Changes to Medicare funded cardiac services

1 August 2020

 

There are significant changes to Medicare funding of cardiac imaging services, which came into effect on 1 August 2020.

The most important changes are:

  • General Practitioners can only refer a patient for an echocardiogram once in a 24 month period.

    • Exceptions to this are for patients requiring more frequent echos for monitoring of potentially cardiotoxic medication or with pericarditis / pericardial effusion. There is also an exception for followup of patients with valvular dysfunction when referred by a GP practising in a Modified Monash Model Area 3-7.

  • General Practitioners can only refer a patient for stress testing (exercise stress ECG or exercise stress echocardiogram) once in a 24 month period.

  • Some services such as more frequent repetition of echocardiogram for patients with valvular dysfunction or structural heart disease, or more frequent stress echocardiogram for specific indications are restricted to request by Specialists or Consultant Physicians.

We recognise that a referring practitioner may not be aware of a patient’s eligibility for a medicare rebate at the time of referral. We will be checking at the time of booking, so it is important for us to have a copy of a patient’s referral at this time. To assist us in this process, please send all referrals directly to us by:

If an eligibility restriction is identified, we will communicate this directly to the referring doctor and patient.

Further information can be found online here.