Pathology, imaging and other diagnostic services

Web article

Last updated: 09 Jul 2026

AIHW (Australian Institute of Health and Welfare) (2026) Pathology, imaging and other diagnostic services, AIHW, Australian Government, accessed 13 July 2026.

Pathology, diagnostic imaging and other diagnostic services assist medical and other health practitioners to assess, diagnose and monitor a patient’s illness or injury. When these services are provided in non‑hospital settings, they are typically requested by a medical practitioner for individual patients. Patients may also receive pathology and diagnostic services in hospital settings, depending on their care needs.

Pathology services include a wide range of tests on patient samples, such as blood or body tissue.

Diagnostic imaging services include radiography (X-ray), ultrasound, computed tomography (CT scan), nuclear medicine and magnetic resonance imaging (MRI). These services are performed by qualified technical staff in conjunction with registered medical practitioners who are often specialists in diagnostic radiology.

In addition to pathology and diagnostic imaging, a wide range of other diagnostic services are performed by, or under the direct supervision of, a medical practitioner (often a specialist). These services include electrocardiography (ECG), sleep studies, bone densitometry, audiograms and spirometry.

This page has information on pathology, diagnostic imaging and other diagnostic services subsidised by the Medicare Benefits Schedule (MBS), based on services provided from financial years 2014–15 to 2024–25. Some services are not covered by the MBS, which include services:

provided to public patients in public hospitals
covered by the Department of Veterans' Affairs
covered by third party insurers or workers' compensation arrangements.

How many Medicare-subsidised pathology, imaging and other diagnostic services were provided?

In 2024–25, 18.3 million (67%) Australians received at least one Medicare-subsidised pathology, imaging or other diagnostic service. In total, 213.1 million of these services were provided. Most of these services (91% or 193.4 million) were delivered in non-hospital settings.

The most used services in this group were pathology and diagnostic imaging. In 2024–25, 60% of people had at least one pathology service and 40% had at least one diagnostic imaging service (Table 1).

Pathology services are generally split into 2 components:

pathology tests
patient episode initiation items, which cover the collection and transport of specimens associated with the pathology tests.

The 2 pathology components are reported separately in Table 1. However, pathology tests are used throughout this report as the primary measure of service volume because they best reflect the healthcare delivered to the Australian community. In contrast, to reflect the full cost of pathology testing, the cost of the associated patient episode initiation items is included with the cost of the pathology tests throughout this report.

Table 1: Use of Medicare-subsidised pathology, imaging and other diagnostic services, 2024–25
Type of service	Number of patients (million)^a	Proportion of people receiving a service (%)^b	Number of services (million)	Number of services per patient (average)
Pathology – total	16.3	60.0	173.3	10.6
Pathology – tests^c	16.3	60.0	123.8	7.6
Pathology – patient episode initiation^d	16.2	59.7	49.5	3.0
Diagnostic imaging^e	10.8	39.7	32.2	3.0
Other diagnostic services^f	4.3	15.7	7.6	1.8
Total	18.3	67.3	213.1	11.6

This is the number of unique patients, with patients being only counted once in each total, even if they have had services across different types of service.
The proportion of people receiving a service is calculated by dividing the total patients by the Australian Estimated Resident Population as at 30 June 2024.
Pathology tests include tests of patient samples, such as blood, urine, stools or body tissues. One sample may result in multiple tests and therefore multiple pathology items. Some pathology items cover multiple tests. Each time a Medicare benefit is paid for a pathology item, it is counted as one test in Medicare benefits statistics. It is not feasible to report statistics on the components of individual items.
Medicare benefits are only payable for the 3 most expensive tests ordered by a general practitioner outside hospital for the same patient on the same day. Tests after the 3 most expensive tests do not appear in Medicare benefits statistics. There are some exceptions to this pathology coning rule.
Patient episode initiation items are for the collection and transport of specimens – not for the pathology tests themselves.
Diagnostic imaging includes X-rays, CT scans, ultrasound scans, MRI scans and nuclear medicine scans.
Other diagnostic services include diagnostic procedures and investigations, such as electrocardiography, allergy testing, audiograms, bone densitometry and sleep studies.

