Heart Tests Compared

📋 Sources: MBS Book, July 2026 (items 11729, 55141–55146, 61324–61357, 57360, 57364; explanatory notes DR.1.2, IN.1.10, IN.2.1, IN.2.2, IR.0.1, IR.4.1) via mbsonline.gov.au. Heart Foundation, Medical tests for heart disease (reviewed 29 April 2025). Australian Commission on Safety and Quality in Health Care, Third Australian Atlas of Healthcare Variation, Cardiac tests chapter (2016–17 data). Storey P. Cardiac imaging: 2022 update. Aust J Gen Pract 2022;51(9).

Exercise ECG, stress echo, nuclear scan (MPS) and CT angiogram — what each is, and how Medicare treats it

Pick the tests you want to compare

Tap a test to show or hide its column. This page explains what each test is — it does not tell you which one you need. Your doctor decides that with you.

	Exercise ECG	Stress echo	Nuclear scan (MPS)	CT angiogram (CTCA)
What it is	An ECG recorded while you exercise, usually on a treadmill. It records electrical activity; it does not produce pictures.	An ultrasound of the heart taken before and after exercise (treadmill or bike) or after a medicine that makes the heart work harder.	Radioactive-tracer imaging of blood flow to the heart muscle and heart function, at rest and during activity (also called a nuclear stress test).	A CT scan that produces a 3-dimensional image of the heart chambers and coronary arteries, using dye injected into a vein.
How it is done	Chest electrodes and a blood-pressure cuff; speed and incline increase in stages while the team watches your ECG and blood pressure.	Ultrasound images are compared before and after the stress.	A tiny dose of tracer is injected; cameras outside the body capture the energy it releases.	Dye is injected into a vein while the scanner takes a series of pictures.
Radiation	None Records electrical signals.	None Uses ultrasound.	Yes Radioactive tracer. Amount varies by protocol and centre — ask the provider.	Yes X-rays (CT). Amount varies by scanner and protocol — ask the provider.
Medicare item(s)	11729 (aged 17+)	55141 (exercise), 55145 (medicine-induced); repeat items 55143, 55146	61324 / 61357 (stress only); 61329 / 61345 (stress and rest); 61349 (repeat after revascularisation)	57360 (coronary artery disease); 57364 (other listed indications)
MBS schedule fee¹	$182.15	$484.50 (exercise) $561.55 (medicine-induced)	$710.10 (stress only) $1,067.85 (stress and rest)	$808.10
Medicare benefit¹	$154.85	$411.85 / $477.35	$605.60 / $963.35	$703.60
Who can ask for it	Referred to a specialist or consultant physician, or requested by another doctor — Medicare allows both routes.	A doctor's request that states the symptom or clinical reason.	Requested by a specialist or consultant physician (61324, 61345, 61349) or by another medical practitioner (61329, 61357).	Requested by a specialist or consultant physician.
How often Medicare covers it	Once in any 24 months.	Once in 24 months (repeat items have their own conditions).	Once in 24 months for adults (repeat after revascularisation: 12 months).	If a scan finds no obstructive coronary disease, a repeat within 5 years is limited (exceptions apply).
Learn more	Exercise stress test	Echocardiogram	Imaging prep lookup	Calcium score (a different CT test)

¹ MBS schedule fees from the July 2026 MBS Book. Medicare benefit shown at the 85% level; the MBS Book also lists a 75% figure for some settings. A provider can charge more than the schedule fee, so ask what you will pay before the test. Check current figures at mbsonline.gov.au.

Words you may hear

Ischaemia: Reduced blood supply to part of the heart muscle. Several of the tests above look for signs of it.
Perfusion: Blood flow through the heart muscle. A myocardial perfusion scan images this.
Tracer: A small amount of radioactive substance injected into a vein so cameras can follow it to the heart.
Pharmacological stress: Using a medicine (for example dobutamine) instead of exercise to make the heart work harder, as described by the Heart Foundation.

Medicare's own explanatory notes say that stress echocardiography and myocardial perfusion studies provide equivalent information in most cases, that the radiation burden of a test should be considered, and that the patient should be fully informed and involved in the decision. Ask your doctor about the options for you.

MBS requirements at a glance (July 2026)

Summary of descriptors and explanatory notes. Always read the full item text and notes at mbsonline.gov.au before claiming or requesting.

