What is an MRI?

An MRI (or Magnetic Resonance Imaging) is a non-invasive scan commonly used to diagnose injuries, monitor conditions, or guide treatment plans. According to the Australian Diagnostic Imaging Association (ADIA), an MRI takes between 20 to 45 minutes and uses powerful magnet and radio-frequency pulses to collect information. This information then forms a detailed view of the body’s soft tissues such as muscles, ligaments, brain tissue, discs and blood vessels.

How much does an MRI cost?

If you have an MRI as a public patient in a public hospital, then it’s a free service (referred to as an ‘inpatient’ service). If performed outside of a public hospital (an ‘outpatient’ service), you may have to pay a fee as high as $1,000. However, there are some bulk-billing services for eligible outpatient MRIs.

Working out the cost of an MRI as a patient can be complicated. You might like to consider getting a quote before the MRI is performed to find out how much your out-of-pocket costs might be. You may even be able to call other MRI services to see if there’s a lower cost option, as well as discussing alternatives with your medical practitioner.

To give you an idea of costs, the Australian Diagnostic Imaging Association (ADIA) says that in some cases, patients may be required to pay the full amount first (called ‘paying upfront’), which could be as much as $1,000, and then claim funds back from Medicare.
​​
While the cost of an MRI can vary depending on the type of scan required, we have listed the typical cost of an MRI for various conditions in 2023-24, as published by the Australian Government Department of Health and Aged Care’s Medical Costs Finder:

MBS Item Number: 63001

• MRI Type A scan (MRI) to look for a tumour in the brain or the covering of the brain (meninges).
• Typical fee (AUD): $523Medicare paid (on average): $363Typical Out-of-Pocket Cost (AUD): $160

MBS item number: 63328

• MRI type: A scan (MRI) to look for problems with the knee.
• Typical fee (AUD): $548Medicare paid (on average): $363Typical Out-of-Pocket Cost (AUD): $185

MBS item number: 63464

• MRI type: A scan (MRI) of both breasts for detection of cancer. The person has a high risk of breast cancer.
• Typical fee (AUD): $858Medicare paid (on average): $631Typical Out-of-Pocket Cost (AUD): $225

MBS item number: 63543

• MRI type: A scan (MRI) of the prostate following a diagnosis of prostate cancer.
• Typical fee (AUD): $620Medicare paid (on average): $405Typical Out-of-Pocket Cost (AUD): $215

MBS item number: 63243

• MRI type: A scan (MRI) to look at spinal injury (trauma). This scan covers three connected or two separate areas of the spine.
• Typical fee (AUD): $593Medicare paid (on average): $403Typical Out-of-Pocket Cost (AUD): $193

These figures serve as a general guide. Actual costs can vary depending on your location, the provider and the type of MRI scan. To get a quote you’ll need to find out from your medical practitioner the Medicare Benefits Schedule (MBS) number for the type of scan(s) that you need. (There are hundreds of different MBS item numbers for MRI scans.)

For a general cost estimate based on item numbers, you could try the Australian Government’s Medical Costs Finder website.

Compare Health Insurance

Are MRIs covered by Medicare?

If you need an MRI as an inpatient in a public hospital, then Medicare will generally cover the cost. Medicare will also pay a benefit towards MRIs received as an outpatient or a private hospital inpatient, but this may not cover the whole cost. If you receive an MRI from a bulk billing clinic—that is, a clinic that charges you the exact amount that Medicare will pay—then you will generally not have to pay anything.

It’s important to know, however, that if you receive an MRI for an elective cosmetic procedure, or for the purposes of life insurance underwriting, then the service will not be covered by Medicare.

Also, some MRI machines may not have a ‘full’ Medicare licence, which means only part (or none) of the cost is eligible for a rebate. There are also a range of other eligibility requirements to qualify for a Medicare rebate, such as having a particular type of referral from a GP or specialist. This complexity is why it’s a good idea to clarify costs with your medical practitioner and imaging service before you get your scan.

Does private health insurance cover MRIs?

Generally speaking, private health hospital and extras policies probably won’t cover MRIs. This is because there is a Medicare rebate available and diagnostic imaging is considered an ‘outpatient’ service. This may even include if you are an inpatient at a private hospital. However, some funds may offer cover for non-MBS item scans, such as MRIs for health screening purposes.

If you’re an admitted patient in a private hospital and you have to have an MRI, your private health insurance could help if there are any out-of-pocket costs/gap fees (depending on the type of policy you hold). If you need to be admitted to a private hospital for treatment, it’s a good idea to talk to your health insurer to find out what costs are covered and what expenses you may have to pay, particularly when it comes to MRI and other imaging services.

What happens during an MRI?

During an MRI, the patient is asked to lie on a bed which then travels through the MRI scanner. The bed may be adjusted several times during the scan. The operators will keep in touch with the patient via a speaker system or a set of headphones.

Once underway, patients may be asked to lie still and hold their breath for a short period of time. They may also experience a vibrating or knocking sound – this is the sound of the machine switching between frequencies. These radio waves stimulate the hydrogen atoms in the body and their movement is picked up and interpreted by the machine to produce the images. Once complete, the images will be interpreted by a radiologist – a specialist medical doctor trained to diagnose medical conditions using imaging.

What MRIs are covered by Medicare?

Depending on other eligibility requirements, Medicare-eligible procedures could include:

• Brain and Temporomandibular joint (TMJ) scans

• Spinal scan

• Knee, foot and hip scans

• Elbow, shoulder and hand scans

• Prostate and rectum scans

• Breast scan

• Pancreas / Biliary system scan

• Limited heart / vessel scan

A full list of Medicare-eligible procedures and the associated fees are available on the Department of Health and Aged Care website.

Cover image source: VesnaArt/Shutterstock.com