Source: AIHW analysis of MBS data maintained by the Australian Government Department of Health, Disability and Ageing; National, state and territory population, ABS 2025.

Trends in services

Over the 10 years from 2014–15 to 2024–25 the proportion of people receiving a Medicare-subsidised diagnostic service increased. During this period, the proportion of the population who received:

at least one pathology test increased from 55% to 60%
a diagnostic imaging service increased from 38% to 40%.

In 2020–21 and 2021–22, the percentage of the Australian population receiving a pathology test spiked to 62% and 70% respectively. This increase was largely driven by the large number of people receiving a polymerase chain reaction (PCR) test for COVID-19. From 2022–23 onwards, the percentage of the population receiving a pathology test appears to have stabilised at a slightly higher level compared to the period before the COVID-19 pandemic, with between 59% and 60% of people receiving a pathology test. This compares with 55% to 57% in the years between 2014–15 and 2019–20.

The number of diagnostic services also increased over the period. Between 2014–15 and 2024–25, the number of services per 100 people rose from 382 to 455 pathology tests and from 102 to 118 diagnostic imaging services. After adjusting for changes in the age structure of the population, the increase was still observed with the age-standardised rate increasing from 361 to 412 pathology tests per 100 people and 97 to 107 diagnostic imaging services per 100 people. Figure 1 shows further details on the trends in the volume of pathology tests and diagnostic imaging services.

Figure 1: Pathology, imaging and other diagnostic services, 2014–15 to 2024–25

Patient characteristics

In 2024–25, older people were more likely to receive at least one Medicare-subsidised diagnostic service:

97% of people aged 65 and over received at least one service
2 in 3 (66%) people aged 16–64 received at least one service
2 in 5 (43%) people aged 15 and under received at least one service (Figure 2).

Figure 2: Pathology, imaging and other diagnostic services by demographic group, 2014–15 to 2024–25

Females were more likely than males to have had one or more Medicare-subsidised diagnostic service (74% compared with 61%). This difference largely reflects lower use among males aged 16–64.

Use was similar across Major cities, Inner regional and Outer regional areas but lower in Remote and Very remote areas. In Outer regional, Major cities and Inner regional areas, 65% to 70% of people received a diagnostic service, compared with 56% of people living in Remote areas and 49% of people living in Very remote areas. This effect was broadly consistent across age groups, with Remote and Very remote areas having a consistently lower percentage.

The proportion of people receiving a diagnostic service varied across socioeconomic areas. A smaller proportion of residents in areas of the lowest socioeconomic status (quintile 1) received a service when compared to areas of the highest socioeconomic status (quintile 5). Only 59% of residents living in the lowest socioeconomic areas received at least one service, whereas for the highest socioeconomic areas, 76% of residents received at least one service.

Over time, many demographic groups saw a small increase in the number of patients receiving one or more Medicare-subsidised diagnostic services between 2014–15 and 2024–25. Some of the more notable changes were:

a 7-percentage point increase in people aged 15 and under receiving at least one service (from 36% to 43%)
a 6-percentage point increase in people residing in the highest socioeconomic areas receiving at least one service (from 70% to 76%)—in contrast, the lowest socioeconomic areas experienced a 2-percentage point increase (from 57% to 59%)
a 5-percentage point increase in people residing in Very remote areas receiving at least one service (from 44% to 49%)—in comparison, the increase was 3-percentage point in Major cities (from 63% to 66%).

The age-standardised rates of people receiving diagnostic services across different geographic regions were consistent with the patterns above. People residing in Major cities received 724 age-standardised diagnostic services per 100 people compared to 469 age-standardised diagnostic services per 100 people in Very remote areas. Similarly, an age-standardised rate of 840 services per 100 people were delivered to residents in the highest socioeconomic areas, which can be compared to an age-standardised rate of 599 services per 100 people in the lowest socioeconomic areas.

