Group I5: Magnetic Resonance Imaging
120 items with their schedule fees and Medicare benefits.
| Item | Fee | 75% | Out of hospital |
|---|---|---|---|
| 63001MRI scan of the head with or without contrast to diagnose or assess brain or meningeal tumours, including MRA if needed; may require anaesthesia. | $463.80 | $347.85 | $394.25 (85%) |
| 63004MRI brain scan with contrast for suspected brain or meningeal inflammation, including MRA if needed. | $463.80 | $347.85 | $394.25 (85%) |
| 63007MRI scan of the head with contrast to diagnose or evaluate skull base or orbital tumours, including MR angiography if needed; may include anaesthesia. | $463.80 | $347.85 | $394.25 (85%) |
| 63010MRI of the head with or without MRA, including fiducials, performed for planning stereotactic brain surgery. | $386.55 | $289.95 | $328.60 (85%) |
| 63019MRI head scan (including MRA) to assess suitability for MRI-guided focused ultrasound treatment of medically refractory essential tremor; once per patient lifetime. | $463.80 | $347.85 | $394.25 (85%) |
| 63020MRI scan of the head (including MRA if needed) performed once per patient lifetime for post-procedure assessment after MRI-guided focused ultrasound treatment of medically refractory essential tremor. | $463.80 | $347.85 | $394.25 (85%) |
| 63040MRI head scan with contrast to diagnose or assess acoustic neuroma, including MRA if needed. | $386.55 | $289.95 | $328.60 (85%) |
| 63043MRI scan of the head with contrast to assess pituitary tumour, including MRA if needed, performed under anaesthesia. | $412.25 | $309.20 | $350.45 (85%) |
| 63046MRI scan of the head with optional MRA to investigate toxic, metabolic, or ischaemic encephalopathy, with contrast and anaesthesia available if needed. | $463.80 | $347.85 | $394.25 (85%) |
| 63049MRI scan of the head with contrast to evaluate demyelinating disease of the brain, including MR angiography if needed. | $463.80 | $347.85 | $394.25 (85%) |
| 63052MRI scan of the head including MRA if needed, for congenital brain or meningeal malformations, with contrast and anaesthesia if required. | $463.80 | $347.85 | $394.25 (85%) |
| 63055MRI head scan with contrast to diagnose venous sinus thrombosis, including MR angiography if needed. | $463.80 | $347.85 | $394.25 (85%) |
| 63058MRI scan of the head with optional MRA for head trauma evaluation, requiring referral and performed under anaesthesia with contrast. | $463.80 | $347.85 | $394.25 (85%) |
| 63061MRI scan of the head with contrast, including MRA if needed, for patients with epilepsy; requires referral and may involve anaesthesia. | $463.80 | $347.85 | $394.25 (85%) |
| 63064MRI scan of the head with or without contrast and anaesthesia to evaluate acute stroke, including MR angiography if clinically indicated. | $463.80 | $347.85 | $394.25 (85%) |
| 63067MRI scan of the head with optional MRA to diagnose carotid or vertebral artery dissection, with contrast and anaesthesia if needed. | $463.80 | $347.85 | $394.25 (85%) |
| 63070MRI scan of the head with contrast to detect or evaluate intracranial aneurysms, including MR angiography if needed. | $463.80 | $347.85 | $394.25 (85%) |
| 63073MRI head scan with possible MRA to diagnose or evaluate intracranial arteriovenous malformation, performed under anaesthesia with contrast. | $463.80 | $347.85 | $394.25 (85%) |
| 63101MRI or MRA scan of head and neck blood vessels to assess for stroke, with contrast and anaesthesia if required. | $566.90 | $425.20 | $481.90 (85%) |
| 63111MRI of head and cervical spine with optional MRA for suspected central nervous system or meningeal tumours, with contrast and anaesthesia if needed. | $566.90 | $425.20 | $481.90 (85%) |
| 63114MRI scan of head and cervical spine with contrast to diagnose inflammation of the brain, spinal cord or meninges; may include MRA if performed. | $566.90 | $425.20 | $481.90 (85%) |
