All services listed in the Diagnostic Imaging Services Table of the Medicare Benefits Schedule (MBS) excluding Positron Emission Tomography (PET) services, have two different rebates: K items (100% of the MBS Fee) and NK items (50% of the MBS Fee).
The rebate amount is determined by the age of the equipment used to provide the service and is known as Capital Sensitivity.
The "Capital Sensitivity" measure encourages service providers to upgrade and replace (as appropriate) aged equipment with the aim of improving the delivery of quality of diagnostic imaging services.
What is the relevant age of my equipment?
Equipment that has not been upgraded, as defined in the Diagnostic Imaging Services Table (see Category 5 of the Medicare Benefits Schedule (MBS)), is classified by the effective life age of the equipment. Equipment that has been upgraded is classified by the maximum extended life age of the equipment. An upgrade is an additional reasonable investment made by the service provider to improve the overall performance of the imaging system so the services provided are equivalent to new equipment supplied in Australia at the time of the upgrade.Effective life age and maximum extended life age by modality
Modality | MBS Items | Effective Life Age | Maximum extended life (including extension for upgrades) |
---|---|---|---|
Ultrasound | 5005-55855 | 10 years | 15 years |
Computed Tomography (CT) | 56001-57363 | 10 years | 15 years |
X-ray | 57529-57723 58102-59104 59504-60101 | 15 years | 20 years |
Orthopantomogram (OPG) | 57911-57968 | 15 years | 20 years |
Mammography | 59301-59319 | 10 years | 15 years |
Fluoroscopy | 60501-61110 | 15 years | 20 years |
Nuclear Medicine (excluding PET) | 61651-61729 | 10 years | 15 years |
Magnetic Resonance Imaging (MRI) | 63013-63523 | 10 years | 20 years |
Angiography | 59903-60078 | 10 years | 15 years |
How do I calculate the age of my equipment?
If the equipment was installed new, age is calculated from the date the equipment was first installed.If the equipment was installed used, age is calculated from the date the:
- equipment was first used in Australia (for equipment previously used in Australia); or
- equipment's oldest component was manufactured (for equipment previously used outside Australia).
What is the location based exemption?
If equipment that has not been upgraded is older than the effective life age, or if equipment that has been upgraded is older than the maximum extended life age, practices may be eligible for an exemption depending on the practice location.There are two types of exemption:
1) automatic exemptions based on the location of the practice
2) exemptions granted upon application to the Department of Health based on a number of factors.
1) Automatic exemptions
This exemption will automatically apply to practices located in Remoteness Area (RA) categories of outer regional, remote and very remote. Practices in these RAs are exempt from the Capital Sensitivity measure and do not need to apply to the Department for a remote area exemption.Practices can identify what RA they fall under at the Department of Health’s DoctorConnect website.
Note: automatic exemption applies to areas classified as Remoteness Areas 3, 4 and 5.
2) Exemptions granted by the Department of Health
To grant an exemption for inner regional locations, the Department of Health must be satisfied that the practice is located in the RA category inner regional area, Note, this area was previously under the Rural, Remote and Metropolitan Area (RRMA) classification system as, RRMA4 or RRMA5, and:- the diagnostic imaging equipment does not exceed the maximum extended life age by three years or more;
- the equipment is operated on a rare and sporadic basis
- the equipment provides crucial patient access to diagnostic imaging services.
- PDF version: Inner Regional Australia Exemption Application Form (PDF 329 KB)
- Word version: Inner Regional Australia Exemption Application Form (Word 482 KB)
Keeping the Location Specific Practice Number records up to date
Practices are required to keep the Department of Human Services’(DHS) Location Specific Practice Number (LSPN) records up to date including the age of each piece of equipment. To update LSPN information, practices may access the relevant forms and contact details at the Medicare website and practices must inform the Department of Human Services when equipment is upgraded.For further information on what constitutes an upgrade see Diagnostic imaging equipment (Capital Sensitivity) FAQ.
Contact Information
For general enquiries about capital sensitivity email the Department of Health at the Capital Sensitivity team.For assistance with LSPN details, contact the Department of Human Services (Medicare) toll free on 1800 620 589 Monday to Friday, 07.30am to 5.00pm Western Standard Times.
Alternatively email Medicare.