Monday, 22 June 2026
Medicare changes from 1 July 2026
Medicare changes affecting diagnostic imaging
Several Medicare changes affecting diagnostic imaging will commence from 1 July 2026. These changes are designed to improve flexibility for patients and providers, simplify Medicare claiming arrangements and ensure the Medicare Benefits Schedule (MBS) continues to support contemporary diagnostic imaging practice.
Diagnostic imaging request period extended from 7 to 14 days
One of the most significant changes commencing on 1 July 2026 is the extension of the timeframe in which diagnostic imaging services requested on a single referral can be provided.
From 1 July 2026, where multiple diagnostic imaging services are requested on a single referral, all services may be provided within 14 days of the first service while remaining eligible for Medicare benefits. This replaces the previous 7-day timeframe.
The extension to 14 days recognises that patients may require multiple diagnostic imaging appointments that cannot always be scheduled within one week. The change provides greater flexibility for patients, referrers and diagnostic imaging practices while reducing the need for repeat referrals where all requested services cannot be completed within the previous 7-day timeframe.
Changes to breast imaging claiming arrangements
From 1 July 2026, changes will also be made to Medicare claiming arrangements for breast imaging services. Restrictions on claiming breast ultrasound items with chest or abdominal wall ultrasound item 55812 and breast MRI item 63464 will be removed. In addition, the Multiple Services Rule will no longer apply where eligible breast imaging services are performed together.
These changes recognise that comprehensive breast assessment often requires multiple complementary imaging examinations during the same episode of care. Removing these claiming restrictions better supports contemporary clinical practice and streamlines Medicare claiming for eligible services.
Annual indexation of diagnostic imaging MBS fees
Annual indexation will also apply from 1 July 2026, with the schedule fees for most diagnostic imaging services increasing by 2.6%. Practices should ensure they are using the updated MBS schedule fees and item descriptors from 1 July 2026.
12 month deferral of Medicare patient consent changes
Following stakeholder feedback, the Government has deferred planned changes to Medicare Assignment of Benefit (AoB) requirements for 12 months.
Under arrangements previously scheduled to commence on 1 July 2026, patients receiving bulk-billed services would have been required to provide written consent. Verbal consent will now continue to be accepted in all settings until at least 30 June 2027 while further consultation is undertaken. You can read more in the June update from the department here:
Improving the assignment of benefit process
Australian Government Department of Health, Disability and Ageing