| 63125MRI scan of the head and cervical spine, with optional MR angiography, to investigate suspected demyelinating disease of the central nervous system; may include contrast and anaesthesia. | $566.90 | $425.20 | $481.90 (85%) |
| 63128MRI of head and cervical spine with or without MRA for suspected congenital malformation of the central nervous system or meninges, including anaesthesia and contrast if needed. | $566.90 | $425.20 | $481.90 (85%) |
| 63131MRI scan of head and cervical spine with optional MR angiography to diagnose congenital or acquired syrinx, with contrast and anaesthesia as needed. | $566.90 | $425.20 | $481.90 (85%) |
| 63151MRI scan of one or two adjacent spinal regions to investigate infection, with contrast and anaesthesia if needed. | $412.25 | $309.20 | $350.45 (85%) |
| 63154MRI scan of one or two adjacent spine regions to investigate suspected tumour, with contrast and anaesthesia if needed. | $412.25 | $309.20 | $350.45 (85%) |
| 63161MRI scan of one or two adjacent spinal regions to investigate demyelinating disease, with contrast and anaesthesia if needed. | $412.25 | $309.20 | $350.45 (85%) |
| 63164MRI scan of one or two adjacent spine regions to diagnose congenital malformations of the spinal cord, cauda equina, or meninges, with contrast and anaesthesia available. | $412.25 | $309.20 | $350.45 (85%) |
| 63167MRI scan of one or two connected spine regions to diagnose myelopathy, with option for contrast agent and anaesthesia. | $412.25 | $309.20 | $350.45 (85%) |
| 63170MRI scan of one or two contiguous spine regions to assess for syrinx (congenital or acquired), with contrast and anaesthesia as needed. | $412.25 | $309.20 | $350.45 (85%) |
| 63173MRI scan of one or two adjacent spine regions to assess cervical radiculopathy, with contrast and anaesthesia if required. | $412.25 | $309.20 | $350.45 (85%) |
| 63176MRI scan of one or two contiguous spinal regions with contrast to investigate sciatica, requiring anaesthesia. | $412.25 | $309.20 | $350.45 (85%) |
| 63179MRI scan of one or two adjacent spine regions to diagnose spinal canal stenosis, with contrast and anaesthesia if needed. | $412.25 | $309.20 | $350.45 (85%) |
| 63182MRI scan of one or two connected spinal regions in patients with previous spinal surgery, with contrast and anaesthesia available. | $412.25 | $309.20 | $350.45 (85%) |
| 63185MRI scan of one or two adjacent spinal regions to assess spinal trauma, with anaesthesia. | $412.25 | $309.20 | $350.45 (85%) |
| 63201MRI scan of the spine (3 contiguous or 2 non-contiguous regions) to investigate suspected infection, with contrast and anaesthesia if needed. | $515.30 | $386.50 | $438.05 (85%) |
| 63204MRI scan of 2–3 spine regions to investigate suspected tumour, with contrast and anaesthesia if required. | $515.30 | $386.50 | $438.05 (85%) |
| 63219MRI of the spine (up to 3 contiguous or 2 non-contiguous regions) with contrast to assess for demyelinating disease; requires referral. | $515.30 | $386.50 | $438.05 (85%) |
| 63222MRI of spine (3 contiguous or 2 non-contiguous regions) for congenital malformation of spinal cord, cauda equina or meninges, with contrast and/or anaesthesia. | $515.30 | $386.50 | $438.05 (85%) |
| 63225MRI scan of up to 3 contiguous or 2 non-contiguous spinal regions to evaluate myelopathy, with optional contrast and anaesthesia. | $515.30 | $386.50 | $438.05 (85%) |
| 63228MRI scan of up to 3 contiguous or 2 non-contiguous spinal regions to assess for syrinx (fluid-filled cavity in spinal cord), with contrast and anaesthesia as needed. | $515.30 | $386.50 | $438.05 (85%) |
| 63231MRI scan of up to 3 contiguous or 2 non-contiguous spine regions with contrast for diagnosing cervical radiculopathy, requiring referral. | $515.30 | $386.50 | $438.05 (85%) |
