Medicare will pay for PSMA scans if ...

In short:

Medicare (Australia) will pay for one PSMA scan after diagnosis, before you have any treatment, if you are intermediate risk or high risk.


Medicare will pay for two PSMA scans after your first treatment if:

your PSA doesn't become undetectable after surgery; OR

your PSA rises by 2.0 higher than its lowest point (nadir) after radiation.


http://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/0B1F69A0B341A384CA25880F0080089B/$File/Medicare%20Benefits%20Schedule%20Items%2061563%20and%2061564%20-%201%20July%202022.pdf


A fuller name of the PSMA scan is a PSMA PET/CT scan.

Sometimes the name also includes the name of the radioactive tracer used:

eg Gallium-68 PSMA PET/CT scan.


If you had a PSMA scan before 1 July 2022, Medicare paid for the CT part, but you, or your treating Hospital, paid for the Pet part (or perhaps just the PET tracer?).


By my reading, this would not count against your entitlement for a PSMA scan paid for totally by Medicare after 1 July 2022.

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