DEXA GUIDES

Is a DEXA scan covered by Medicare?

Diagnostic bone densitometry may qualify for Medicare when an item’s conditions are met. A body composition scan for fitness or general tracking should not be assumed to qualify. Your referring doctor and imaging clinic confirm eligibility.

Six bone densitometry items to discuss with your clinic

The table summarises six MBS items commonly relevant to bone density assessment. It is not a self-assessment tool. The same reason for a scan can involve different details in a person’s history, and the descriptors include exclusions involving the other items.

MBS Online, checked 26 September 2026. Fees effective 1 July 2026.Scroll across for fees and frequency limits.
ItemPlain-language indicationFrequency limitSchedule fee / 85% benefit
12306Confirming suspected low bone density after a minimal-trauma fracture, or monitoring low density established by densitometry at least 12 months earlier.Once per 24 months$122.55 / $104.20
12312Bone loss related to prolonged glucocorticoid therapy, excess glucocorticoid secretion, male hypogonadism, or female hypogonadism lasting over six months before age 45. The explanatory definitions also apply.Once per 12 months$122.55 / $104.20
12315Bone loss associated with primary hyperparathyroidism, chronic liver or renal disease, a proven malabsorptive disorder, rheumatoid arthritis, or thyroxine excess.Once per 24 months$122.55 / $104.20
12320Age 70 or over, for a first bone density scan or where the previous T-score is -1.5 or higher.Once per five years$122.55 / $104.20
12321At least 12 months after a significant therapy change, for established low bone density or suspected low density following a minimal-trauma fracture. A dosage adjustment alone is not the intended therapy change.Once per 12 months$122.55 / $104.20
12322Age 70 or over, with a T-score strictly below -1.5 and strictly above -2.5.Once per two years$122.55 / $104.20

These are summaries, not an eligibility assessment. Each item has exclusions, referral and reporting conditions. Open the item for its complete descriptor and associated notes. The clinic’s fee can differ from the schedule fee, so the benefit alone does not tell you the gap.

A schedule fee is not a promise of bulk billing

For these six items, MBS Online lists a schedule fee of $122.55 and an 85% benefit of $104.20, effective 1 July 2026. A provider may charge a different amount. Confirm whether the service is bulk billed or what gap you would pay before attending.

Ask for the item number on the quote and whether the fee covers the examination, specialist interpretation and report. Keep the quote with the referral. Do not use a bone density benefit to estimate the price of an unrelated body composition appointment.

MBS item 12306 ↗

MBS item 12312 ↗

MBS item 12315 ↗

MBS item 12320 ↗

MBS item 12321 ↗

MBS item 12322 ↗

Referral, scan sites and reporting matter

The associated MBS notes require a medical practitioner’s referral and specify specialist or consultant physician interpretation and reporting. The examinations involve two or more sites, normally the lumbar spine and proximal femur, with specified clinical exceptions in the notes.

The clinic needs more than your age to confirm the correct pathway. Give it the referral and relevant previous reports, including the date, scan sites and T-scores. Explain any treatment change to your referring doctor rather than choosing an item yourself.

MBS explanatory notes with item 12320 ↗

If you are 70 or older

Item 12320 covers the stated first-scan or T-score pathway at age 70 and over, with a five-year frequency limit. Item 12322 has a two-year limit and a strictly defined T-score interval. The exact endpoints matter: the item wording is not simply “any osteopenia”.

Other clinical indications can involve other items. A frequency limit is a billing condition, not a personal instruction to wait that long or book automatically when the interval ends. Your doctor sets the clinical follow-up plan.

Bone density and T-scores explained ↗

If the clinic says the scan is not covered

Ask whether the issue is the examination type, referral, timing, reporting arrangement or item criteria. Request a written private fee before deciding. You can also ask your referring doctor whether a different service is needed to answer the clinical question.

For private health insurance, describe the exact billed service to the fund. Do not assume a policy covering a dietitian consultation also covers imaging. We do not publish a fund-specific rebate promise.

Compare published scan costs ↗

Questions to take to the appointment

  • Which item, if any, applies to this referral?
  • Does the previous scan date affect eligibility?
  • What is the total fee and expected out-of-pocket amount?
  • Who will report the scan and send the findings to my doctor?
  • When should I return to my doctor to discuss the result?

Common questions

Is every DEXA scan bulk billed?

No. The examination, item conditions, referral and provider billing arrangements matter. Ask the clinic to confirm the benefit and any gap before booking.

Does turning 70 automatically cover any DEXA scan?

No. The age-based items concern bone densitometry and have further conditions. They do not automatically cover a body composition appointment.

Is the Medicare interval my recommended rescan interval?

No. A billing frequency limit and an individual clinical follow-up plan are different. Discuss timing with your doctor.

BEFORE YOU BOOK

Find the right appointment.

For diagnostic bone density, start with your referring doctor. For body composition, compare what is included and who will explain the report.

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