| 63234MRI scan of 2–3 spine regions with contrast for sciatica diagnosis in referred patients. | $515.30 | $386.50 | $438.05 (85%) |
| 63237MRI scan of up to 3 contiguous or 2 non-contiguous spinal regions to assess spinal canal stenosis, with contrast and anaesthesia if needed. | $515.30 | $386.50 | $438.05 (85%) |
| 63240MRI scan of up to 3 contiguous or 2 non-contiguous spinal regions with contrast in patients with previous spinal surgery, performed under anaesthesia. | $515.30 | $386.50 | $438.05 (85%) |
| 63243MRI scan of up to 3 contiguous or 2 non-contiguous spinal regions for trauma assessment, including anaesthesia. | $515.30 | $386.50 | $438.05 (85%) |
| 63271MRI scan of the cervical spine and brachial plexus with contrast to assess for tumour, typically requiring anaesthesia. | $566.90 | $425.20 | $481.90 (85%) |
| 63274MRI scan of the cervical spine and brachial plexus with contrast, performed under anaesthesia, for assessment of traumatic injury. | $566.90 | $425.20 | $481.90 (85%) |
| 63277MRI scan of the cervical spine and brachial plexus with contrast under anaesthesia for patients with cervical radiculopathy. | $566.90 | $425.20 | $481.90 (85%) |
| 63280MRI scan of the cervical spine and brachial plexus with contrast for patients with previous cervical spine surgery, including anaesthesia. | $566.90 | $425.20 | $481.90 (85%) |
| 63301MRI of musculoskeletal system to assess bone or soft tissue tumours, excluding breast, prostate or rectal origins, with contrast and anaesthesia. | $438.05 | $328.55 | $372.35 (85%) |
| 63304MRI scan of bones or muscles to detect infection, excluding breast, prostate or rectal infections; contrast and anaesthesia may be used. | $438.05 | $328.55 | $372.35 (85%) |
| 63307MRI scan of musculoskeletal system with contrast to diagnose osteonecrosis, performed under anaesthesia. | $438.05 | $328.55 | $372.35 (85%) |
| 63322MRI scan of the hip and surrounding structures to detect damage or derangement, with contrast agent and anaesthesia. | $463.80 | $347.85 | $394.25 (85%) |
| 63325MRI scan of the shoulder and surrounding structures to assess for internal derangement, with contrast and anaesthesia as needed. | $463.80 | $347.85 | $394.25 (85%) |
| 63328MRI scan of the knee and surrounding structures to assess for internal derangement, performed with contrast and anaesthesia when needed. | $463.80 | $347.85 | $394.25 (85%) |
| 63331MRI scan of the ankle and/or foot to identify structural abnormalities, with optional contrast and anaesthesia. | $463.80 | $347.85 | $394.25 (85%) |
| 63334MRI scan of one or both temporomandibular joints and supporting structures to assess for derangement, with optional contrast and anaesthesia. | $386.55 | $289.95 | $328.60 (85%) |
| 63337MRI scan of the wrist or hand to assess structural damage or derangement, with optional contrast and anaesthesia. | $515.30 | $386.50 | $438.05 (85%) |
| 63340MRI scan of the elbow and supporting structures to assess for derangement, with contrast and anaesthesia. | $463.80 | $347.85 | $394.25 (85%) |
| 63361MRI scan of the musculoskeletal system to assess Gaucher disease, performed under anaesthesia. | $463.80 | $347.85 | $394.25 (85%) |
| 63385MRI scan of the heart or major blood vessels to diagnose congenital heart disease, with contrast and anaesthesia if needed. | $515.30 | $386.50 | $438.05 (85%) |
| 63388MRI scan of the heart or great vessels to detect tumours, performed under anaesthesia with contrast injection. | $515.30 | $386.50 | $438.05 (85%) |
| 63390Cardiac MRI to assess myocardial structure and function in suspected myocarditis with acute heart failure, unexplained arrhythmia, or drug-induced cases when standard tests (troponin, chest X-ray, echocardiogram) are inconclusive. | $632.65 | $474.50 | $537.80 (85%) |