Spending

In 2024–25, $11.4 billion was spent on Medicare-subsidised pathology, imaging and other diagnostic services. This comprised:

$10.1 billion in Medicare benefits paid by the Australian Government
$1.3 billion in out-of-pocket costs paid by private patients.

Patient out-of-pocket costs

Out-of-pocket costs incurred by patients were calculated by subtracting the Medicare benefit from the fee the doctor charged. Rebates provided by private health insurers for Medicare services in hospital are not included because these payments are not captured in MBS claims data.

Private health insurance does not cover Medicare services outside hospital.

Of the $1.3 billion in out-of-pocket costs:

$882.2 million was paid by patients in non-hospital settings
$466.3 million was paid by patients in hospital settings.

Total spending (benefits and out-of-pocket costs) by service type in 2024–25 comprised:

$4.2 billion being spent on pathology (combined pathology tests and patient episode initiation items)
$6.4 billion being spent on diagnostic imaging services
$0.8 billion being spent on other diagnostic services.

In 2024–25, 185.3 million Medicare‑subsidised pathology, imaging and other diagnostic services (87%) were bulk‑billed, meaning patients did not pay any out‑of‑pocket costs. Bulk billed pathology services, including both pathology tests and patient episode initiation items, made up the majority of these bulk‑billed services, accounting for 84% of the total.

For people who did incur out-of-pocket costs, diagnostic imaging had the highest average annual cost per patient for all imaging services received in 2024–25:

$226 per patient in non-hospital settings (an average of $132 per service)
$296 per patient in hospital settings (an average of $94 per service).

It may seem counterintuitive that the average out-of-pocket cost per patient is higher in hospital settings than non-hospital settings, even when the average out-of-pocket cost per service is lower. This is because of the different mix of diagnostic imaging items being provided in hospital settings as opposed to non-hospital settings, the amount of diagnostic imaging services being provided to each patient and the different pricing models employed between hospital and non-hospital settings.

An example of an item provided in hospital and non-hospital settings: MBS item 58503 (chest x-ray)

Item 58503 (chest x-ray) accounts for 21% of all diagnostic imaging services in hospital settings, but only 4.6% of services in non-hospital settings. For services that incurred out-of-pocket costs:

the average out-of-pocket cost was $26 per service in hospital settings, compared with $67 per service in non-hospital settings
patients received an average of 2.3 services per patient with out-of-pocket costs in hospital settings, compared with 1.1 services per patient with out-of-pocket costs in non-hospital settings.

These differences demonstrate the different propensity for items to be delivered to patients at different prices across hospital and non-hospital settings.

Pathology had a lower average annual out-of-pocket cost per patient for all tests incurring a cost in the year:

$85 per patient in non-hospital settings (an average of $25 per test)
$171 per patient in hospital settings (an average of $21 per test).

As with diagnostic imaging services, pathology tests have a higher average out-of-pocket cost paid by patients for tests in hospital settings than that for tests occurring in non-hospital settings, with the opposite being true for the average out-of-pocket cost per test. This reflects similar reasons for diagnostic imaging services, with the addition of the pathology coning rule (see note (c) of Table 1) not applying to pathology tests delivered in hospital settings. The absence of episode coning means that Medicare benefits will be paid (and associated out-of-pocket costs captured) for a greater number of lower-cost tests, which will lower the average out-of-pocket cost per test for tests provided in hospital settings.