Item	Test	Fee / 85% benefit	Requester	Frequency and key conditions
11729	Exercise or pharmacological stress ECG, 17+	$182.15 / $154.85	Referral to specialist/consultant physician, or request (four requester-provider combinations defined in DR.1.2)	Once per 24 months; not within 24 months of 55141, 55143, 55145, 55146, 61324, 61329, 61345, 61349, 61357, 61394, 61398, 61406, 61410 or 61414. Monitoring ≥20 minutes incl. resting ECG; written report. Not for asymptomatic patients with a normal cardiac examination, stable known disease used for monitoring, or a resting ECG that prevents interpretation (DR.1.2).
55141	Exercise stress echo (focused)	$484.50 / $411.85	Request must identify the symptom or clinical indication (IR.0.1)	Once per 24 months. Not claimable if stress echo would not give adequate information (body habitus, unable to exercise, previous imaging) (IR.0.1 cl.4).
55143	Repeat exercise or pharmacological stress echo	$484.50 / $411.85	Specialist or consultant physician	Once per 12 months; prior 55141/55145/55146/55143 within 24 months and ischaemic symptoms that have evolved and are not controlled with optimal medical therapy.
55145	Pharmacological stress echo	$561.55 / $477.35	Request must identify indication (IR.0.1)	Once per 24 months; not if 55141, 55143 or 55146 in prior 24 months.
55146	Pharmacological stress echo after failed 55141	$561.55 / $477.35	Request must identify indication (IR.0.1)	55141 within the previous 4 weeks failed due to inadequate heart-rate response; once per 24 months.
61324 61357	MPS, single stress (SPECT)	$710.10 / $605.60	61324: specialist/consultant physician. 61357: other medical practitioner.	Symptoms of cardiac ischaemia and at least one of: stress echo would not provide adequate information (body habitus/rhythm), unable to exercise adequately, or failed stress echo. Once per 24 months (17+).
61345 61329	MPS, combined stress and rest / reinjection / redistribution	$1,067.85 / $963.35	61345: specialist/consultant physician. 61329: other medical practitioner.	Same criteria as above; once per 24 months (17+).
61349	Repeat combined MPS after revascularisation	$1,067.85 / $963.35	Specialist or consultant physician	Prior MPS within 24 months, subsequent revascularisation, evolved symptoms not controlled with optimal medical therapy; once per 12 months.
57360	CT coronary angiography (CAD), ≥64-slice	$808.10 / $703.60	Specialist or consultant physician	Stable or acute symptoms consistent with coronary ischaemia; low-to-intermediate risk of acute coronary event, no significant biomarker elevation or ischaemic ECG changes. Not more than once in 5 years after a 57360/57364 service that found no obstructive CAD, unless criteria for invasive angiography are met (IN.2.2).
57364	CT coronary angiography (other indications)	$808.10 / $703.60	Specialist or consultant physician	Stable symptoms with newly recognised LV systolic dysfunction of unknown aetiology; exclusion of coronary anomaly or fistula; before non-coronary cardiac surgery; or alternative to invasive angiography for bypass graft patency where item 38247/38249/38252 criteria are met.

Indications and safety requirements in the notes

Stress echo and MPS (IR.0.1, IR.4.1): the notes list typical or atypical angina features, known CAD with symptoms not controlled or evolved since the last functional study, and further indications (for example resting ECG changes consistent with CAD without known CAD, lesions of uncertain functional significance on CTCA or invasive angiography, undue exertional dyspnoea of uncertain aetiology, selected pre-operative assessments, and pre-intervention assessments). The request must identify the symptom or indication. Premises must have resuscitation equipment including a defibrillator, a person trained in CPR (and for stress echo, exercise testing) in personal attendance, and a second trained person immediately available, one of whom must be a medical practitioner.

Functional studies (IN.1.10): the notes state that stress echocardiography and MPS provide equivalent information in most cases, that radiation burden should be considered when choosing the modality, and that the patient should be fully informed and involved in the decision.

CTCA preparation (IN.2.1): heart rate should be below 65 beats per minute wherever possible, and sublingual GTN given immediately before scanning where clinically appropriate. The presence of coronary calcium alone does not preclude CTCA.

What published sources say

Third Australian Atlas of Healthcare Variation, cardiac tests chapter: exercise ECG made up 53% of cardiac stress tests and imaging nationally in 2016–17, stress echo 33%, MPS 8% and CTCA 6%. It states that stress echocardiography should generally be preferred over MPS where it provides similar information because it does not involve radiation, and that for many low-risk symptomatic patients an exercise ECG gives enough information to plan management.
Storey, AJGP 2022: describes stress echo as widely available, MPS as a validated long-standing technique, and CTCA as a mainstay with a triage role; notes CTCA can be non-diagnostic with a grossly elevated calcium load, in which case referral for MPS or stress echo is suggested. The article does not print radiation doses in mSv.
Radiation doses: effective doses depend on protocol, tracer and scanner. This page does not quote mSv figures; refer to the performing service and to ARPANSA for patient information on medical radiation.

Training standard for stress echocardiography providers is given in the MBS notes as CSANZ Level 2 (Guidelines for Training and Performance in Adult Echocardiography) or equivalent.

Common questions

What is the difference between a stress echo and a nuclear stress test (MPS)?

A stress echocardiogram uses ultrasound to look at the heart before and after (or during) exercise or a stress-inducing medicine, and uses no radiation. A myocardial perfusion scan (MPS, also called a nuclear stress test) injects a small amount of radioactive tracer into the bloodstream, and external cameras image blood flow to the heart muscle at rest and during stress. The Medicare (MBS) explanatory notes say that in most cases the two provide equivalent information, that the radiation burden should be considered, and that the patient should be fully informed and involved in the decision.

Do all of these heart tests use radiation?

No. An exercise ECG records electrical signals and a stress echocardiogram uses ultrasound, so neither uses ionising radiation. A myocardial perfusion scan uses a radioactive tracer and a CT coronary angiogram uses X-rays. The amount of radiation varies with the protocol and the centre, so ask the imaging provider.

Does Medicare cover these heart tests?

Medicare Benefits Schedule (MBS) items exist for all four tests, but each has its own rules about the symptoms or indications required, who can request the test, and how often it can be claimed. For example, the July 2026 MBS schedule fee is $182.15 for exercise ECG (item 11729), $484.50 for an exercise stress echocardiogram (item 55141), $710.10 for a single stress myocardial perfusion study (items 61324 and 61357), and $808.10 for a CT coronary angiogram (item 57360). The schedule fee is not necessarily what a provider charges, so ask for the fee before the test.

Who decides which heart test is used?

The doctor who requests the test decides based on the individual situation, and Medicare rules also set out which tests can be claimed and when. This page explains what each test is and how Medicare treats it. It does not recommend a test. Talk to your doctor about which test is right for you.