| 63391MRI scan of the chest with contrast to assess for thoracic aorta abnormalities, performed under anaesthesia. | $463.80 | $347.85 | $394.25 (85%) |
| 63395MRI scan of the heart with detailed right ventricle imaging to assess structure and function in patients with suspected or confirmed arrhythmogenic right ventricular cardiomyopathy. | $983.75 | $737.85 | $879.25 (85%) |
| 63397MRI scan of the heart assessing right ventricular structure and function in asymptomatic patients with first-degree relatives diagnosed with arrhythmogenic right ventricular cardiomyopathy. | $983.75 | $737.85 | $879.25 (85%) |
| 63401MRA of the cardiovascular system for vascular abnormality in patients with previous anaphylactic reaction to iodinated contrast medium. | $463.80 | $347.85 | $394.25 (85%) |
| 63404MRA of cardiovascular system using contrast to assess obstruction of the superior vena cava, inferior vena cava, or major pelvic veins when clinically indicated. | $463.80 | $347.85 | $394.25 (85%) |
| 63416MRI angiography scan of limb blood vessels in children under 16 with congenital limb deficiency, performed before planned limb or digit transfer surgery, with contrast and anaesthesia. | $463.80 | $347.85 | $394.25 (85%) |
| 63425MRI scan of the growth plate (physis) in a child under 16 to assess fusion following inflammation or trauma, including anaesthesia. | $463.80 | $347.85 | $394.25 (85%) |
| 63428MRI scan of a child under 16 with Gaucher disease, performed under anaesthesia. | $463.80 | $347.85 | $394.25 (85%) |
| 63440MRI scan of the pelvis or abdomen in a child under 16 with a suspected mass, with contrast and anaesthesia. | $463.80 | $347.85 | $394.25 (85%) |
| 63443MRI scan of the chest with contrast and anaesthesia for a child under 16 with a suspected or confirmed mediastinal mass. | $463.80 | $347.85 | $394.25 (85%) |
| 63446MRI scan of the pelvis in children under 16 with suspected congenital uterine or anorectal abnormality, with contrast and anaesthesia. | $463.80 | $347.85 | $394.25 (85%) |
| 63454MRI of pelvis or abdomen in pregnancy at 18+ weeks when fetal abnormality is suspected on specialist ultrasound with indeterminate findings, requested by an obstetrician. | $1,380.40 | $1,035.30 | $1,275.90 (85%) |
| 63461MRI scan of the body to evaluate an adrenal mass in a patient with otherwise resectable malignancy, including anaesthesia. | $412.25 | $309.20 | $350.45 (85%) |
| 63464Bilateral breast MRI for asymptomatic women under 60 with high genetic risk, prior early breast cancer, prior mantle radiation, or calculated high lifetime/10-year risk; limited to once per 12 months. | $793.75 | $595.35 | $689.25 (85%) |
| 63467Bilateral breast MRI scan using a dedicated coil for cancer detection when an abnormality was found on a recent mammogram or ultrasound within the past 12 months. | $793.75 | $595.35 | $689.25 (85%) |
| 63470Pelvic MRI scan for staging of histologically confirmed cervical cancer at FIGO stage 1B or above, requiring documented histology and stage confirmation. | $463.80 | $347.85 | $394.25 (85%) |
| 63473MRI scan of pelvis and upper abdomen for staging histologically confirmed cervical cancer at FIGO stage 1B or above. | $721.50 | $541.15 | $617.00 (85%) |
| 63476Pelvic MRI using high-resolution T2 technique for initial staging, restaging, or surveillance of rectal cancer. | $463.80 | $347.85 | $394.25 (85%) |
| 63482MRI scan of the pancreas and biliary system to investigate suspected pancreatic or biliary disease, including anaesthesia. | $463.80 | $347.85 | $394.25 (85%) |
| 63487MRI scan of both breasts using a dedicated coil for patients with metastatic cancer in regional lymph nodes where clinical examination and conventional imaging haven't identified the primary cancer. | $793.75 | $595.35 | $689.25 (85%) |
