Billing

Inpatient medical imaging services

Costs relating to diagnostic imaging examinations performed during an inpatient admission can generally be claimed against your private health insurance.

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Health Funds which have a ‘No-GAP’ agreement with Lumus Imaging

The Health Funds listed in the table below have a ‘No-GAP’ agreement with Lumus Imaging. meaning that you will NOT have an out-of-pocket expense (gap fee) for any Medicare eligible inpatient examinations.

Lumus Imaging will submit claims to your Health Fund on your behalf. If an examination that is not eligible for Medicare is requested, you will be advised of the out-of-pocket expense and will be required to sign a financial consent form.

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Private health funds with no agreement & health fund unknown

If your Health Fund is not listed in the table below, then you will have an out-of-pocket expense (gap fee) for inpatient Medical Imaging services.

Lumus Imaging will submit claims to your Health Fund on your behalf. After payments from Medicare and/or your Health Fund are received, you will be sent an invoice for the remaining gap fee.

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How Much Will My Scan Cost?

Your estimate is based on the Medicare Benefits Schedule (MBS) item number linked to your referral. This determines:

• Your Medicare rebate
• Whether your scan is bulk billed
• Any out-of-pocket (gap) fee

Final costs may change slightly on the day if your referral needs to be reviewed or additional imaging is required for accurate diagnosis.

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Payment Information

• Payment is required on the day if a gap fee applies
• We process your Medicare rebate at the clinic (if eligible)
• Accepted payments: EFT, Visa, MasterCard and cash

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Is My Scan Bulk Billed?

Bulk billing is available for some patients and services, including:

• Pensioners and concession card holders (at participating sites)
• Selected Medicare-eligible scans

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What Affects Medicare Coverage?

Eligibility depends on:

• MBS item code (service must be listed)
• Clinical reason meeting Medicare criteria
• Age requirements (for some scans)
• Referrer type (GP vs Specialist)

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MRI Costs

MRI pricing varies based on:

• Whether the MRI unit is Medicare-licensed
• The referring doctor (GP or Specialist)
• The clinical indication meeting Medicare criteria

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Does Private Health Insurance Cover Imaging?

Some services may be partially covered by private health insurance, particularly for inpatient or specialist-referred scans.

We recommend checking with your health fund to confirm your level of cover.