specialist

63482

MRI of the pancreas and biliary tree

Specialist

MRI Specialist

63487

MRI of the breast/s (occult breast cancer)

Specialist

MRI Specialist

63489

MRI guided breast biopsy

Specialist

MRI Specialist

63740

MRI of the pelvis and upper abdomen (Crohn’s disease)

Specialist

MRI Specialist

63741

MRI enteroclysis for Crohn’s disease)

Specialist

MRI Specialist

63743

MRI pelvis (fistulising Crohn’s disease)

Specialist

MRI Specialist

63395

MRI of the heart (suspected ARVC )

Specialist

MRI Specialist

63397

MRI of the heart (family history of ARVC)

Specialist

MRI Specialist

63547

MRI of the breast (BIA-ALCL)

Specialist

MRI Specialist

63491

MRI modifying item – contrast agent

Specialist

MRI Specialist

63494

MRI modifying item – sedation

Specialist

MRI Specialist

63497

MRI modifying item – anaesthetic

Specialist

MRI Specialist

63531

MRI of both breasts to detect breast cancer where conventional imaging is inconclusive.

Specialist

MRI Specialist

63533

MRI of both breasts following breast cancer diagnosis, where there is a discrepancy between clinical assessment and conventional imaging.

Specialist

MRI Specialist

Notes: An MRI Specialist is a person who is a specialist in diagnostic radiology and a participant in RANZCRs’ Quality and Accreditation Program.  For items 63395 to 63398 an MRI specialist is a specialist in diagnostic radiology or a consultant physician, and is recognised by the Conjoint Committee for Certification in Cardiac MRI.

A specialist requestor is a medical specialist or consultant physician (other than a specialist radiologist) who determined that the service was necessary and whose patient the person was, consistent with requirements of the specific items. 

Items relating to breast implants manufactured by Poly Implant Prothèse (PIP)

The summary of items in table 3 were established following the TGA recall of silicone-filled breast implants manufactured by the French company Poly Implant Prothèse (PIP) in 2012.  These MRI items are to evaluate the integrity of the PIP implants and detect implant rupture in patients presenting with symptoms.  These items are eligible for a Medicare rebate when provided on any DIAS-accredited MRI unit, with or without Medicare eligibility.

Table 3: Breast MRI items associated with PIP implants

MBS Item

Descriptor Summary

Requestor

Provider

63501

MRI of the Breast for evaluation of PIP/suspected PIP implant integrity, where results show loss of integrity

Any Medical Practitioner

MRI Specialist

63502

MRI of the Breast MRI of the Breast for evaluation of PIP/suspected PIP implant integrity, where result doesn’t show loss of integrity

Any Medical Practitioner

MRI Specialist

63504

MRI of the Breast for evaluation of PIP/suspected PIP implant integrity, where rupture is suspected, and results show a loss of integrity

Any Medical Practitioner

MRI Specialist

63505

MRI of the Breast for evaluation of PIP/suspected PIP implant integrity, where rupture is suspected, and result doesn’t show a loss of integrity

Any Medical Practitioner

MRI Specialist

63498

PIP Modifying item - sedation

Any Medical Practitioner

MRI Specialist

63499

PIP Modifying item - anaesthetic

Any Medical Practitioner

MRI Specialist

Note: An MRI Specialist is a person who is a specialist in diagnostic radiology and a participant in RANZCRs’ Quality and Accreditation Program.