| 63489MRI scan of one breast with dedicated coil, performed with concurrent ultrasound and biopsy, when a suspicious lesion is visible on MRI but not conventional imaging and ultrasound confirms it's not amenable to conventional-guided biopsy. | $1,159.50 | $869.65 | $1,055.00 (85%) |
| 63491MRI or MRA service with contrast agent, performed in accordance with clause 2.5.1 requirements, where the item description includes '(Contrast)'. | $51.55 | $38.70 | $43.85 (85%) |
| 63494MRI or MRA service performed with intravenous or intramuscular sedation on a person meeting the criteria in clause 2.5.1. | $51.55 | $38.70 | $43.85 (85%) |
| 63496MRI of hepatobiliary system with eligible provider supervision using hepatobiliary-specific contrast agent; benefits only payable when claimed with other MRI services and sedation/anaesthesia modifiers cannot be combined. | $287.55 | $215.70 | $244.45 (85%) |
| 63497MRI or MRA scan performed under anaesthetic with a qualified anaesthetist present for a person meeting eligibility criteria under clause 2.5.1. | $180.35 | $135.30 | $153.30 (85%) |
| 63498MRI service performed on a person under intravenous or intramuscular sedation, where the base MRI item (63501, 63502, 63504 or 63505) applies. | $51.55 | $38.70 | $43.85 (85%) |
| 63499MRI performed under anaesthetic with an anaesthetist present for patients requiring sedation or general anaesthetic during the scan. | $180.35 | $135.30 | — |
| 63501MRI scan of breast(s) using dedicated coil to assess silicone implant integrity in patients with suspected or confirmed PIP implants. | $575.20 | $431.40 | $488.95 (85%) |
| 63502MRI of breast(s) using dedicated coil to assess silicone breast implant integrity in patients with or suspected PIP implants. | $575.20 | $431.40 | $488.95 (85%) |
| 63504MRI breast scan using dedicated coil to evaluate silicone implant integrity in patients with suspected PIP implant rupture and symptoms consistent with rupture. | $575.20 | $431.40 | $488.95 (85%) |
| 63505MRI scan of one or both breasts using a dedicated coil to assess silicone implant integrity in patients with suspected PIP implant rupture. | $575.20 | $431.40 | $488.95 (85%) |
| 63507MRI head scan for patients under 16 years with unexplained seizure, unexplained headache with suspected significant pathology, or paranasal sinus pathology unresponsive to conservative treatment. | $463.80 | $347.85 | $394.25 (85%) |
| 63510MRI scan of spine for patients under 16 with significant trauma, unexplained neck/back pain with neurological signs, or suspected significant pathology following radiographic examination. | $515.30 | $386.50 | $438.05 (85%) |
| 63513MRI scan of the knee to assess internal joint damage in patients under 16 years, with contrast and anaesthesia. | $463.80 | $347.85 | $394.25 (85%) |
| 63516MRI scan of the hip for patients under 16 years to investigate suspected septic arthritis, slipped capital femoral epiphysis, or Perthes disease after initial radiographic examination. | $463.80 | $347.85 | $394.25 (85%) |
| 63519MRI scan of the elbow for patients under 16 with suspected significant fracture or avulsion injury that would alter management, following prior radiographic examination. | $463.80 | $347.85 | $394.25 (85%) |
| 63522MRI scan of wrist in patients under 16 years to confirm suspected scaphoid fracture after initial X-rays. | $515.30 | $386.50 | $438.05 (85%) |
| 63531MRI scan of both breasts using a dedicated breast coil when a patient has a breast lesion, conventional imaging is inconclusive for breast cancer, and biopsy is not feasible. | $793.75 | $595.35 | $689.25 (85%) |
| 63533MRI scan of both breasts for patients with diagnosed breast cancer where clinical and conventional imaging assessments of tumour extent differ, and MRI findings may change treatment planning. | $793.75 | $595.35 | $689.25 (85%) |
