1758 - Expansion of MBS item numbers 12320 & 12322 for bone mineral density testing to include patients aged 60-69 years

Page last updated: 17 October 2023

Application Detail

Description of Medical Service

Medicare Benefits Schedule (MBS) items 12320 and 12322 currently provide for bone densitometry, using dual energy X‑ray absorptiometry or quantitative computed tomography, in patients aged 70 years of age and over. Bone densitometry measures a patient’s bone mineral density (BMD) and compares the patient’s BMD with the average BMD of young healthy adults (called a T-score).

Description of Medical Condition

Osteoporosis is a condition in which the bones become fragile and brittle, leading to a higher risk of fractures (breaks or cracks) than in normal bone. Diagnosis of osteoporosis requires an assessment of BMD. Patients with osteoporosis are defined as those with a T-score of -2.5 or lower.

Fractures due to osteoporosis (osteoporotic fractures) can lead to changes in posture, muscle weakness, loss of height and bone deformity of the spine. Fractures can lead to chronic pain, disability, loss of independence and even premature death.

Patients aged 70 years or older with osteoporosis (defined as those with a BMD T-score of -2.5 or less) and without a history of minimal trauma fracture, can access osteoporosis medications listed on the Pharmaceutical Benefits Scheme (PBS) for primary prevention of fractures. The Pharmaceutical Benefits Advisory Committee (PBAC) has considered proposals to expand the current age restriction for PBS listed osteoporosis medicines for primary prevention of fractures to include patients aged 60 to 69 years. However, the PBAC deferred making a recommendation to amend the current age restriction for PBS listed osteoporosis medicines for primary prevention of fracture to include patients aged 60 to 69 years, pending a review of the MBS implications, to ensure that the bone densitometry MBS items could be aligned with the PBAC recommendations. See PBAC outcome for Osteoporosis Therapy Restrictions Review and Public Summary Document for Risedronic Acid (November 2022).

Reason for Application

The application will assess the cost-effectiveness and total cost of amending the current age restriction for MBS items 12320 and 12322 to include patients aged 60 to 69 years to align with proposals to amend the age restriction for PBS listed osteoporosis medicines for primary prevention of fracture.

Medical Service Type

Investigative, codependent technology

Previous Application Number/s

Not Applicable

Associated Documentation

Application Summary

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Consultation Survey

Consultation Survey (PDF 778 KB)
Consultation Survey (Word 36 KB)

PASC Consultation
Expedited – Bypassing PASC

MSAC Consultation
MSAC consultation input must be received by no later than Friday, 16 February 2024 for it to be considered by MSAC at its April 2024 meeting.

For further information please refer to PASC, ESC, MSAC Key Dates
For further information on the consultation process please refer to MSAC Consultation Process

PICO Confirmation

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Assessment Report

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Public Summary Document

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Meetings for this Application

PASC

Expedited – Bypassing PASC

ESC

15-16 February 2024

MSAC

4-5 April 2024