Bone Densitometry and Medicare
Bone densitometry items (MBS items 12306 - 12323) are outlined in a Ministerial determination and published in the General Medical Services Table (GMST) which is one of several tables of medical services that collectively comprise the Medicare Benefits Schedule (MBS).
Currently, Medicare benefits are payable for:
- the diagnosis and monitoring of bone loss if a patient has certain specific medical conditions or is undergoing particular treatments likely to cause rapid bone loss;
- the confirmation of clinically suspected low bone mineral density, usually following a fracture;
- the subsequent monitoring of established low bone mineral density; and/or
- those patients over the age of 70 years.
For Medicare purposes, all bone density testing is subject to a restriction on the time interval between tests, from one every 12 to 24 months, depending on the item. This is because bone density loss is considered a relatively slow process and repeat testing within 24 months is unlikely to assist in clinical decision making. For those specific medical conditions or particular treatments that may cause more rapid bone loss, a rebate is available for repeat testing at 12 monthly intervals.
The Medical Services Advisory Committee (MSAC) is reviewing the evidence regarding the use of bone densitometry and will provide advice to the Minister for Health and Ageing.
More information can be found on the MSAC website.