How much does an MRI cost?

How much does an MRI cost?

The cost of an MRI can be anywhere between $300 and over $1,000 per body part, or could be free if you can have it bulk-billed under Medicare.

Now look, I know that's a vague answer. Unfortunately, the cost of a scan varies a tonne, based on things like which clinic you visit and what needs to be scanned.

• Cost by clinic: While it's possible to get MRIs covered under Medicare, there are less and less clinics that bulk-bill, and so will either charge you a full or a partial out-of-pocket cost. If you need an MRI in a public hospital it will be free, but depending on your underlying or suspected condition, you may have to go on a waiting list.
• Cost by body part: Put simply, the more stuff you need scanned, the more expensive the MRI will be. It's not a perfect relationship, but it's a reliable relationship.

Your best bet is to talk to your GP, or call your local imaging clinic to get an estimation of the non-rebatable cost before you get the scan.

Does Medicare cover MRI scans in Australia?

Medicare somteimes covers MRI scans - it's not always straightforward. If you're receiving care in a public hospital as an 'inpatient' it should be relatively straight forward, and you shouldn't be charged. But outside of a hospital, where most MRIs happen, Medicare might cover the cost, depending on the body part and reason for the scan.

You'll generally need a GP referral - you might also need a specialist referral - and to visit an imaging provider that bulk bills. Unfortunately, you'll often need to pay for that GP or specialist out of pocket as well. So yeah, it's not as simple as it should be. Your best bet is to see your GP - who hopefully bulk bills - and ask them about the likely costs.

• Full table of Medicare MBS limits for MRI

  Item number	Purpose of the scan	Fee charged	Medicare benefit
  63551	Head scan for a patient 16 years or older to investigate: Unexplained seizures Unexplained chronic headaches with suspected intracranial pathology	$403.20	75%: $302.40 85%: $342.75
  63554	Spinal scan for a patient 16 years or older for suspected cervical radiculopathy	$358.40	75%: $268.80 85%: $304.65
  63557	Spinal scan for a patient 16 years or older for suspected cervical spine trauma	$492.80	75%: $369.60 85%: $418.90
  63560	Knee scan for a patient 16 years or older following acute knee trauma with: Inability to extend the knee suggesting the possibility of acute meniscal tear Clinical findings suggesting acute anterior cruciate ligament tear	$403.20	75%: $302.40 85%: $342.75
  63507	Head scan for a patient under 16 years for any of the following: Unexplained seizures Unexplained headaches where significant pathology is expected Paranasal sinus pathology, which has not responded to conservative treatment	$403.20	75%: $302.40 85%: $342.75
  63510	Spinal scan for a patient under 16 years following radiographic examination for: Significant trauma Unexplained neck or back pain with associated neurological signs Unexplained back pain where a significant pathology is suspected	$448.00	75%: $336.00 85%: $380.80
  63513	Knee scan for a patient under 16 years following radiographic examination for internal joint derangement	$403.20	75%: $302.40 85%: $342.75
  63516	Hip scan for a patient under 16 years following radiographic examination for: Suspected septic arthritis Suspected slipped capital femoral epiphysis Suspected Perthes disease	$403.20	75%: $302.40 85%: $342.75
  63519	Elbow scan for a patient under 16 years following radiographic examination where a significant fracture or avulsion injury is suspected that will change management	$403.20	75%: $302.40 85%: $342.75
  63522	Wrist scan for a patient under 16 years following radiographic examination where scaphoid fracture is suspected	$448.00	75%: $336.00 85%: $380.80

Does private health insurance cover MRI?

Private health insurance generally covers MRI scans in Australia, but only under certain conditions. You'll need to be admitted to a hospital as an inpatient, and the scan will need to be for a condition that you're covered for. Here's the breakdown:

• Outpatient MRIs: These are typically not covered by private health insurance or Medicare.
• Inpatient MRIs: If you're admitted to a hospital and need an MRI as part of your treatment, your private health insurance can cover the gap between what Medicare pays and the total cost of the scan.
• Coverage conditions: The MRI must be part of a treatment covered by your policy and listed on the Medicare Benefits Schedule (MBS).

Generally, private health insurance won't be able to help you for outpatient MRIs. If you can't afford an MRI you've been referred to by your GP, have a look around for an MRI provider that bulk bills under Medicare.

How to save money on your MRI scans

With the out-of-pocket costs for MRIs rising - as waiting lists grow and clinics stop bulk billing - it's more important than ever to know how to save money on MRIs. Here are a couple of ways you can start to save.

• Talk to your doctor: If your GP has your best interests at heart, they should be able to point you in the direction of cheaper treatment. It's definitely possible they might give youa bum steer, but you might as well ask your GP how to save money on a scan when they refer you.
• Shop around: Different radiology clinis have different bulk billing practices, even ones that are in the same suburb. That means a clinic down the road could charge you a lower gap fee - or maybe none at all. Your referral should work anywhere - it pays to make some calls.
• Call your health fund: If you need a scan, call your health fund and see if they have any advice. What and how much you're covered for will vary based on your policy and medical condition, but they'll be able to give you the most relevant advice.

MRI cost: Medicare vs private health insurance

For private heath insurance MRI scans are considered a treament, not a formal clinical category. That means your MRI may or may not be covered by your policy - it depends on why you're getting the scan. If you need an MRI scan for a particular treatment, then your private health insurance will cover some of the costs if your policy covers that particular type of illness – for example, cancer.

Health insurance can cover MRI scans, depending on your cover. Whether you are going the Medicare or health insurance route, always be sure to check that your treatment is covered or whether you will need to pay any upfront costs. Here are some of the ways these costs will be calculated:

• Public patient in a public hospital (no health insurance): Medicare can cover 100% of the MBS fee.
• Private patient in a public hospital: Medicare covers 75% with the remaining "gap" covered by your health insurer.
• Private patient in a private hospital: Medicare once again covers 75% with the remainder paid by your health insurer.
• Out of hospital MRI scan with specialist referral: Medicare covers 85% of the cost.

To have your MRI scan covered by health insurance, you'll need hospital cover. Each hospital insurance tier will cover a different set of conditions, so you'll need to have a product that covers your particular issue to be covered.

Frequently asked questions

• How much is an MRI scan?

  MRI scans generally cost between $100 and $1,000, depending on what part of the body needs to be scanned, and your specific condition.

• What is the best health insurance for MRI scans?

  There is no best health insurance that specifically covers MRI scans. This is because MRI scans are not a treatment category, they're a treatment type. If you need an MRI scan for a particular treatment, then your private health insurance will cover some of the cost if your policy covers the particular type of injuries or illness that you're receiving treatment for. Learn more about health insurance for MRI scans.

To make sure you get accurate and helpful information, this guide has been edited by Tim Bennett as part of our fact-checking process.

Written by

Gary Ross Hunter

Editor, Insurance

Gary Ross Hunter was an editor at Finder, specialising in insurance. He’s been writing about life, travel, home, car, pet and health insurance for over 6 years and regularly appears as an insurance expert in publications including The Sydney Morning Herald, The Guardian and news.com.au. Gary holds a Kaplan Tier 2 General Advice General Insurance certification which meets the requirements of ASIC Regulatory Guide 146 (RG146). See full bio

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