Medicare Rebates

Understanding Medicare rebates for your pathology bill

Medicare may cover some or all of the cost of your pathology bill with a rebate. Once you’ve paid the account, send your receipt to Medicare to claim your rebate. Just be aware that there are some tests and services that aren’t covered by Medicare and you’ll incur a charge for them.

What isn’t covered by Medicare?

Most pathology tests with PathWest qualify for a Medicare rebate, but there are some tests that don’t qualify under any circumstances:

Urine Drug Screening

  • Patients requesting self-testing
  • Employment-related testing
  • Testing for court purposes
  • GCMS confirmations of detected urine drug screens for drugs of abuse (even if the original drug screen was for the monitoring of patients participating in a drugs-of-abuse treatment program).

Other circumstances where a Medicare rebate never applies

  • Employment-related screening including pre-employment and Occupational Health & Safety (OHS) tests
  • Screening of students for clinical access
  • Testing for court purposes
  • Insurance medical assessments
  • Immigration and visa tests
  • Screening for sports including sports surveillance for performance enhancement substances and serology for boxing medical assessments
  • Screening of IVF donors
  • Testing for elective cosmetic surgery
  • Detection of nicotine and metabolites in smoking withdrawal programs
  • Fertility tracking for ART treatment
  • Travel-purpose COVID-19 tests.

If your pathology test relates to one of the circumstances above, an upfront payment is required.

Non-medical conditions

If your pathology tests aren’t related to a medical condition (such as Workers’ Compensation, Motor Vehicle Accident, pre-employment screening, merchant shipping assessment, Defence Force assessment), your bill may be sent to your employer or the relevant organisation upon their request. 

Department of Veteran Affairs Gold Card holders

Your account will be directly billed to the Department of Veteran Affairs and you won’t be required to pay an account.

Last Updated: 26/11/2021