Shoulder and Knee Ultrasound

Are Your Patients Eligible for a Medicare Rebate?

In May 2003, the Health Commission issued amendments to the benefits payable for ultrasound of the Shoulder and Knee. These amendments outline that Medicare will only provide a rebate if the referral specifically includes one of the suspected pathologies:

Shoulder Ultrasound

Benefits are payable when referred with suspicion of the following clinical conditions:

  • evaluation of injury to tendon, muscle or tendon/muscle junction including tears, calcification or tendinosis;
  • rotator cuff tear/calcification/tendinosis of biceps, subscapular, supraspinatus or infraspinatus;
  • biceps subluxation;
  • capsulitis and bursitis;
  • evaluation of mass, including ganglion;
  • occult fracture;
  • acromioclavicular joint pathology.

Benefits are not payable when referred for non-specific shoulder pain alone.

Knee Ultrasound

Benefits are payable when referred with suspicion of the following clinical conditions:

  • abnormality of tendons or bursae about the knee;
  • meniscal cyst, popliteal fossa cyst, mass or pseudomass;
  • nerve entrapment, nerve or nerve sheath tumour.

Benefits are not payable when referred for non-specific knee pain alone alone or other knee conditions including:

  • meniscal and cruciate ligament tears;
  • assessment of chondral surfaces.

If you would like further information, please call 9322 4650.