By Dr. Mark Bekhit, Radiologist · Last updated July 2026
Short answer: usually, yes. For a Medicare benefit, an R-type X-ray, ultrasound or CT service needs a written request before the scan unless a narrow MBS exemption applies. A GP, other medical practitioner, specialist or consultant physician has broad request rights, subject to item rules. Registered dentists, chiropractors, physiotherapists, osteopaths, podiatrists, participating nurse practitioners under the MBS and participating midwives under the MBS have limited item lists. The request does not expire, you may choose another provider, and bulk billing is a separate decision.
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Do you need a referral for an X-ray, ultrasound or CT?
For the usual Medicare pathway, yes. Patients and clinics commonly say referral, while the Medicare Benefits Schedule (MBS) calls the document a diagnostic imaging request. An R-type service is an MBS service that requires a request. For Medicare benefits to be payable, the imaging practitioner must receive it before the service starts.
The requester is the practitioner who determined that the scan was necessary.
This is a Medicare-benefit condition, not a universal rule that imaging can never be performed without a form. Examples of narrow exemptions in MBS Note IN.0.6 include an emergency needing imaging as quickly as possible, certain imaging a specialist determines is necessary within their specialty, and some additional imaging found necessary after a requested service. The additional-service exemption does not extend to MRI, PET or a service the original requester was not permitted to request.
Healthdirect gives the broad consumer rule that a patient needs a doctor’s referral before booking a CT scan. A narrow MBS pathway also allows a participating nurse practitioner to request specified low-dose CT items for the National Lung Cancer Screening Program. For ultrasound, healthdirect says patients usually need a referral from a doctor or health professional. X-ray rights are also requester-specific: for example, physiotherapists have a defined musculoskeletal X-ray list rather than permission to request every X-ray.
Request or referral? For these scans, the MBS term is request. The practical validity rule is simple: a diagnostic imaging request remains valid until the requested examination has been performed.
Who can write the request?
A GP or other medical practitioner can request ordinary X-ray, ultrasound and CT services. Specialists and consultant physicians have broad diagnostic-imaging request rights, although the wording of an individual item can add a condition. Obstetric ultrasound item 55712, for example, requires obstetric qualifications.
Registered dentists, specified allied-health professions, participating nurse practitioners under the MBS and participating midwives under the MBS use profession-specific item lists. Their title alone does not create a general right to request every examination in a modality.
The general-dentist list contains selected X-ray items but no ultrasound or CT item. Approved dental practitioners and named dental-specialty categories have separate additional lists. The category attached to the requester therefore matters as much as the word “dentist” on the form.
This table is about who can request these services for a Medicare benefit under the MBS; it is not a universal legal rule about who may recommend imaging.
“Selected” means the exact examination must appear in that profession’s current MBS list; if you are unsure, use the three questions under “What should you ask before booking?”
The limits are specific, not theoretical. A chiropractor, physiotherapist or osteopath has a list of musculoskeletal radiographs. A podiatrist’s list includes ankle or hind-foot ultrasound item 55888 and lower-limb X-ray item 57527, but no CT item.
A participating nurse practitioner has selected X-ray and ultrasound items plus two low-dose CT items for the National Lung Cancer Screening Program. Those screening items do not create a general right to request any chest CT. A participating midwife’s list contains selected ultrasound items, including pelvic ultrasound item 55065.
What must be on the request, and does it expire?
The request does not need a particular clinic’s form. Under MBS Note IN.0.6, it must be in writing and contain enough information to identify the requested service. A signature is not generally required. An electronic request can be used when the recipient agrees, the information is stored and it remains accessible.
A clear request contains
✓ The patient’s identifying details.
✓ The requester’s name, contact details and provider number.
✓ The examination, written clearly and legibly.
✓ The date and clinical justification for each examination.
✓ For X-ray or CT, enough clinical information to weigh expected benefit against radiation risk, including known pregnancy status where relevant.
These fields answer different questions. The patient details and examination identify who and what the request covers. The practitioner details identify who decided the scan was necessary. A clear request should include clinical justification for each examination, and for ionising-radiation examinations it should contain enough information to weigh the expected benefit against the radiation risk.
CT uses more ionising radiation than a plain X-ray. Ultrasound is different because it uses sound waves rather than ionising radiation.
No expiry period: a diagnostic imaging request remains valid until the requested examination has been performed. The date records when it was written; it is not a use-by date.
Can you choose another clinic, and will Medicare cover it?
Yes, you may choose another diagnostic imaging provider. The MBS says a request does not need to be addressed to one provider and, even when it names a provider, the service may be performed elsewhere. Request forms supplied by an imaging provider must tell the patient that the form can be taken to a provider of their choice. Services Australia likewise says patients may choose a provider offering the required scan.
