Knee and hip injections in Australia: Medicare, gel and PRP costs

Steroid injections

We found no MBS item specifically for a joint injection. Image-guided injections are usually billed with an imaging item, such as ultrasound item 55850. Medical Costs Finder reported that in 2023–24, 61% of 55850 services were bulk-billed; it also lists typical out-of-pocket costs.

Hyaluronic acid (gel) and PRP

The MBS rules say Medicare consultation items don’t apply to intra-articular viscosupplementation for knee osteoarthritis, and no MBS item applies to services given in connection with injecting a patient’s own blood products such as PRP. In a 2026 Australian Prescriber podcast, a rheumatologist said hyaluronic acid injections have not been approved for MBS or PBS subsidy and that PRP is not subsidised. Image guidance for the injection may still attract a rebate.

How coverage works in Australia

As a public patient in a public hospital, you are treated at no charge, but you may wait. For specialist care outside hospital, Medicare pays 85% of the Medicare Benefits Schedule (MBS) fee; as a private patient in hospital it pays 75% and your private hospital cover pays the rest of the schedule fee. Doctors can charge more than the schedule fee, so you may have a “gap” to pay. How coverage works in Australia.

Private hospital cover: waiting periods

Private hospital cover can have waiting periods of up to 12 months for pre-existing conditions and up to 2 months for most other treatment. A condition counts as pre-existing if you had signs or symptoms in the 6 months before you joined or upgraded; a doctor appointed by your insurer decides this.

If you are refused

• Ask your insurer which clinical category and policy rule applies, and get it in writing.
• If you can’t resolve it, the Commonwealth Ombudsman handles private health insurance complaints for free.
• Complaints about a health service go to your state’s health complaints body, such as the Health Care Complaints Commission in NSW or the Health Complaints Commissioner in Victoria.

Frequently asked questions

Does Medicare cover gel injections for knee arthritis?

No. Hyaluronic acid injections are not subsidised by Medicare or the PBS, and Medicare doesn’t pay for the knee consultation, though imaging guidance may still attract a rebate.

This page explains how coverage usually works, using public Australian Government, insurer, ombudsman and clinic sources listed above. It is general information, not medical, insurance, financial or legal advice, and it does not recommend any treatment, policy or provider. Rules differ by policy and can change, so confirm with your doctor, your insurer or the hospital before you decide. Protocol Archive is independent and is not affiliated with Medicare, the Australian Government or any insurer.