Changes to Diagnostic Imaging MBS Services - July 2024

The following changes relating to diagnostic imaging Medicare Benefits Schedule (MBS) services will commence 1 July 2024.

• New items for abdominal magnetic resonance imaging (MRI) for rare genetic conditions
  New MBS MRI items (63539 and 63540) will commence for eligible patients with defined rare inherited conditions associated with an increased lifetime risk of renal tumours. These MRI items will allow for annual surveillance to detect newly developed renal tumours as well as ongoing assessment over time to existing renal tumours. A factsheet on this will be published on MBS Online factsheets shortly.

In addition, you may be interested to review the outcomes of recent considerations from the Medical Services Advisory Committee (MSAC) meeting of April 2024:

• 1686.1 –177 Lutetium PSMA i&t for metastatic castrate resistant prostate cancer.
• 1720 – 68Ga PSMA-11 PET/CT imaging for patients who are candidates for PSMA targeted therapy.
• 1713 – Cardiac MRI in the diagnosis of myocarditis

The public summary documents have either been published or will be available shortly.

Changes from Budget 2024-25 that will commence on 1 November 2024 include:

• Positron emission tomography (PET) imaging for rare cancer
  A new PET MBS item will be introduced for the assessment of treatment response and recurrence for patients with an eligible rare or uncommon cancer. The item follows on from the previously introduced initial staging item (61612) for rare cancers.
   
• Expansion of magnetic resonance imaging (MRI) item for rectal cancer
  The existing pelvic MRI item (63476) for the initial staging of rectal cancer will be expanded for use in the restaging and follow up of rectal cancer.
   
• Ultrasound imaging requesting rights for nurse practitioners
  Requesting rights for nurse practitioners will be expanded to cover MBS items 55700, 55704 and 55065. This will support patients in the before and after care requirements of the MS-2 Step medical abortion program.
   
• Targeted fee changes for nuclear medicine imaging and CT services
  The subgroup for non-PET imaging services will receive a one-off fee increase of 3.5% which will address discrepancies between the fees and costs of providing these services. This will be followed by annual indexation from 1 July 2025. The schedule fee for all CT services will be reduced by 2%. This change is intended to support patients to access more appropriate imaging modalities, rather than limit access to CT, through reinvesting in MRI and nuclear medicine. This change will not apply to the lung cancer screening CT items that are proposed to commence from 1 July 2025.

Further information on diagnostic imaging changes announced in Budget can be found here.

Factsheets for the November 2024 changes will be available online closer to implementation.

 

Further changes relating to diagnostic imaging MBS services will commence 1 July 2024:

• Temporary nuclear medicine items 61470 (Thallium-201) and 61477 (Gallium-67) (Factsheet)
  Items 61470 and 61477 will continue to be available until 30 June 2026. These items were due to cease on 30 June 2024. The schedule fee for these items will increase to: Item 61470 - $1,463.80 and Item 61477 - $963.00. There are no changes to the use or application of these items.
   
• Supervision requirements for nuclear medicine (Factsheet)
  Supervision requirements for nuclear medicine imaging services are changing to ensure patients receiving these services are appropriately managed.
   
• Capital sensitivity exemption application changes (Factsheet)
  Medicare benefits are not payable for services performed on diagnostic imaging equipment that is older than its effective age (referred to as capital sensitivity). From 1 July 2024, the arrangements will be amended to reduce the administrative burden associated with applications for exemption from the capital sensitivity requirements. Key changes include the two application pathways being consolidated into a single pathway with one application form and the maximum exemption period for an initial exemption changing from 3 months to 6 months.
   
• 1 July 2024 MBS Indexation
  The MBS indexation factor for 1 July 2024 is 3.5 per cent. This will be applied to most diagnostic imaging services (excluding nuclear medicine imaging services). This will also be applied to most general medical services (including bone densitometry and therapeutic nuclear medicine).

Further information on 1 July 2024 changes to other areas of the MBS can be found on MBS Online July 2024 News.