The growth of Medicare rebatable cone beam computed tomography and panoramic radiography in Australia

There is a lack of objective data documenting the growth of cone beam radiology in Australia. Medicare rebates for cone beam computed tomography (CBCT) scans have been available since 1 July 2011. The aim of this study was to examine the Medicare data on the use of CBCT in order to quantify the growth of this technology over a three-year period and to assess if the growth of CBCT was impacting upon the use of dental panoramic radiology.

The Medicare dataset was accessed, and data relating to the number and distribution of CBCTs and panoramic radiographs (PRs) were extracted. The data were broken down by state and territory, as well as by age group and gender of the patient, for the financial year periods July 2011 to June 2012, July 2012 to June 2013 and July 2013 to June 2014. Items relating to PRs were also extracted for the periods 2005-2008 and 2008-2011.

In the period July 2011 to June 2014, a total of 226 232 CBCTs and 2 881 351 PRs were rebated through Medicare. The rate of CBCT services provided per 100 000 population increased by 42.3% over the three-year period, whereas the rate of PRs remained fairly constant. From the age group 5-14 years through to 55-64 years, females received more CBCTs and PRs than males. The total number of PRs rebated through Medicare increased slightly over each previous three-year period (2005-2008 and 2008-2011).

There has been rapid growth of the use of CBCT over a three-year period, most marked in the State of Victoria. The higher number of CBCT examinations in females across almost all age groups, but most notably in the 15-24 years age group, raises questions about clinical decision making in the selection of cone beam imaging. There was little evidence that CBCTs were being used as a substitute for PRs, except for a small but consistent drop in the number of PRs being requested for diagnosis of surgically related dental conditions.