AMA Proposes Spinal Imaging Limits for Chiropractors

The Australian Medical Association (AMA) has proposed limiting chiropractors to three spinal imaging requests per patient per year. These limits would be accompanied by focused education and audit activities.

Rising Imaging Requests Drive New Controls

Data cited by the AMA indicates that chiropractors accounted for a significant 89% of all diagnostic imaging requests from allied healthcare workers in 2024. This figure notably exceeds usage by physiotherapists and osteopaths. The volume of imaging requests from chiropractors has also seen a substantial increase, rising from 473,922 in 2020 to 624,613 in 2024.

Chiropractors accounted for 89% of all diagnostic imaging requests from allied healthcare workers in 2024, significantly exceeding usage by physiotherapists and osteopaths.

The proposed frequency controls aim to discourage repeat, low-value imaging and reduce patient radiation exposure.

Medicare Benefits Schedule Reforms Advocated

Regarding the Medicare Benefits Schedule (MBS) items, the AMA recommended against creating new chiropractor-specific items for every anatomical permutation. Instead, the association urged a policy response that focuses on streamlining the schedule, strengthening claiming clarity, and targeting education and compliance initiatives.

Exceptions Require GP Authorization

Exceptions to the three-per-year limit would apply for patients with complex conditions. These include examples such as progressing scoliosis or a fracture with evolving symptoms. Importantly, any such exception would require authorization from a patient’s regular General Practitioner (GP).

Clarifying Roles and Preventing Co-claiming

The AMA also called for co-claiming restrictions to prevent medical radiation practitioners from splitting services across multiple claims.

Additionally, reforms were recommended to clarify the distinct responsibilities within imaging. Radiologists are to be responsible for advising on alternative imaging, making modality choices, optimizing doses, administering contrast, modifying protocols, and communicating findings with a patient’s treating doctor. Medical radiation practitioners are to provide technical expertise and escalate urgent or unexpected findings to the on-duty radiologist first.