| 63539MRI of the abdomen to monitor renal tumor development in patients with genetic predisposition to kidney cancer, limited to once per 12 months and requiring specialist request. | $721.50 | $541.15 | $617.00 (85%) |
| 63540Abdominal MRI for patients with genetic disorders causing increased renal tumour risk, to assess tumour changes or treatment response; once per 3 months. | $721.50 | $541.15 | $617.00 (85%) |
| 63541Multiparametric MRI of the prostate for suspected cancer detection, requested by a urology, radiation oncology or medical oncology specialist, using T2-weighted, diffusion-weighted and dynamic contrast enhancement imaging protocols. | $517.55 | $388.20 | $439.95 (85%) |
| 63543Multiparametric MRI of the prostate for patients under active surveillance after confirmed cancer diagnosis, using standardised T2-weighted, diffusion-weighted, and dynamic contrast-enhanced imaging protocols; requested by urology, radiation oncology… | $517.55 | $388.20 | $439.95 (85%) |
| 63545Multiphase contrast-enhanced liver MRI to detect metastases in patients with known non-HCC cancer when CT is negative/inconclusive and findings would alter treatment, limited to once per 12 months. | $632.65 | $474.50 | $537.80 (85%) |
| 63546Contrast-enhanced multiphase liver MRI for patients with chronic liver disease (Child-Pugh A or B) and a hepatic lesion >10mm to diagnose or stage suspected hepatocellular carcinoma; limited to once per 12 months. | $632.65 | $474.50 | $537.80 (85%) |
| 63547Bilateral breast MRI with dedicated breast coil for cancer detection in patients with breast implants and diagnosed anaplastic large cell lymphoma. | $793.75 | $595.35 | $689.25 (85%) |
| 63549MRI of pelvis or abdomen for multiple pregnancy at 18+ weeks gestation when ultrasound by an obstetrician shows indeterminate or suspected fetal abnormality requiring further imaging confirmation. | $2,070.50 | $1,552.90 | $1,966.00 (85%) |
| 63551Head MRI for patients 16+ with unexplained seizures or chronic headache with suspected intracranial pathology, requested by a GP or non-specialist doctor. | $463.80 | $347.85 | $394.25 (85%) |
| 63554MRI of spine with contrast under anaesthesia for patients 16+ with suspected cervical radiculopathy, requiring referral from a non-specialist medical practitioner. | $412.25 | $309.20 | $350.45 (85%) |
| 63557MRI scan of cervical spine for patients aged 16+ with suspected trauma, requiring referral from a non-specialist medical practitioner; includes contrast and anaesthesia. | $566.90 | $425.20 | $481.90 (85%) |
| 63560MRI scan of knee for patients aged 16–49 after acute trauma, referred by a GP, when clinical signs suggest possible meniscal or anterior cruciate ligament tear. | $463.80 | $347.85 | $394.25 (85%) |
| 63563MRI of pelvis or abdomen for subfertility assessment (Mullerian duct anomaly, uterine mass evaluation, or recurrent IVF implantation failure) or surgical planning for deep endometriosis with inconclusive ultrasound; maximum once per 2 years. | $463.80 | $347.85 | $394.25 (85%) |
| 63564MRI whole body scan for early cancer detection in patients with heritable TP53-related cancer syndrome, requested by a specialist or consultant physician in consultation with a clinical geneticist. | $1,698.25 | $1,273.70 | $1,593.75 (85%) |
| 63740MRI scan of small bowel for Crohn's disease evaluation at initial diagnosis, during exacerbation/suspected complications, in pregnancy, or to assess therapy changes. | $525.90 | $394.45 | $447.05 (85%) |
| 63741MRI scan with enteroclysis to assess Crohn's disease, performed in relation to a prior gastroenterology consultation or procedure. | $305.10 | $228.85 | $259.35 (85%) |
| 63743MRI scan of the pelvis to evaluate or monitor fistulas and sepsis related to Crohn's disease, performed with contrast. | $463.80 | $347.85 | $394.25 (85%) |