The short answer
Yes. An MRI needs a written request, and for a Medicare rebate a GP can only request it for a short list of specific reasons, such as an unexplained seizure or a suspected acute knee ligament tear in people aged 16 to 49 [1][2]. Most other Medicare MRIs need a request from a specialist [1]. If an MRI doesn't fit Medicare's rules, you pay the full fee privately.
On this page
Do you need a referral for an MRI?
Yes. Medicare only pays for an MRI when there's a written request that identifies the clinical reason for the scan, it's supervised by an eligible provider, and it's done on eligible equipment [1].
Who writes the request matters more for MRI than for any other common scan:
- A specialist or consultant physician can request the full range of Medicare MRI items, as long as the request states the clinical indication [1].
- A GP can request Medicare MRIs from two short lists, one for people 16 and over and one for children under 16 [1].
- Anything else is private. If an MRI doesn't meet Medicare's requester and indication rules, no benefit is payable, so you'd pay the practice's full fee.
Which MRIs can a GP request under Medicare?
As at November 2026, these are the GP-requested Medicare MRI items.
People aged 16 and over [2]
| Item | Area | What it's for |
|---|---|---|
| 63551 | Head | Unexplained seizure(s), or unexplained chronic headache with suspected intracranial pathology |
| 63554 | Neck (cervical spine) | Suspected cervical radiculopathy (a nerve root problem in the neck) |
| 63557 | Neck (cervical spine) | Suspected cervical spine trauma |
| 63560 | Knee | After an acute knee injury, for people aged 16 to 49 who can't fully straighten the knee (suggesting a meniscal tear) or whose examination suggests an acute ACL tear |
Children under 16 [3]
| Item | Area | What it's for |
|---|---|---|
| 63507 | Head | Unexplained seizure, unexplained headache where significant pathology is suspected, or sinus disease that hasn't responded to conservative treatment |
| 63510 | Spine (after an X-ray) | Significant trauma, unexplained neck or back pain with neurological signs, or unexplained back pain where significant pathology is suspected |
| 63513 | Knee | Internal joint derangement |
| 63516 | Hip (after an X-ray) | Suspected septic arthritis, slipped capital femoral epiphysis or Perthes disease |
| 63519 | Elbow (after an X-ray) | Suspected significant fracture or avulsion injury that would change management |
| 63522 | Wrist (after an X-ray) | Suspected scaphoid fracture |
Medicare pays for up to three of these GP-requested MRIs per patient in a rolling 12 months [1]. Outside these lists, the only MRI a GP can request with a Medicare rebate is a scan to check suspected PIP silicone breast implants [1].
You may have read that GP access is expanding. In late 2025 the health department consulted on adding GP-requested MRIs of areas such as the lumbar spine, hip, shoulder, foot and ankle [7]. Those changes only apply once new items are listed on the MBS. Until then, the lists above are what a GP can request with a Medicare rebate.
When do you need a specialist for an MRI?
For most other Medicare MRIs, including scans of other body areas and many conditions, the request has to come from a specialist or consultant physician [1]. Some items are narrower still. Prostate MRI, for example, can only be requested by a urologist, radiation oncologist or medical oncologist [1].
So the usual path is GP, then specialist, then MRI. For headaches, seizures or nerve symptoms that don't fit the GP items, your GP may refer you to a neurologist, who can then request the scan. Depending on the problem, your GP may also talk to you about whether a test they can request directly, such as a CT scan, would answer the question.
Does it matter which MRI machine I use?
Yes. Medicare only pays when the scan is done on eligible equipment at a comprehensive practice, meaning one that also provides X-ray, ultrasound and CT [1][6].
- In regional, rural and remote areas (Modified Monash areas 2 to 7), eligible equipment at a comprehensive practice qualifies [1].
- In major cities (Modified Monash area 1), the MRI must be covered by a deed with the Commonwealth, often called a licence [1][6].
- The government has announced that the licence requirement is to be removed from 1 July 2027, subject to legislation, so that all MRI machines meeting the other requirements become Medicare-eligible [6].
When you book, ask whether your scan will be Medicare-rebated on their machine.
What should an MRI request include, and how long does it last?
An MRI request must be in writing and identify the clinical indication [1]. Like other imaging requests, it should be dated and include the requesting practitioner's name and practice address or provider number, and it can be sent electronically if the practice accepts it [4].
Imaging requests don't expire. They're valid until the scan has been done [4]. That's different from a specialist referral, which has a set period; see how long a referral lasts.
How much does an MRI cost?
As an example, the schedule fee for a GP-requested head MRI (item 63551) is $463.80, and the Medicare benefit is $394.25 (fees updated 1 July 2026, checked November 2026) [2].
- Bulk billed. You pay nothing, and Medicare pays the practice 95% of the schedule fee [5].