Trends in spending

In the 10 years between 2014–15 and 2024–25, spending on Medicare-subsidised pathology, imaging and other diagnostic services increased. Spikes in 2020–21 and 2021–22 were associated with the COVID-19 pandemic. Between 2014–15 and 2024–25:

Medicare benefits paid by the Australian Government increased in real terms (after adjusting for inflation), from $8.2 billion in 2014–15 to $10.1 billion in 2024–25 (Figure 3), with $1.3 billion of this increase being for diagnostic imaging services. Per patient, this was an increase in real terms from an average of $546 to $549 over the same period.
Patient out-of-pocket costs in non-hospital settings increased in real terms, from $595.9 million in 2014–15 to $882.2 million in 2024–25. Among those patients who incurred out-of-pocket costs, the average cost per patient rose from $197 to $207 (in real terms) over this period. The increase in average out-of-pocket costs per patient reflects changes in both service use and the composition of services that attract an out-of-pocket cost. In particular, growth in patients with out-of-pocket costs and out-of-pocket charges for higher-cost diagnostic imaging services (such as ultrasounds) contributed to higher costs, alongside rising bulk-billing rates (to over 99.5%) for lower-cost pathology items. Together, these factors shifted the mix of services with out-of-pocket costs towards higher-cost items.
Patient out-of-pocket costs in hospital settings decreased in real terms from $476.7 million in 2014–15 to $466.4 million in 2024–25. On a per patient basis, there was a decrease in real terms from an average of $346 to $283 during this period. The reason for the sharper decrease in out-of-pocket costs per patient when compared to the total out-of-pocket costs paid is due to both an increase in the volume of patients with out-of-pocket costs (19% increase) and a decrease in the total out-of-pocket costs paid (2.2% decrease), resulting in a steeper decrease in the average out-of-pocket cost on a per patient basis.

Figure 3: Spending on pathology, imaging and other diagnostic services, constant prices, 2014–15 to 2024–25

For pathology tests, the number of patients who had an out-of-pocket cost increased slightly from 1.5 to 1.6 million between 2014–15 and 2024–25. Over the same period, the average cost per patient (for those who paid out-of-pocket costs) decreased slightly in real terms:

from $93 to $85 per patient in non-hospital settings
from $207 to $171 per patient in hospital settings.

For diagnostic imaging services, the number of patients who had an out-of-pocket cost increased from 2.5 million in 2014–15 to 3.6 million in 2024–25 (this represented an increase from 10% to 13% of the population). The average cost per patient (for those who paid an out-of-pocket cost) changes over time:

it increased in real terms from $222 to $226 per patient in non-hospital settings
it decreased from $330 to $296 per patient in hospital settings.

What types of pathology tests do people use?

The volume of pathology tests increased between 2014–15 and 2024–25. This includes the large increase as a result of the COVID-19 pandemic in 2020–21 and 2021–22. Among all pathology groups, microbiology group was the most affected by the pandemic.

Pathology groups

MBS pathology tests are categorised into 9 pathology groups:

Haematology: tests for blood-related conditions such as anaemia, leukaemia, and clotting or bleeding disorders.

Chemical: uses chemical tests to detect abnormalities associated with diseases, for example, diagnosis of a heart attack, high cholesterol or diabetes.

Microbiology: tests for infections and diseases caused by bacteria, viruses, fungi and parasites, for example, influenza, pneumonia, meningitis and COVID-19.

Immunology: tests for allergies and auto-immune diseases, for example, testing for allergy antibodies, or monitoring the level of T-lymphocytes after HIV infection.

Tissue pathology: tests on tissue samples for disease diagnosis, largely for detection and diagnosis of cancer.

Cytology: tests for the diagnosis of disease by examining single cells and small clusters of cells, mainly for diagnosis and prevention of cancer, for example, testing for human papillomavirus which causes most cervical cancer.

Genetics: tests for genetic abnormalities, for example, prenatal diagnosis of Down’s syndrome and predictive testing for cancer.

Infertility and pregnancy tests: tests used in the diagnosis of infertility and pregnancy.

Simple basic pathology tests: non-referred pathology tests for simple basic tests performed by a medical practitioner or a participating nurse practitioner.

Microbiology group

The microbiology group experienced a sharp increase in the volume of tests in 2020–21 and 2021–22 followed by a steep decline in 2022–23. This pattern was driven by several factors, including the scaling back of mandatory COVID-19 testing, increased availability of rapid antigen tests and rising vaccination rates.

