From 1 July 2025, the Australian Government has restricted eligibility criteria under which Urine MCS testing (Item number 69333) is covered by Medicare.
Despite this change, we remain committed to providing high quality and affordable pathology services and will bulk bill patients for this test whenever bulk billing is available.
A patient will be eligible for bulk billing only when the new eligibility criteria set by Medicare are met.
It’s therefore very important that appropriate clinical notes are included on the request form.
From 4 August 2025, patients who do not meet the Medicare eligibility criteria may be charged once testing is completed, reported and their eligibility for a Medicare rebate assessed.
We have kept any out-of-pocket cost as low as possible to ensure patients who don’t meet Medicare eligibility criteria can still access this important test.
Medicare eligibility criteria
Patients with symptoms of urinary tract infection (UTI) or kidney disease
OR
Clinically-indicated asymptomatic patients who are:
- Pregnant women
- Children <16 years of age
- Recipients of renal transplant
- Suffering from recurrent urinary tract infections
- Being investigated or monitored for kidney disease
- Undergoing urinary tract instrumentation, a urological procedure or transurethral resection of the prostate
Given the above, a patient may be excluded from Medicare bulk billing, for example, as per below:
- Patients who do not have appropriate clinical notes on their pathology request forms
- Asymptomatic patients undergoing non-urological surgery
- Asymptomatic patients with spinal cord injuries
- Catheter stream urine (CSU) samples from patients with indwelling catheters
- Screening of asymptomatic patients of advanced age or in aged care facilities
- Screening of asymptomatic patients with diabetes
