Prostate MRI receives Medicare rebate

From 1 July 2018, a Medicare rebate will be available for MRI scans to diagnose and monitor prostate cancer.

In Australia, almost 17,000 men are diagnosed with prostate cancer each year - the most commonly diagnosed cancer in men.  It’s a disease that claims more than 3,000 lives annually in this country.

MRI provides an optimum way of imaging the prostate and the availability of a rebate could make a real difference to many thousands of Australian men who require prostate cancer testing.

The availability of the scan may also reduce a significant number of prostate biopsies, which relieves the associated costs, risks and complications inherent with such procedures.

Benson Radiology has a well-deserved reputation in delivering a high quality prostate MRI service, via its dedicated and specialised radiologist reporting group.

We provide prostate MRIs on the latest 3 Tesla MRI technology at our City West and Ashford locations, and from our Salisbury clinic (from October).

South East patients can also attend our Mount Gambier scanner.

For more information contact our City West clinic.

Rebateable item numbers and clinical indications are listed below;

Diagnosis (63541)

Multiparametric Magnetic Resonance Imaging (mpMRI) using a standardised image acquisition protocol involving T2 weighted imaging, Diffusion Weighted Imaging, and Dynamic Contrast Enhancement (unless contraindicated); and performed under the professional supervision of an eligible provider at an eligible location; and the patient is referred by an urologist, radiation oncologist, or medical oncologist; and the request specifies that the clinical criteria below are met; and the patient is suspected of having prostate cancer based on:

  1. A digital rectal examination (DRE) which is suspicious for prostate cancer; or
  2. In a person less than 70 years, at least two prostate specific antigen (PSA) tests performed within an interval of 1-3 months are greater than 3.0 ng/ml, and the free/total PSA ratio is less than 25% or the repeat PSA exceeds 5.5 ng/ml; or
  3. In a person aged less than 70 years, whose risk of developing prostate cancer based on a family history is at least double the average risk, at least two PSA tests performed within an interval of 1-3 month, are greater than 2.0 ng/ml, and the free/total PSA ratio is less than 25%; or
  4. In a person aged 70 years or older, at least two PSA tests performed within an interval of 1-3 months are greater than 5.5 ng/ml and the free/total PSA ratio is less than 25%.

Scan of the prostate for:
- detection of cancer (R)

Note: benefits are payable on one occasion only in any 12 month period.

Relevant family history is first degree relative with prostate cancer or suspected of carrying a BRCA

1. BRCA 2 mutation

Active Surveillance (63543)

Multiparametric Magnetic Resonance Imaging (mpMRI) using a standardised image acquisition protocol involving T2 weighted imaging, Diffusion Weighted Imaging, and Dynamic Contrast Enhancement (unless contraindicated); and performed under the professional supervision of an eligible provider at an eligible location; and the patient is referred by an urologist, radiation oncologist, or medical oncologist; and
the request specifies that the clinical criteria below are met;

a) the patient is under active surveillance following a confirmed diagnosis of prostate cancer by the biopsy histopathology; and
b) The patient is not planning or undergoing treatment for prostate cancer

Scan of the prostate for:
- detection of cancer (R)

Note: benefits are payable at the time of diagnosis of prostate cancer, 12 months following diagnosis and then every 3rd year thereafter or at any time, if there is any concern clinically or with PSA progression. This item is not to be used for the purposes of treatment planning or for monitoring after treatment.

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