New Medicare benefits for breast imaging

From 1 November 2019, the Australian Government has improved access to important scans for women who have or are suspected of having breast cancer.

Two new item numbers have been added to the Medicare Benefits Schedule (MBS) for MRI of the breast meaning patients will now be able to claim Medicare benefits where they:

  • have a breast lesion where conventional imaging has been inconclusive for the presence of breast cancer and biopsy has not been possible (Medicare item number: 63531)
  • have been diagnosed with breast cancer and there has been a discrepancy between clinical and conventional imaging assessment and that the results of the breast MRI may alter treatment planning (Medicare item number: 63533)

In addition, two new MBS items have been added for the evaluation of breast cancer with PET scans (Medicare item numbers 61524 and 61525). These scans can help to manage and plan treatment for patients with metastatic, or suspected metastatic, breast cancer to assist with staging the cancer and monitoring whether treatments are working.

We are pleased to see these new inclusions in the MBS to ensure more women have affordable access to this important diagnostic imaging.

For further information relating to these new MBS items, please download our MBS Updates:

Breast imaging – PET/CT

Breast imaging – MRI

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