- Not bulk billed. You pay the practice's fee and claim the Medicare benefit back. The difference is your out-of-pocket cost.
- Private MRI. If the requester, indication or machine doesn't meet Medicare's rules, there's no benefit [1]. Ask for a quote before you book.
Private health insurance generally won't help with an MRI done outside hospital. If you're not an admitted hospital patient, your fees may only be claimable through Medicare [8].
What to expect at an MRI
MRI doesn't use ionising radiation [9]. It does use a very strong magnet, so the practice needs to know about anything metal or electronic in or on your body.
- Tell the practice before your scan if you have a pacemaker or any other implant, and bring any documents about it [9].
- If you're claustrophobic, mention it when booking. Sedation may be possible, and you'd need someone to drive you home [9].
- A scan can take from 10 minutes to over an hour, depending on the area being imaged [9].
A radiologist reports to the practitioner who requested the scan, and MRI reports uploaded to My Health Record are viewable after 5 days [10].
Can I get an MRI request through telehealth?
A GP can assess you by phone or video and, where one of the GP items applies, send the request electronically [4]. Some items depend on examination findings, for example the knee item refers to findings suggesting an ACL tear [2], so your GP may ask you to be examined in person first. Our guide to getting a referral online explains more.
A sudden severe headache, a first seizure, new weakness or numbness, or a neck injury with tingling or weakness can be an emergency. Call 000 or go to the emergency department. Don't wait for an MRI booking.
Getting a referral
Referral GP offers phone and video consultations with AHPRA-registered Australian GPs. Where it's clinically appropriate, your GP can write an MRI request under the GP items above, or a referral to a specialist if your situation needs one. Parents or guardians can request a consult for their child, who attends with them.
Fees. 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.
A consultation doesn't guarantee a referral. Your GP decides what's clinically appropriate. We're not an emergency service.
Request a consult for an imaging request
This page is general information, not medical or legal advice.
Common questions
Can a GP refer me for an MRI?
Yes, but Medicare only pays for a short list of GP-requested MRIs, covering the head, neck and knee for people 16 and over, and the head, spine, knee, hip, elbow and wrist for children under 16, each for specific reasons [2][3]. For other MRIs, you'll generally need a specialist's request for a Medicare rebate [1].
How much is an MRI without a Medicare rebate?
It depends on the practice and the scan, so ask for a quote before you book. Without an eligible request, no Medicare benefit is payable, so you pay the full fee [1].
Does an MRI referral expire?
No. Medicare diagnostic imaging requests don't expire and stay valid until the scan has been done [4].
Can GPs now order back, hip or shoulder MRIs under Medicare?
References
- MBS Online. Explanatory note IN.0.18: Group I5, Magnetic resonance imaging. Accessed November 2026. www9.health.gov.au/mbs/fullDisplay.cfm?type=note&q=IN.0.18&qt=noteID
- MBS Online. Items 63551 to 63560: MRI for patients 16 years or older, general practice requests. Schedule fees updated 1 July 2026. Accessed November 2026. www9.health.gov.au/mbs/search.cfm?q=63551-63560&sopt=I
- MBS Online. Items 63507 to 63522: MRI for patients under 16 years, general practice requests. Schedule fees updated 1 July 2026. Accessed November 2026. www9.health.gov.au/mbs/search.cfm?q=63507-63522&sopt=I
- MBS Online. Explanatory note IN.0.6: Requests for R-type diagnostic imaging services. Accessed November 2026. www9.health.gov.au/mbs/fullDisplay.cfm?type=note&q=IN.0.6&qt=noteID
- MBS Online. Explanatory note IN.0.19: Bulk billing incentive. Accessed November 2026. www9.health.gov.au/mbs/fullDisplay.cfm?type=note&q=IN.0.19&qt=noteID
- MBS Online. Fact sheet: Changes to eligibility for magnetic resonance imaging (MRI) equipment from 1 July 2025 and 1 July 2027. Last updated 16 September 2024. Accessed November 2026. mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/7D28ED6C964
- RACGP newsGP. RACGP backs plan to expand bulk-billed MRIs. 16 December 2025. Accessed November 2026. www1.racgp.org.au/newsgp/professional/racgp-backs-plan-to-expand-bulk-
- Australian Government, privatehealth.gov.au. Out of pocket costs. Accessed November 2026. privatehealth.gov.au/health_insurance/howitworks/out_of_pocket.htm
- InsideRadiology (RANZCR). Magnetic resonance imaging (MRI). Accessed November 2026. insideradiology.com.au/mri
- Australian Digital Health Agency. Better and faster access to health information (pathology and diagnostic imaging reports in My Health Record). Accessed November 2026. digitalhealth.gov.au/initiatives-and-programs/better-and-faster-access
Published by Referral GP. Last updated 6 November 2026. This page is general information only and isn’t a substitute for advice about your own situation. If you or someone else is in danger, call 000.