Ultrasound Medicare Guidelines

Ultrasound Medicare Guidelines

In order for an ultrasound request of the shoulder or knee to be eligible to attract a medicare rebate, benefits are only payable when referred by a Medical Doctor based on the clinical indicators outlined in the item descriptions below.


Shoulder

For the assessment of one or more of the following conditions or suspected conditions:

  • evaluation of injury to tendon, muscle/tendon junction; or
  • rotator cuff tear/calcification/tendinosis (biceps, subscapular, supraspinatus and infraspinatus); or
  • biceps subluxation; or
  • capsulitis and bursitis; or
  • evaluation of mass including ganglion; or
  • occult fracture; or
  • acromioclavicular joint pathology

Please note benefits are not payable when referred for non-specific shoulder pain alone.


Knee

For the assessment of one or more of the following conditions or suspected conditions:

  • abnormality of tendons or bursae about the knee; or
  • meniscal cyst, popliteal fossa cyst, mass or pseudomass; or
  • nerve entrapment, nerve or nerve sheath tumour; or
  • injury of collateral ligaments

Please note benefits are not payable when referred for non-specific knee pain alone and including meniscal and cruciate ligament tears or assessment of chondral surfaces.


A full Medicare Benefits Schedule can be downloaded here