Medicare testing criteria & limitations

Most pathology tests automatically qualify for a Medicare rebate; however, for some tests, Medicare requires that the patient satisfy certain clinical criteria before the rebate applies, or limits the frequency of testing, or both. Some tests do not qualify for a rebate under any circumstances.

For a list of all tests with up-to-date criteria, please visit www.medicareaustralia.gov.au.

Medicare criteria for rebates & guidelines for repeat testing

Please note that this list is not comprehensive and the criteria may change at anytime.

A large number of specialised tests in the general areas of metabolic and molecular genetic testing, occupational health and environmental and nutritional testing are not included.

 

View Medicare Criteria