Changes to Medicare imaging claims
From 1 July 2026, updated Medicare legislative requirements are available for imaging services that are bulk billed.
If your imaging service is billed directly to Medicare, you will be asked to provide consent for an Assignment of Benefits (AoB) prior to your examination. This allows Medicare to pay the benefit directly to your imaging provider on your behalf. A consent form is required for each billed service, and Imaging providers are required to retain a record of this consent.
What this means for your appointment
As per this new legislation, consent will be completed as part of the check‑in process:
- You will be asked to review and sign an AoB form when you arrive
- This is a brief step and part of standard administrative procedures
- Where multiple services are performed, these may be grouped or recorded separately depending on how they are billed
- Your signed form will be securely stored as part of your billing record
Who this applies to
This requirement applies to patients whose imaging services are billed directly to Medicare.
Privately billed services are not affected, unless otherwise advised.
If consent is not provided
Medicare requires consent for bulk billing to occur. If consent is refused, the service will be billed privately, and payment will be required on the day.
Additional information
- A parent or legal guardian can provide consent for a patient under 18
- If a patient is unable to sign, appropriate arrangements will be made in line with relevant legal requirements.
What does Medicare cover?
Let’s provide a more comprehensive explanation of what Medicare covers and the reasons for exceptions, as well as the importance of contacting your local Capital Radiology clinic for specific billing details:
At Capital Radiology, we typically bulk bill. This means that, in most instances, you do not need to make any upfront payments for the services you receive. Instead, we submit claims to Medicare on your behalf, effectively covering the cost of your medical procedures.
Moreover, we extend our bulk billing service to pension or concession card holders, provided they meet the specific criteria set by Medicare. This additional support further ensures that financial constraints do not hinder individuals from accessing essential medical services. It is a reflection of our commitment to making healthcare accessible for a broader spectrum of the population.
In some instances Medicare’s coverage may be limited, or Medicare may not apply at all. For example, certain specialised services, such as specific MRI procedures, or certain examinations like obstetric ultrasounds, may fall into this category. In such cases, you may be required to pay the difference. This also applies to specialised interventional procedures that are performed by a radiologist, in this case, supplementary fees may be incurred.
Billing practices can vary by location, and local variations may apply. To obtain precise and detailed information regarding the billing process specific to your situation, we encourage you to reach out to your local Capital Radiology clinic.
Costs & Billing
What expenses are associated with my procedure?
In the majority of situations, we bulk bill to Medicare for the expenses associated with your procedure. However, it’s important that you take the time to confirm with your local clinic before you undergo the procedure.
It’s important to note that there are exceptions to this standard practice. There are instances where Medicare may not be applicable or where it may only partially cover the costs related to the examination you are booked for. This means that you may be responsible for covering the remaining expenses. Additionally, in cases where a specialist radiologist is required to perform interventional procedures, there may be extra charges incurred.
For comprehensive information about the billing process, we encourage you to reach out to your local Capital Radiology clinic. Our clinic can provide you with detailed insights and address any specific questions or concerns you may have regarding the financial aspects of your procedure. This will ensure that you have a clear understanding of the associated costs before you attend our clinic.
Useful Links:
If you still need more information, you may find these links useful.