Bulk-billing means we accept the Medicare rebate as full payment — nothing to pay on the day. Private billing means the patient pays our full fee at reception, and Medicare later refunds them a portion. Whether a scan bulk-bills is not a choice — it's a test against four gates.
GP-referred MRI for a specialist-only item — e.g. an adult knee MRI on a GP referral falls outside the GP-eligible list and goes private unless a specialist re-refers.
Allied-health referrer (physio/osteo) outside the allowed spine items — may attract the NR (Non-Referred) item at a reduced rebate, or be fully out-of-pocket.
Chiropractor referrals for spine X-ray — not eligible for the allied-health spine items. Medicare will reject.
Frequency limit exceeded — same MRI item billed more than 3 times in 12 months. Check prior imaging history before confirming bulk-bill.
Non-Australian resident / no Medicare card — fully private, no rebate.
"If you have a valid Medicare card and your referrer is eligible for this scan, we bulk-bill — no cost on the day. If we can't bulk-bill, the private fee varies by site — let me check with the office manager and we'll quote it before you book."
Private health insurance does not cover outpatient imaging in Australia — only inpatient imaging (while admitted to hospital). Tell callers who ask about using their "extras" or hospital cover that it won't apply to a scan booked through us as an outpatient. Medicare is the only rebate path.