A written request is necessary for most R-type services, but it does not by itself guarantee a Medicare benefit. The examination still needs to match an MBS item and its requester conditions. Billing is another decision: providers set their own fees, and a patient does not pay when the provider bulk bills the service.
The Imaging Finder directory lists radiology clinics, and the Australia location index groups them by area. The scan comparison explains how the modalities differ.
What should you ask before booking?
The exact examination and requester need to match the same MBS pathway. Under MBS Note IN.0.6, non-medical requester categories are limited to their listed items. A podiatrist’s listed ultrasound or a participating nurse practitioner’s listed X-ray may qualify, while a different examination outside that profession’s list does not follow that requester pathway.
Fees are separate from requester eligibility. Services Australia says providers set their own fees and advises asking the price before the test. If the provider bulk bills the service, the patient does not pay.
Use the exact test name and the requester’s profession when asking about the first question. “Is this covered?” is too broad when a profession can request one listed X-ray but not a CT. The other two questions separate the clinic’s fee from CT preparation.
Ask these three questions
✓ “Is this exact examination Medicare-rebatable when requested by this practitioner?”
✓ “Will you bulk bill it; if not, what is the total price?”
✓ “If this is a CT, is contrast planned and do I need to fast?”
Healthdirect explains that CT contrast can be given by mouth or injection and may require fasting. For X-ray, it advises patients to tell their doctor if they are pregnant or may be pregnant. The MBS request guidance also says known pregnancy status should be included on an X-ray or CT request where relevant.
For more detail, see the Medicare scan guide, the guide to bulk-billed radiology and the ultrasound preparation guide.
Common questions about imaging requests
Can I get an X-ray without seeing a GP?
Sometimes. The MBS gives several professions limited X-ray item lists. Chiropractors, physiotherapists and osteopaths have specified musculoskeletal radiographs; podiatrists have listed radiographic items; registered dentists have dental lists; and participating nurse practitioners have selected X-ray items. Outside an applicable list, a medical practitioner is the usual Medicare pathway.
Can a physiotherapist request an ultrasound or CT for a Medicare benefit?
No, not under the current physiotherapist list in MBS Note IN.0.6. That list contains specified musculoskeletal radiographs, not ultrasound or CT items. This is a Medicare-benefit requester rule; it does not prevent a physiotherapist from recommending medical assessment when another examination may be useful.
Does an X-ray, ultrasound or CT request expire?
No. A diagnostic imaging request remains valid until the requested examination has been performed. The date on the request records when it was written; it does not create an expiry period. The same rule applies to a valid electronic request.
Can I use the form at another radiology company?
Yes. The MBS permits the service to be performed by another diagnostic imaging provider. Services Australia also supports patient choice of a provider offering the required scan.
Does a request mean the scan will be bulk billed?
No. The request and the fee answer different questions. A request is part of the eligibility rules for R-type imaging, while the provider sets its own fee. If the provider bulk bills the service, the patient does not pay. A valid request can therefore still be associated with a private fee.
How we know: sources and method
The requester matrix and request-validity rules were checked against MBS Note IN.0.6 and current MBS item pages on 27 July 2026. Provider choice and fee wording comes from Services Australia. Healthdirect supplies the plain-language modality, radiation, pregnancy and CT-contrast information. The matrix describes Medicare-benefit requester rules; it does not recommend a particular scan or define every circumstance in which imaging may be performed.
The item examples are illustrations rather than complete lists. Current profession lists come from MBS Note IN.0.6; individual item pages identify modality and item-specific conditions. Services Australia fee wording remains separate from MBS eligibility rules.
- MBS Online — Note IN.0.6: requests for diagnostic imaging services
- Services Australia — screening, tests and scans
- healthdirect — X-rays
- healthdirect — ultrasound
- healthdirect — CT scan
This article is general information, not personal medical advice. Availability, Medicare eligibility, billing and preparation can change — confirm the specifics with your referrer and the clinic.
Author: Dr. Mark Bekhit
Dr Mark Bekhit (MBChB, FRANZCR) is a musculoskeletal radiologist practising in Brisbane and an AHPRA-registered specialist in diagnostic radiology (MED0002920947). He spends as much time building software as reading scans: he founded Imaging Finder (Australia) and Radiology Clinics NZ to make imaging easier to find, and builds radiology dictation and pain-tracking tools with one aim — better patient outcomes and a smoother reporting workflow. Outside the reading room he's usually training, bringing the same performance mindset to imaging.
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