What is Magnetic Resonance Imaging (MRI) and is it claimable?

The acronym MRI stands for Magnetic Resonance Imaging. This type of imaging procedure uses a magnetic field and radio waves to take pictures of your bodies internal structure.

How does it work? 

An MRI works by having the patient lie on a table, that slides into a large cylinder, which contains a magnet. When the machine is operating, a powerful magnetic field is created. The magnetic field acts on the protons (microscopic substances contained in the water molecules of your soft tissue) to send out an echo in response to the MRI’s radio waves. A computer is then used to create images from these echoes.

Can I claim on an Magnetic Resonance Imaging (MRI) procedure?

There are some situations where you’ll be able to claim a Medicare and/or Health Fund rebates for MRI procedures. 

In some cases, MRI’s are Medicare rebateable for scans where others are not. This will always be noted on your Radiology invoice. Where a rebate isn’t not claimable for an MRI procedure, the invoice will state something similar to “Not Medicare Rebateable”. In this case, benefits are unable to be paid by Health Funds either.

Where an MRI invoice has a Medicare Benefit Schedule (MBS) item number shown (i.e. 63395) and the service was performed as an admitted service within a hospital as a private patient, benefits may be payable under your HIF Hospital cover.

Where an MRI procedure has been performed whilst not an admitted service within a hospital as a private patient, benefit is not payable – this is due to Australian Government Legislation, which prevents Health Funds from paying benefits towards Outpatient medical services.

You can speak with your referring doctor or Radiology provider as to whether your specific MRI procedure is eligible for a rebate.