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 20 to 45 minutes and uses magnetic and radio waves to create detailed images of soft tissues like muscles, ligaments, the brain, discs and blood vessels.
How much does an MRI cost?
If you're having an MRI as a public patient in a public hospital, then they're usually free of charge. But if you need an out-of-hospital scan, it could cost as much as $1,000, depending on the type of scan, the imaging clinic and your location.
Some outpatient MRIs may be bulk billed, which means you won’t have any out-of-pocket costs. To be eligible, your scan must meet specific Medicare criteria, such as being referred by an approved specialist for eligible medical conditions.
If your MRI isn’t covered by Medicare, you may need to pay upfront and then claim some of the funds back from Medicare if it qualifies for a rebate.
The Department of Health, Disability and Ageing’s Medical Costs Finder lists typical MRI costs for different conditions in 2023–24.
Type of | MBS | Typical | Medicare paid | Average |
|---|---|---|---|---|
Tumour in the brain | 63001 | $523 | $363 | $160 |
Knee | 63328 | $548 | $363 | $185 |
Both breasts | 63464 | $858 | $631 | $225 |
Prostate | 63543 | $620 | $405 | $215 |
Spinal injury | 63243 | $593 | $403 | $193 |
Note: These figures serve as a general guide. Actual costs can vary depending on your location, the provider and the type of MRI scan.
Are MRIs covered by Medicare?
If you need an MRI as an inpatient in a public hospital, Medicare will generally cover the cost. Medicare also pays a benefit for 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, you'll usually not have to pay anything. Do keep in mind, though, if you have an MRI for an elective cosmetic procedure or for life insurance underwriting, Medicare will not cover the service.
Other eligibility requirements also apply, such as needing a specific referral from a GP or specialist. Because of this complexity, it’s a good idea to clarify costs with your medical practitioner and imaging service provider before your scan.
Is it necessary to get a referral for an MRI?
It may be possible to get an MRI without a referral at some imaging centres but it's generally not recommended.
If you want Medicare benefits, you need an MRI request from a specialist or a GP (depending on the type of scan). The request must include details to meet Medicare's eligibility criteria.
Allied healthcare professionals, like physiotherapists, can also refer patients for an MRI, but their referrals are unlikely to get Medicare rebates.
Does private health insurance cover MRIs?
Generally speaking, private health, hospital and extras policies probably won't cover MRIs. This is because there's a Medicare rebate available and diagnostic imaging is usually considered an 'outpatient' service.
If you're an admitted patient in a private hospital and your doctor orders an MRI as part of your treatment, your private health insurance could help if there are any out-of-pocket costs/gap fees. To qualify, the MRI must be a Medicare-eligible service, and your policy must include coverage for in-hospital diagnostic 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, Disability and Ageing website.
