Do I need a referral for a colonoscopy?

Do you need a referral for a colonoscopy?

In practice, yes. A colonoscopy is a procedure where a specialist, such as a gastroenterologist, uses a thin flexible camera to look inside your large bowel ^[1]. If polyps are found, they're removed during the procedure and tested ^[1].

To see a specialist with the full Medicare rebate, you need a valid referral, usually from your GP. You can see a specialist without one, but Medicare pays less and you'll likely pay more out of pocket ^[2]. Public hospital endoscopy services also work from referrals. In WA, for example, public colonoscopy referrals are triaged against set criteria into urgency categories, with the most urgent aiming for an appointment within 30 days ^[8].

Urgent symptoms: call 000 or go to the emergency department if you have very heavy bleeding from your bottom, black or dark red poo, vomit that contains blood or looks like coffee grounds, severe pain in your rectum, or you faint or have signs of shock such as dizziness or confusion ^[10]. Don't wait for a referral.

Why might you need a colonoscopy?

Common reasons include ^[1][9]:

• a positive bowel cancer screening test
• bleeding from the rectum or blood in your poo
• a lasting change in bowel habits, or unexplained abdominal pain or weight loss
• a personal or family history of bowel polyps or bowel cancer
• follow-up of findings from a previous colonoscopy

Any rectal bleeding is worth getting checked by a doctor. Most people with rectal bleeding don't have cancer, but it should still be looked at ^[10]. For a broader look at gut specialists, see do I need a referral for a gastroenterologist.

What about the free bowel cancer screening test?

If you're 45 to 74 and have no symptoms, the National Bowel Cancer Screening Program offers a free home test that checks your poo for tiny traces of blood ^[3].

• Ages 50 to 74: a kit is mailed to you every 2 years ^[3].
• Ages 45 to 49: request your first free kit online or by calling 1800 627 701 ^[3].
• Any eligible age: you can also ask your doctor for a kit ^[4].

You need a Medicare card or DVA registration and an Australian mailing address ^[3]. Results go to you and your doctor within 4 weeks ^[3].

The screening test isn't for everyone. If you have symptoms such as blood in your poo, or a family history of bowel cancer, talk to your GP instead ^[5]. The test also isn't suitable if you've recently had a colonoscopy, have bleeding haemorrhoids, or are having or have just had your period ^[5].

If your result is positive

A positive result doesn't always mean you have bowel cancer, but you should see your doctor as soon as possible. Your doctor may refer you for a colonoscopy ^[4]. If no polyps or growths are found, you can usually skip the next screening round and screen again 4 years after the colonoscopy ^[4].

Can you ask for a colonoscopy without symptoms?

For people at average or near-average risk with no symptoms, national guidelines recommend the screening test every 2 years. They don't support colonoscopy for this group unless there are symptoms or a positive screening test ^[6]. GPs are expected to make sure colonoscopy referrals line up with these national guidelines ^[6].

Family history changes things. Medicare has separate colonoscopy items for people at moderate or high risk, including because of family history or an inherited condition ^[6]. If that might be you, your GP can talk through what applies.

What should a colonoscopy referral include?

A good colonoscopy referral helps the service judge how urgently you need to be seen. On top of the basics every referral letter needs, national guidance suggests it covers ^[7]:

• why you're being referred, such as a positive screening test, surveillance, or symptoms
• your symptoms and how long you've had them, such as bleeding, weight loss or anaemia
• previous screening results and colonoscopies, with dates and findings
• your medical and family history, including bowel cancer in the family
• your medicines and allergies, especially blood thinners, diabetes medicines and weight-loss medicines

Your GP may also arrange a blood test, for example to check for iron deficiency, before referring you.

How much does a colonoscopy cost?

It depends mostly on whether you go public or private.

• Public: as a public patient in a public hospital, you usually have no out-of-pocket costs ^[9].
• Private: in a private hospital, or as a private patient in a public hospital, costs depend on your private health insurance. Ask your insurer about out-of-pocket costs, waiting periods and which facilities are covered ^[9].

Medicare has several colonoscopy items depending on the reason for the procedure. For most of them, the schedule fee is $400.20 and the Medicare benefit is $300.15, as listed on MBS Online in November 2026 ^[6]. Specialists set their own fees, so ask for an estimate of all the costs, including any anaesthetic and facility fees, before you book.

How long does a colonoscopy referral last?

A GP referral to a specialist is valid for 12 months unless your GP writes a different period. It starts from your first appointment with the specialist, not the date it was written ^[2]. More detail is in how long does a referral last.

Getting a referral

Referral GP offers telehealth consultations by phone or video with AHPRA-registered Australian GPs. A GP can talk through your symptoms, screening result or family history and, where it's clinically appropriate, write a referral to a specialist for colonoscopy or arrange tests first. Some symptoms need an in-person examination, and your GP will tell you if that's the case.

A consultation doesn't guarantee a referral. Your GP decides what's clinically appropriate.

Bulk billed for eligible patients. If you're not eligible, a consultation fee may apply, and we'll confirm it with you before your consult.

We're not an emergency service. For heavy bleeding or severe pain, call 000. Otherwise, you can request a specialist referral consult.

This page is general information, not medical advice.