New Medicare rebates for bowel inflammation testing

Latest News

Health minister Greg Hunt has announced the introduction of funding for faecal calprotectin testing to diagnose inflammatory bowel disease (IBD) on the Medicare Benefits Schedule (MBS).

"From 1 November 2021, patients with chronic bowel inflammation will be able to claim a Medicare rebate for non-invasive laboratory tests, reducing the need for diagnostic endoscopy and colonoscopy procedures," said Minister Hunt.

"Its use means that fewer patients will require diagnostic endoscopy and colonoscopy, with faecal calprotectin shown to be an effective, safer and significantly cheaper alternative.

Crohn’s disease and ulcerative colitis – collectively known as IBD – are chronic diseases that require complex and long-term care.

Two new items will be listed on the MBS – one to test faecal calprotectin levels for diagnostic purposes as requested by a medical practitioner and another for follow-up testing for diagnostic confirmation when requested by a specialist gastroenterologist.

Patients presenting to a medical practitioner must have been experiencing symptoms suggestive of inflammatory or functional bowel disease for more than six weeks, be under 50 years of age, and have had infectious causes excluded to be eligible for the MBS rebated test, which will assist in distinguishing inflammatory from functional bowel disease.

The new item was recommended by the Medical Services Advisory Committee (MSAC).

The committee backed the new item numbers on the basis faecal calprotectin testing is cheaper than a colonoscopy.

"MSAC noted that the financial estimates suggest introduction of the test could result in substantial cost savings to the MBS of ~$4-7 million per year and government health budgets of ~$11-20 million per year.

"MSAC also noted the estimated saving to the private sector (private health insurers and patients) of ~$32–73 million per year."