Medicare X-Ray Billing


Medicare Australia now supports payments to chiropractors for X-rays under some circumstances. Invoicing these X-rays can be problematic, as the patient/client will not be paying for them, and as other services rendered to the patient are not funded by Medicare, it would be problematic to treat each patient/client as an insurance patient/client purely for billing X-rays. This knowledgebase article describes an alternate strategy for dealing with this challenge.

Underlying challenge

The main problem with the Medicare funded X-rays is that the patient/client will be self funded (or funded by a different third party) for all other services. To this extent, it is not a simple procedure to configure Capable 21C to invoice X-rays to Medicare, and other services to the patient (or another third party).


To resolve the problem, complete the following steps:

  • Create a new patient/client file called Medicare.
  • Update the configuration of the X-ray services so that their item codes are all ???
  • Invoice all X-rays using the Walk-In feature to Medicare directly.

When an invoice is raised for the X-ray services, Capable 21C will recognize the special item codes, and will prompt the operator to key their own item codes. In this case, keying the patient/client name is advised.

Detailed Information

To update the configuration of X-ray services, complete these steps:

  • Go to Setup|Setup Appointment Types and Fees.
  • Locate the first X-ray service. Double click on it.
  • On the Service Details window, change the item codes to be ??? (3 question marks in a row and nothing else).
  • Close the Service Details window.
  • Repeat steps 2-4 for all other X-ray services.

Note that Walk-In patients may only be invoiced for products.  For this reason, it will be advantageous for the office to setup a Product Group for the Medicare services, and Add the services to that group.

It is also possible to adapt the Invoice/Receipt Design so that the Patient/Client's Medicare number is displayed.  Note that this functionality will only work if the Medicare Number has been recorded on the Patient/Client file via Patient/Client Details.

This knowledge resource is designed for use on a Windows (tm) XP system operating at a screen resolution of 1024x768 or better. Windows Media Player must be installed for this training resource to operate correctly.

Copyright 2008 Capable Software Pty Ltd

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