How much does an MRI cost?

How much does an MRI cost?

Although the total cost of an MRI scan varies depending on the part of the body being imaged, costs generally range from $300 and $1,000.

Both Medicare and private health insurance (in some cases) can pay towards the cost of the MRI scan, so long as the type of MRI scan you’re receiving is on Medicare Benefit Schedule (MBS) – meaning you’re eligible for a rebate. The MRI machine must also be fully or partially licensed.

If you’re treated in a public hospital as an inpatient and they bulk-bill, you might not have any out of pocket expenses.

Health insurance for MRI scans

Use the tool below to compare health insurance from multiple funds. Keep in mind that MRI scans are not a clinical category, they’re a treatment type. If you need an MRI scan for a particular treatment, then your private health insurance will cover some of the costs if your policy covers that particular type of illness – for example, cancer.

MRI cost: Medicare vs private health insurance

Health insurance can cover MRI scans, depending on your cover. Whether you are going the Medicare or health insurance route, always be sure to check that your treatment is covered or whether you will need to pay any upfront costs. Here are some of the ways these costs will be calculated:

• Public patient in a public hospital (no health insurance): Medicare can cover 100% of the MBS fee.
• Private patient in a public hospital: Medicare covers 75% with the remaining “gap” covered by your health insurer.
• Private patient in a private hospital: Medicare once again covers 75% with the remainder paid by your health insurer.
• Out of hospital MRI scan with specialist referral: Medicare covers 85% of the cost.

To have your MRI scan covered by health insurance, you’ll need hospital cover. Each hospital insurance tier will cover a different set of conditions, so you’ll need to have a product that covers your particular issue to be covered.

Does Medicare cover MRI scans in Australia?

Medicare will cover the cost of some MRI scans, depending on the reason for the scan. The Medicare Benefits Schedule (MBS) lists item numbers (conditions) for which benefits can be claimed. The table below lists the

Item numberPurpose of the scanFee chargedMedicare benefit63551Head scan for a patient 16 years or older to investigate:

• Unexplained seizures
• Unexplained chronic headaches with suspected intracranial pathology

$403.2075%: $302.4085%: $342.7563554Spinal scan for a patient 16 years or older for suspected cervical radiculopathy$358.4075%: $268.8085%: $304.6563557Spinal scan for a patient 16 years or older for suspected cervical spine trauma$492.8075%: $369.6085%: $418.9063560Knee scan for a patient 16 years or older following acute knee trauma with:

• Inability to extend the knee suggesting the possibility of acute meniscal tear
• Clinical findings suggesting acute anterior cruciate ligament tear

$403.2075%: $302.4085%: $342.7563507Head scan for a patient under 16 years for any of the following:

• Unexplained seizures
• Unexplained headaches where significant pathology is expected
• Paranasal sinus pathology, which has not responded to conservative treatment

$403.2075%: $302.4085%: $342.7563510Spinal scan for a patient under 16 years following radiographic examination for:

• Significant trauma
• Unexplained neck or back pain with associated neurological signs
• Unexplained back pain where a significant pathology is suspected

$448.0075%: $336.0085%: $380.8063513Knee scan for a patient under 16 years following radiographic examination for internal joint derangement$403.2075%: $302.4085%: $342.7563516Hip scan for a patient under 16 years following radiographic examination for:

• Suspected septic arthritis
• Suspected slipped capital femoral epiphysis
• Suspected Perthes disease

$403.2075%: $302.4085%: $342.7563519Elbow scan for a patient under 16 years following radiographic examination where a significant fracture or avulsion injury is suspected that will change management$403.2075%: $302.4085%: $342.7563522Wrist scan for a patient under 16 years following radiographic examination where scaphoid fracture is suspected$448.0075%: $336.0085%: $380.80

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