St George Cardiology

Phone
02 8580 1649

Address
Suite 7H, Level 5, 1 South St
Kogarah NSW 2217

Holroyd Heart Centre

Phone
02 8604 0933

Address
Suite 7H, Level 5, 1 South St
Kogarah NSW 2217

Medicare changes to cardiac testing

Posted By Dr George Touma  
14/03/2021
09:20 AM

Medicare is an amazing privilege of living in Australia. 

 

On 1 August 2020, the Federal government implemented significant changes to cardiac testing which limits bulk billing and medicare rebates for 

 

1. Echocardiograms

2. Exercise stress tests

3. Consults performed immediately after tests

 

Essentially, stress tests for patients without symptoms (unless diabetic) can't be performed through medicare (either bulk billed or rebatable). THIS DOES NOT MEAN THEY CAN'T BE PERFORMED - just that the patient will need to pay for the test. For example, if you have a 60% blockage under surveillance - a stress test is a valuable tool to monitor for ischaemia (deprivation of blood flow to heart muscle) that may occur before symptoms develop. Screening tests can no longer be put through medicare. Examples include

 

1. General screening

2. License renewal

3. Moderate coronary disease without symptoms

 

 

I simply will not perform a test through medicare that isn't eligible in the new criteria - penalties for myself and the patient for wrongly claiming from medicare are harsh. We can still perform it but there will be a cost involved. 

 

Unfortunately, not all practices apply the rules. Everything will be ok until there is an audit!

 

If you are having a stress test performed through medicare (either bulk billed or rebatable) without symptoms (unless diabetic) this is a breach of medicare rules.