15 July 2022
Effective immediately, we will need to amend the Discogram fees. Due to Medicare changes and the fact that this procedure involves a lot of expertise (and is on the same level as in-hospital surgical procedures) we need to be able to charge accordingly.
Therefore, further to the email sent on 3/5/22 and 23/5/22, the new gap payment effective immediately will be around $300 for one level.
If the patient has a current valid Medicare card, they will be able to take their invoice to Medicare to claim. They will NOT get a refund for all they’ve paid but the out of pocket fee will start at $300.
The gap is an estimate only and is subject to change as per Medicare rulings.
The quick codes for discograms are required to be used and the referral will need to be sent in prior to appointment being arranged so that it enables correct quoting for the examination. PLEASE NOTE – DO NOT USE THE $ SIGN IN COMRAD TO COME UP WITH A FEE FOR THE ITEMS. THE DISCO FEE HAS BEEN ARRANGED AT A SPECIAL DISCOUNTED RATE AND THE $ FEE IN COMRAD WILL PROVIDE A HIGHER FEE – THEREFORE PLEASE MAKE SURE YOU USE THE FEE BREAKDOWN BELOW!
One level discogram will be $965.
An additional $100 will be charged for each additional level. For e.g. if two levels are required then the fee would be $1065 and the gap payment (or out of pocket for the patient will be approx. $400). We will cap it as a max gap of $400 and any disco requiring more than one level will be charged $1065.
DISCO – 1 LEVEL
57341 = $570
18232 = $245
104 = $150
Total fee = $965
DISCO - 2 LEVELS or MORE
57341 = $670
18232 = $245
104 = $150
Total Fee = $1065
