Understanding costs
Mater Pathology does not charge any out of pockets for all Medicare rebateable items. Some Medicare rules, if not met, will trigger a bill for patients. These rules are specific to the test and often require specific statements by you to avoid any out-of-pocket charges.
Mater Pathology has significant arrangements with private health insurers to bill directly rather than sending the patient a bill. Please do not hesitate to contact us if you have any questions as to insurance providers where this applies.
Should patients receive a bill, it will usually be in relation to a non-Medicare rebateable test requested. You may outline the cost to the patient prior to collection, and our collection staff will provide details to the patient upon collection. If a patient opts not to progress with the test, you will be notified of that decision.
For any Mater Pathology account enquiries please contact 07 3163 8636 between 8 am and 4.30 pm Monday to Friday.
Price list
Our price list outlines the most commonly requested non-Medicare rebateable tests performed by Mater Pathology.
Medicare Pathology Item Limits
View the latest Medicare Pathology Item Limit guidelines and information.
Rule 3 exemption
Rule 3 of the Pathology Services Table limits the benefits payable for pathology items during a single patient episode. Exemptions to this rule have been granted for certain specified tests in certain clinical circumstances. The exemption is referred to as ‘Rule 3 Exemption’.
Mater Pathology has produced the following user-friendly guide to tests covered by the Rule 3 Exemption to assist practitioners in its appropriate application in Out Patients.
In these instances, the request form must be endorsed ‘Rule 3 Exemption’ for the request to be valid. This request is then valid for the earlier of six months or the test frequency limit.
| Patient Condition/Therapy | Tests Eligible for Rule 3 Exemption | Test Frequency |
Anticoagulant (Warfarin) therapy | INR | Unlimited tests up to 6 months of request |
Cancer patients receiving Bisphosphate infusions | Calcium, phosphate, magnesium, urea, creatinine and electrolytes | Up to 6 tests within 6 months of request |
| FBC, ESR | Up to 6 tests within 6 months of request |
| Chronic renal failure of a patient in a dialysis program conducted by a recognised hospital | Urea, creatinine and electrolytes | Up to 6 tests within 6 months of request |
| Cis-platinum therapy | Urea, creatinine and electrolytes | Up to 6 tests within 6 months of request |
| Cyclosporin therapy | Urea, creatinine and electrolytes | Up to 6 tests within 6 months of request |
| Leflunomide therapy | E/LFT (or part thereof) | Up to 6 tests within 6 months of request |
| Lithium therapy | Lithium | Up to 6 tests within 6 months of request |
| Methotrexate therapy | FBC, ESR, E/LFT (or part thereof) | Up to 6 tests within 6 months of request |
| Vitamin D (metabolites or analogues) therapy | Calcium and albumin | Up to 6 tests within 6 months of request |
Procedure for requesting Rule 3 Exemption tests
1. Request the pathology test in the normal way with the usual request form.
2. Specify the number of and frequency of the test.
3. Clearly endorse the form by writing ‘Rule 3 Exemption’.
4. Tests not listed as eligible for Rule 3 Exemption should be requested on a separate request form.
Tests eligible for Rule 3 Exemption will be carried forward and performed on subsequent episodes.
The information in this guide has been derived from the Medicare Benefits Schedule, 1 May 2010 (Rule 4 (2), p 631).
