Update - SI Joint Injection Fees

Please see below for some updates regarding SI Joint Injection appts as well as clarification on a couple of things.

An SI Joint injection is a medicare coverable service as long as patient has a valid medicare card.  But instead of bulk billing these services, we now have to charge a fee. Once the patient pays they will be able to claim back from Medicare and get everything except approx. $150.   

There are some exceptions – as follows: We won’t charge the full fee (but will bulk bill) the following:

• If a patient has had more than two prior SI joint injections with Dr Lee – then we will continue to bulk bill and not charge them.
• If bilateral we will only charge for one side (but may do them separately on different days). Please arrange the booking and advise the patient that Dr Lee will let them know on the day if is able to do both – there are times when this is not possible due to a number of factors.
• If another injection is required within 2 months or so – we will bulk bill the service – patient won’t have to pay then claim from Medicare.  We will do it without the $150 charge. 
• If patient is over 75 years. 

If people ask about payment you can let them know that Dr Lee is one of the preferred providers of back injections by spinal surgeons both in NSW and interstate and that they will get an expert providing the service who has performed thousands of prior injections and that unfortunately Medicare have made changes to items and this then doesn’t cover the cost of scan.

The fee structure will be as follows:

• Item 57341 = $500
• Item 104 = $150
• Total Fee = $650

Out of pocket with Medicare will be approx. $150.

PLEASE DO NOT REFER TO THE PRIVATE $$ CODE IN COMRAD AS THIS FEE ONLY APPLIES TO PRIVATE FEES FOR NON MEDICARE CARD HOLDERS