Do you need a referral for a CT scan?

Yes — you need a referral for a CT scan. You can’t simply book one yourself, and the referral matters for cost as well as access.

Why you need a referral

A CT must be requested by a doctor — usually your GP, sometimes a specialist — who decides the scan is clinically appropriate. That referral is also what makes you eligible for a Medicare rebate (when the scan meets Medicare’s criteria).^[1] Imaging referrals are generally valid for 12 months for the same problem.

Why your out-of-pocket cost varies

This is the part that surprises people. Medicare pays a set rebate for an eligible CT, but each clinic sets its own fee. When a clinic charges more than the rebate, the difference is called the gap — and that gap is your out-of-pocket cost.^[2]

Because clinics set their own fees, the gap can vary quite a bit between providers for the same scan. So the MBS item number matters far less to you than the simple question: what will I actually pay?

Bulk billing means no gap

Some clinics bulk bill eligible CT scans — they accept the Medicare rebate as full payment, so there’s no gap for you to pay.^[1] Whether a clinic bulk bills is its own decision (and may depend on your circumstances), separate from whether the scan is Medicare-eligible.

The practical tip

With a referral in hand, ring a few clinics and ask: “With this referral, will it be bulk billed — and if not, what’s my out-of-pocket cost?” A short phone-around can save you a meaningful amount.^[2]

Frequently asked questions

Can I get a CT scan without a referral?

No — a CT must be referred by a doctor, and the referral is also what makes you eligible for a Medicare rebate.^[1]

Why is a CT cheaper at one clinic than another?

Because Medicare pays a fixed rebate but each clinic sets its own fee. The gap between the two is your out-of-pocket cost, and it varies — some clinics bulk bill, so there’s no gap at all.^[2]