Are ultrasounds bulk billed in Australia, and who decides?
Yes, most ultrasounds are bulk billed under Medicare, but only if they meet specific referral and eligibility criteria. Whether your ultrasound is bulk billed depends on who referred you, what type of scan you need, and whether it’s covered by a Medicare item number. In this blog, we’ll explain exactly how bulk bill ultrasound rules work, who can refer, and why some patients may be asked to pay a private fee.
A bulk bill ultrasound means the full cost of your scan is covered by Medicare, with no out-of-pocket payment required. However, this only applies under certain conditions:
At Capri Ultrasound, unlike many other clinics, we offer bulk billing for ultrasound services provided your referral and scan type meet Medicare’s requirements. Our team can help clarify this when you book.
This is where Medicare rules can get confusing for patients.
If your referral is from one of these providers and the scan is eligible, you can usually access a bulk billed ultrasound without issue.
Medicare does not allow referrals from some health professionals, even if they regularly recommend imaging:
These providers can still recommend imaging, but if you bring in a referral from them, your ultrasound won’t be eligible for a full Medicare rebate. In this case, a private fee will apply.
There are a few situations where you may not be eligible for bulk billing:
At Capri Ultrasound, we always inform patients upfront if private fees will apply.
Medicare sets strict rules about how and when it will fund imaging services, especially when multiple scans are performed on the same day. Some scan combinations are not allowed to be billed together, or are significantly reduced in rebate amount, requiring patients to return on another day to stay eligible for full rebates.
If you want to dive deeper into how Medicare determines who can refer, especially in this case, for nurse practitioners – this article from the Department of Health offers a broader overview.
If you’re googling:
…you’re not alone. These are some of the most common search terms from patients trying to understand their options.
Capri Ultrasound is conveniently located on the Gold Coast, and unlike most clinics, offers bulk billing ultrasound appointments for all eligible scans. We accept all referrals and work with GPs, specialists, nurse practitioners, and podiatrists, and can check your referral before your appointment to confirm eligibility.
Are ultrasounds bulk billed at all clinics?
No, not all clinics offer bulk billing, even with a valid referral. Some choose to charge private fees to avoid the complexity of Medicare’s referral and rebate rules.
At Capri Ultrasound, we take the extra step to match your referral to the correct Medicare item number and apply bulk billing wherever possible. Our goal is to help you access your rebate, not miss out on it.
Is ultrasound covered by Medicare?
Yes, but only for scans with a Medicare item number and with a valid referral from an eligible provider. Not all scans or providers are covered.
Can I get a bulk billed ultrasound without a referral?
No. All Medicare-funded ultrasounds require a referral. If you don’t have one, or if your referral isn’t from an approved practitioner, the scan will need to be paid privately.
Confused by Medicare rules? You’re not alone, and we’re here to help.
At Capri Ultrasound, we’re committed to providing clear, accessible information and affordable imaging services. Whether you’ve got a referral from your GP, a nurse practitioner, or a podiatrist, our team can help confirm if your scan is eligible for bulk billing under Medicare.
Contact us today for a bulk-billed ultrasound.