From March 2020, new Medicare items were introduced within the microbiology group to fund COVID-19 PCR testing performed by accredited public and private pathology laboratories (rapid antigen tests were not funded under Medicare, nor was the mass testing conducted at Government-run testing sites during the pandemic).

As shown in Figure 4, the number of microbiology tests gradually rose from 14.4 to 18.1 million tests between 2014–15 and 2019–20. In 2019–20, only a small number of COVID-19 PCR tests were delivered to patients. This reflects the early stage of the COVID-19 pandemic, when COVID-19 testing was limited to specific groups of patients (for example, those returning from overseas, and healthcare workers).

Over the following 2 years, COVID-19 PCR testing became more available and the volume of COVID-19 testing grew rapidly. In 2021–22 this accounted for nearly 63% of all microbiology tests provided (and 82% of all microbiology benefits paid). However, 2022–23 saw the decline in the number of COVID-19 tests funded through Medicare to only 18% of the volume of all microbiology tests.

From 1 July 2024, Medicare items for respiratory pathogen testing including compulsory COVID-19 testing have been discontinued, and replaced with items 69421 and 69422, which provide testing for 4 respiratory pathogens and 5 or more respiratory pathogens, respectively. These 2 items may or may not include testing for COVID-19.

For more information, see Infectious and communicable diseases.

Figure 4: Pathology tests by group, 2014–15 to 2024–25

Cytology group

Another observable change in pathology testing occurred in the cytology group, which includes cervical screening items. The number of cytology tests decreased by 40% between 2018–19 and 2021–22, followed by a 61% increase between 2021–22 and 2023–24.

New cervical screening items were introduced in December 2017. These items replaced the previous 2-yearly Pap test with a 5-yearly test for people without symptoms. The initial decline in cytology test volumes could be attributed to the decreased frequency of cervical screening required by the new items. The subsequent increase is consistent with patients returning for their rescreening after 5 years. Medicare benefits paid for cytology tests followed a similar pattern.

Genetics group

The genetics group experienced a 70% increase in the number of tests delivered between 2021–22 and 2024–25. This growth occurred in tests delivered in non-hospital settings. Genetic testing volumes rose from 346,000 tests in 2021–22 to 589,000 tests in 2024–25.

This increase is largely attributed to the introduction of 2 new Medicare items, 73451 and 73452, in November 2023. Item 73451 provides genetic testing for people who are pregnant or are planning a pregnancy to determine carrier status for cystic fibrosis, spinal muscular atrophy and fragile X syndrome. Item 73452 covers testing for their reproductive partners. In 2024–25, 124,000 tests were delivered under item 73451 alone.

What types of diagnostic imaging services do people use?

Between 2014–15 and 2024–25, all diagnostic imaging groups experienced an increase in the number of services provided, although different groups saw the service volumes increase at different rates. In 2018–19 ultrasound services (which had a 43% increase in service volumes over the 10-year period from 2014–15) overtook diagnostic radiology services as the group with the highest number of services provided (see Figure 5).

Diagnostic imaging groups

MBS diagnostic imaging services are categorised into 5 imaging groups:

Ultrasound: uses high-frequency sound waves to produce moving images of the body's internal structures. It is often used to monitor a pregnant woman and her unborn baby and to help diagnose unexplained pain, swelling and infection.

Computed tomography (CT): uses multiple X-rays to create detailed images of internal organs, bones, soft tissue and blood vessels. It is often used to detect many different cancers and to reveal internal injuries and bleeding.

Diagnostic radiography (or X-ray): uses a very small dose of ionising radiation to produce images of the body's internal structures. X-rays are often used to help diagnose fractured bones, look for injury or infection and to locate foreign objects in soft tissue.

Nuclear medicine imaging: uses small amounts of radioactive material, a special camera and a computer to create images inside the body. It helps diagnose many types of cancers, heart disease, gastrointestinal, endocrine, neurological disorders and other conditions. It may detect disease in its earliest stages. Positron emission tomography (PET) is a type of nuclear medicine imaging.

