Medicare changes to Vitamin D billing

January 27, 2015

Mater Pathology provides one of very few mass spectrometry Vitamin D assays in Australia. Vitamin D measurement by mass spectrometry is widely acknowledged to be superior to immunoassay, especially in patients with low Vitamin D levels[i].

In November 2014, Medicare introduced changes to the Medicare Billing Schedule for Vitamin D testing, restricting funding for Vitamin D measurement to patients who fulfil Medicare’s eligibility criteria.

Due to this restriction, pathology laboratories can now only bulk bill patients who are eligible to be funded.

To ensure Mater Pathology is able to bulk-bill appropriate requests for Vitamin D, it is important to note eligibility criteria clearly in the clinical notes on the request form.

Suggested notes include:

  • Lack of sun
  • Deeply pigmented
  • Malabsorption
  • CRF or Renal transplant
  • Hypercalcaemia, hypocalcaemia, hypophosphataemia or hyperparathyroidism
  • Osteoporosis or osteomalacia
  • Anticonvulsant treatment
  • Infant of mother with Vit D deficiency
  • If one of these simple notes is on the request form the laboratory can bulk bill the patient.

From 1 February 2015, patients who are not eligible for Medicare-funded Vitamin D measurement will be sent a bill from the laboratory for the Medicare Schedule Fee for the test, currently $30.

For more information on Mater Pathology’s billing policies, visit our Accounts and Billing page or telephone 07 3163 8500.

Mater Pathology is Queensland’s leading not-for-profit pathology provider, reinvesting revenue into improving health care.

[i] Vitamin D and health in adults in Australia and New Zealand: a position statement. Med J Aust 2012; 196 (11): 686-687



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