Medicare Rebates for Bone Density Testing and
Fracture Prevention Medication
Medicare Australia
provides rebates for Bone Mineral Densitometry and Fracture
Prevention Medication only for people who
meet specific eligibility criteria.
These are set out below.
For those people who do not
meet the criteria for bone density testing, a fee is payable. Please contact the centre if
you are unsure.
Bone Density (DEXA)
Eligibility Guidelines
|
 |
|
Item No |
| Eligibility Rules |
|
|
|
|
12306 |
(i)
for confirmation of a presumptive diagnosis of
low bone mineral density made on the basis of 1
or more fractures occurring after minimal trauma
(ii) for the monitoring of low bone mineral density
proven by bone densitometry at least 12 months
previously
Note: 1
service only per 24 months |
|
|
|
|
12312 |
For
the diagnosis and monitoring of bone loss associated with 1 or more
of the following conditions:
(i) prolonged glucocorticoid therapy (Definition)
(ii) conditions associated with excess glucocorticoid
secretion
(iii) male hypogonadism (Definition)
(iv) Female hypogonadism lasting more than 6
months before the age of 45 (Definition)
Note: 1
service only per 12 consecutive months |
|
|
|
|
12315 |
For
the diagnosis and monitoring of bone loss associated with 1 or more
of the following conditions:
(i) primary hyperparathyroidism
(ii) chronic liver disease
(iii) chronic renal disease
(iv) proven malabsorptive disorders (Definition)
(v) rheumatoid arthritis
(vi) conditions associated with thyroxine excess
Note: 1
service only per 24 consecutive months |
|
|
|
|
12321 |
For
the measurement of bone density 12 months following a
significant change in therapy (Definition)
for:
(i) established low bone mineral density
(ii) the confirmation of a presumptive diagnosis of
low bone mineral density made on the basis of 1
or more fractures occurring after minimal trauma
Note: 1
service only per 12 consecutive months |
|
|
|
|
12323 |
For
the measurement of bone density in patients over the age of
70 years. |
Medications For Fracture Prevention on
the PBS
Men and women aged 70 years and over with a BMD T-score of ≤
-3.0 can receive treatment for osteoporosis on the PBS without
having sustained a fracture, ie for primary prevention.
The following medications are listed for primary prevention:
-
Alendronate (Fosamax, Fosamax-Plus, Alendro and Alendrobell)
-
Risedronate (Actonel and Actonel-Combi)
-
Strontium ranelate
The PBS also subsidises treatment for osteoporosis in patients
of any age who have had a minimal-trauma fracture:
-
Alendronate
-
Risedronate
-
Etidronate (Didrocal)
The following are subsidised for treatment of osteoporosis in
post-menopausal women who have had a minimal-trauma fracture:
-
Raloxifene (Evista)
-
Strontium ranelate
|
