Changes to Medicare Benefits Schedule (MBS) Items for Bone Densitometry

Effective from 1 November 2017 (subject to the passage of legislation)

Page last updated: 22 August 2017

MBS Bone Densitometry Items (PDF 167 KB)
MBS Bone Densitometry Items (Word 489 KB)

What do the changes involve?

Two new time-restricted MBS items will be introduced for bone mineral density testing (bone densitometry) for people aged 70 years and over. Patients 70 years and over will continue to be eligible for an initial screening study. Patients assessed as having mild to moderate osteopenia will be eligible for repeat testing every five years; and patients assessed with moderate to marked osteopenia will be eligible for repeat testing every two years. The current MBS item for people aged 70 years and over will be deleted from the MBS.

The Dual Energy X-Ray Absorptiometry (DEXA) bone densitometry MBS items will be amended to require that the scans must be performed by a:

(a) specialist or consultant physician; or

(b) person who holds a radiation license, as required by State or Territory law, and the scan is performed under the supervision of an appropriate specialist or consultant physician.

Changes will be made to the supervision requirements for Quantitative Computed Tomography (QCT) scans so that an appropriate specialist or consultant physician is available to monitor and influence the conduct of the scan and personally attend the patient if required. In relation to QCT scans, it is important to note that on 8 June 2017 the MBS Review Taskforce recommended the removal of two current QCT items, namely items 12309 and 12318, from the MBS. This change is subject to a decision by Government. Should this recommendation be confirmed, it would also take effect on 1 November 2017. The QCT qualification changes detailed in the following table would then apply only to the two new items for bone densitometry (12320 and 12322).

The changes also introduce a requirement that for all DEXA and QCT items the interpretation and report must be provided by a specialist or consultant physician.

Why is the Government making this change?

The changes align MBS items with clinical best practice, enhance item specificity and improve the accuracy and quality of testing provided to patients by ensuring that the services are performed by suitably qualified practitioners. They follow the recommendations of the Medical Benefits Schedule Review Taskforce following the Diagnostic Imaging Clinical Committee Review of Bone Densitometry.

What does this mean for MBS claiming?

There are no changes to MBS recommended fees and benefits.

For those individuals with specific medical conditions or for patients undergoing particular treatments that may cause more rapid bone loss, a Medicare rebate is available for repeat testing at 12 monthly intervals.

The two new items for individuals aged 70 years and over, take into account the clinical evidence that bone density loss is a relatively slow process, and that changes in bone loss cannot be reliably measured by yearly testing. The introduction of these new items will reduce the number of individuals in this age group who receive unnecessary repeat testing.

Changes to items:

Draft amendments to items in the MBS (final wording of items subject to finalisation and passage of legislation):

MBS ItemsDescription of change
Bone densitometry for patients aged 70 years and over

(new items)

12320
12322
Item 12323 will be replaced by two new items with different testing intervals based on a risk profile, as follows:
patients aged 70 years and over with no or mild osteopenia (down to T score of -1.5), one scan every 5 years.

Patients aged 70 years and over with moderate to marked osteopenia (T score of -1.5 to -2.5), one scan every 2 years.

Patients diagnosed with osteoporosis will continue to be tested using other clinically appropriate MBS bone densitometry items.

The fee for the two new items will be the same as for the current item 12323

Fee: $102.40

Qualification requirements for Dual Energy X-ray Absorptiometry (DEXA) scans12306, 12312, 12315, 12321, 12320, 12322 (applies to the new items when performed using DEXA)These items will be amended to require that the scans must be performed by a:
(a) specialist or consultant physician; or
(b) person who holds a radiation license, as required by State or Territory law, and the scan is performed under the supervision of an appropriate specialist or consultant physician.

Additionally, these items will be amended to specify that the interpretation and report for these scans must be provided by a specialist or consultant physician

Fee: $102.40
Quantitative Computed Tomography (QCT) scans12309*, 12318*, 12320 & 12322 (applies to the new items when performed using QCT)These items will be amended to require that an appropriate specialist or consultant physician must be available to monitor and influence the conduct of the scan and to personally attend the patient, if required.

Additionally, these items will be amended to specify that the interpretation and report for these scans must be provided by a specialist or consultant physician

Fee: $102.40
NOTE: *it is recommended that these items are removed from the MBS.