Magnetic resonance imaging (MRI): uses a powerful magnetic field, radio waves and a computer to produce detailed images of the body's internal structures. It is used to evaluate a variety of conditions, including tumours and diseases of the liver, heart, and bowel.

Computed tomography (CT) services recorded the largest percentage increase in services provided among diagnostic imaging groups over the 10-year period. Service volumes increased by 87% from 2.8 million in 2014–15 to 5.2 million in 2024–25. The increase in CT services was driven by both higher use of existing items and by the introduction of new items. For example, the volume of existing CT Medicare items 57341, 56507 and 56301 increased by more than 250,000 services between 2014–15 and 2024–25. Newer Medicare items, such as items 56622 and 56627 (listed in May 2020) had over 100,000 services provided in 2024–25.

Figure 5: Diagnostic imaging services by group, 2014–15 to 2024–25

Magnetic resonance imaging (MRI) services also experienced a large percentage increase (60% from 1.0 to 1.6 million) in service volumes over the period. This was likely due to an increase of the availability of MRI scanners, as well as the uptake of additional Medicare items to provide rebates for MRI services requested by general practitioners in November 2013.

Nuclear medicine imaging services grew at a comparatively smaller rate overall, rising by 41% from 0.7 to 0.9 million services between 2014–15 and 2024–25. However, within this group, positron emission tomography (PET) services experienced a large increase in both services and the amount of Medicare benefits paid by the Australian Government over the 10-year period. PET service volumes increased by 334% (from 59,000 to 254,000), and benefits increased by 228% (from $70.4 to $231.3 million – in inflation adjusted terms). Factors likely driving this increase in recent years are the addition of new PET Medicare items from 2017–18 onwards, along with increased availability of PET scanners.

Although the service volumes of CT, MRI and nuclear medicine imaging were much lower than ultrasound and diagnostic radiology, these high technology forms of imaging are more expensive. The average out-of-pocket costs per patient for these 3 groups are correspondingly higher. In 2024–25, patients paid an average out-of-pocket cost of:

$265 for nuclear medicine imaging services
$263 for CT services
$227 for MRI services
$204 for ultrasound services
$128 for diagnostic radiology services.

Despite this, MRI services showed a declining trend in average out-of-pocket costs in real terms across both hospital and non-hospital settings. Overall, MRI out-of-pocket costs dropped from $296 per patient in 2017–18 to $227 in 2024–25.

Key data gaps

MBS claims data is drawn from the Medicare assessing system, which is a payment system for the assessment of claims for Medicare benefits. The MBS data was not designed for secondary use, such as health research. While MBS data captures the item numbers for which Medicare benefits have been paid, it does not capture the reasons for attendance with a Medicare provider, the diagnosis resulting from an attendance, nor does it contain the results of tests and investigations.

From 1 July 2026, all written pathology and diagnostic imaging reports prepared by (or on behalf of) a pathologist or radiologist will be ‘shared by default’ with the My Health Record system. This is intended to help ensure patients and their healthcare providers can access key information through My Health Record to support care (ADHA 2026a). Eventually, this data may become available for research purposes to guide health service planning, policy development and research to further improve Australia’s health system. This data would always be de-identified so that it cannot be traced back to an individual unless they specifically agreed to the use of their personal information (ADHA 2026b).

MBS data also does not capture any rebates paid by private health insurance and cannot be used to calculate actual out-of-pocket costs for privately insured episodes of hospital treatment or hospital substitute treatment (for example, treatment at home).

Where do I go for more information?

For more information on pathology and imaging, see:

Medicare Benefits Scheme funded services: monthly data.

References Expand

ABS (Australian Bureau of Statistics) (2011) Australian Demographic Statistics, Jun 2011, ABS website, accessed 2 December 2025.

ABS (2025) National, state and territory population, Jun 2025, ABS website, accessed 23 December 2025.

ADHA (Australian Digital Health Agency) (2026a) Better and Faster Access to health information, ADHA website, accessed 16 April 2026.

ADHA (2026b) Secondary use of data, ADHA website, accessed 16 April 2026.