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  1. #11
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    I've had to pay for both my nt scans (2011 and this year). I also went in expecting 1 in 2010 however found out bub had passed. All 3 of those I was told when booking them that Medicare do not rebate the scan at all and it would be a private account to be paid in full on the day

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  2. #12
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    You were given incorrect info. There is an item code under Medicare and in order to bill it as an NT they MUST bill at that code. The only reasons you might not get a rebate is if the sono who did the scan wasn't qualified and accredited to do the scan, if the practice is going to double dip by billing you and then billing Medicare as well, or if they're billing it incorrectly (wrong item code).

    I promise you. Take your receipts to Medicare and ask them to process the rebate. You can do it up to two years after your scan. If they can't, ask why there's no rebate payable and they will give you the truth.

    (I worked in radiology for two years and my husband is a sono )

  3. #13
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    Oh, to clarify: many clinics will tell you that there is a fee payable on the day an that Medicare will not pay the full amount of the scan. That's because the rebate amount is literally not enough to cover the costs of having the sono do the scan, the program they run to give you your figures, the machinery and overhead costs etc. The clinic I used to work at did this routinely too. That does not mean there's no rebate payable, just that you'll have to pay on the day and claim the rebate yourself separately, of that you'll have to pay the gap (the amount of money between the rebate amount and the actual cost of the scan) on the day and no further rebate will be available because they'll bill Medicare directly for the rebate amount. You will have to sign a form for them to do that though. Hope that makes sense?

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    smallpotatoes  (06-05-2014)

  5. #14
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    At the main radiology practice in WA I was also told is was not covered at all by Medicare, and was just over $180 in full payable on day. Took that receipt into medicare just to check, and got $53 back. Not much, but something. Medicare lady explained that it was an 'optional scan' and therefore not covered to the extent other scans are.

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  6. #15
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    Gosh my nt and 20 week scans are $300 each. I get like $80 back :/

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  7. #16
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    If the clinic is billing you using the correct item code, every person should get the same amount of rebate. You can get more details on the rebate amounts from the Medicare benefits schedule, which is available online.

    I punched in one obstetrics code I could remember to do a general search and got this info which may help some understand how particular the clinics need to be when billing you, and why it's so important that your doctor fills in the clinical details section of the form when you have ANY scan done: http://www9.health.gov.au/mbs/search.cfm?q=55700&sopt=S

    This list of obstetric ultrasound scans covered by Medicare is not exhaustive; you can look them up in more detail by reviewing category 5 of the full Medicare benefits schedule, a copy of which is available here:
    https://www.health.gov.au/internet/mbsonline/publishing.nsf/Content/B3424CE2210FFE9FCA2577E6007BFF08/$File/201101-Cat%205.pdf

    Like I said, the rebate amount is the amount that Medicare would otherwise pay the clinic if you were able to be bulk billed - obviously the small amounts listed are not enough to cover the actual costs involved with performing the scan for you, so a lot of places will ask you to either pay an amount on top of the bulk billing amount they will charge Medicare (called a "gap" payment), or ask you to pay a lump sum and then claim the rebate yourself from Medicare afterwards.

    Hope that helps to clear things up

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    Porky  (07-05-2014)

  9. #17
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    Thank you all so much !!! I might go into Medicare and check. I've complained to the radiology place and heard nothing ( I'm yet to follow up again) I had an awlful experience there other than not explaining the payment.

    I had a trainee do my scan so possibly it was about that but they didn't explain it to me of course!! My 10 wk scan was definately not a NT scan so should not have been charged as one ( I did get a rebate on that one). I'll pull out both receipts and take to Medicare.
    Thank you for all the info and help!!

  10. #18
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    Wow a trainee did your nuchal? Make sure you report that tidbit, that's totally not on! Trainees are allowed to do just about everything else, but nuchals and echocardiograms must be performed by a fully qualified tech! A sono has to have their general ultrasound qualification before they are allowed to even undertake the study to do NTs, then they have to finish that study before they can perform even one unsupervised nuchal scan 😳

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    smallpotatoes  (07-05-2014)

  12. #19
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    Quote Originally Posted by Tattereds View Post

    Just so you know, if they want you to have another scan at all during the pregnancy, Medicare will only rebate for 1 scan between 22-26 weeks and 1 after that, regardless of what the dr puts on the referral form. Just a heads up so you don't get put in this crummy situation again!
    This isn't correct, I worked in radiology specifically in women's imaging and also had three scans between 26-38 weeks in my pregnancy and all were rebated by Medicare, I think it depends on who refers and what is on referral. Mine was a 55721 on 18/03, 03/04 and 15/04.
    Last edited by MickeyMouse84; 07-05-2014 at 09:23.

  13. #20
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    I did too, and my husband is a sono. Check out the MBS, it also supports you can only get a certain number of scans


 

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