How much does an MRI cost in Australia?

Magnetic Resonance Imaging (MRI) is a useful diagnostic tool. While it might be costly, it can be covered by Medicare or private health insurance.

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Magnetic Resonance Imaging (MRI) is a useful diagnostic tool. While it might be costly, it can be covered by Medicare or private health insurance.

Key points:

Many outpatient MRIs are covered by Medicare, meaning you may be able to claim some or all of the cost back.
You may be required to pay upfront for an MRI before claiming back from Medicare.
The latest figures show that the average MRI cost is $523, but MRIs can cost $1,000 and up.

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 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.

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. The latest data from the ADIA shows the average upfront cost for MRIs is $523.

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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.

Related: How much does private health insurance cost?

What is an MRI?

According to the 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. Often called the ‘gold standard’ in radiology, MRI delivers very detailed imaging and can provide a more accurate diagnosis of certain diseases and conditions – particularly soft-tissue injuries that might not show up on other imaging services. There’s also no radiation involved in this test, unlike an X-ray or CT scan.

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.