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Friday, April 1

Abdominoplasty Update: Medicare Supports Medical Tummy Tucks for Women Experiencing Muscle Separation Caused by Pregnancy!

As of the 1st of July 2022, women who meet the Medicare criteria for surgical repair of muscle separation as a result of pregnancy will now be able to access support from Medicare and Private Health Funds.   The new abdominoplasty or tummy tuck medical item number and descriptions are yet to be defined, however, the government has confirmed postpartum women can once again access medical abdominoplasty from 1 July 2022.

What is the medicare item number and description for medical abdominoplasty after pregnancy?

Item Number 30175

 Radical abdominoplasty, with repair of rectus diastasis, excision of skin and subcutaneous tissue, and transposition of umbilicus, not being a laparoscopic procedure, where the patient has an abdominal wall defect as a consequence of pregnancy, if:

 (a) The patient:

(i) Has a diastasis of at least 3cm measured by diagnostic imaging prior to this service; and

(ii) has symptoms of at least moderate severity of pain or discomfort at the site of the diastasis in the abdominal wall during functional use and/or low back pain or urinary symptoms likely due to rectus diastasis that have been  documented in the patient’s records by the practitioner providing this service; and

(iii) Has failed to respond to non-surgical conservative treatment including physiotherapy; and

(iv) Has not been pregnant in the last 12 months


When should I have my ultrasound scan assessment of the muscle separation?

Medicare has not specified the timing for an abdominal ultrasound scan, however, Dr Cheng would suggest a scan as soon as you have identified any symptoms of muscle separation.  Your GP or surgeon can arrange a referral for this scan.

Does a radiologist need to measure the diastasis or can a physiotherapist undertake the scan? 

The muscle separation must be formally scanned and reported by a diagnostic imaging practice. As such, a physiotherapist does not qualify.


What are the acceptable non-surgical treatment options that I may have tried before considering abdominoplasty surgery?

Acceptable examples of non-surgical treatment may include:

  • pain medication
  • lower back braces
  • lifestyle changes
  • physiotherapy and/or exercise

Are there any physiotherapy services that specialise in muscle separation exercise programs? 

What is the minimum timeframe I must try non-surgical conservative treatment before I can qualify for  an abdominoplasty? 

Medicare does not dictate a minimum timeframe, however, you must be at least 12 months post-partum and have undergone and failed to respond to non-surgical conservative treatment including physiotherapy before qualifying for abdominoplasty.

How often can I apply to use this medicare item number?

Applicable once per lifetime. 

What private health fund tier should I have to claim for a medical tummy tuck following pregnancy?

It is still not clear as yet, which level of cover will be required, however, it is likely to be similar to post weightloss surgery items requiring gold tier cover. 

Next steps

1. Book a consultation with Dr Eddie Cheng or Dr Ajay Chauhan
We recommend booking your consultation with your surgeon in advance, as wait times can be up to 10 months. During your consultation, your specialist plastic surgeon will be able to advise if you meet the medicare criteria for claiming as well as the best surgical option for your desired result. He will also address any questions or concerns you may have relating to your surgery. You will also be allocated your own personalised Treatment Coordinator who will not only provide you with a formal estimate at the conclusion of your consultation but will be available to guide you throughout your surgical journey.
2. GP referral
In preparation for your appointment with our surgeons you will also need to discuss your symptoms and concerns with your GP and ideally obtain referrals for your surgeon and your abdominal ultrasound scan.
3. Arrange a consultation with a Women's Physiotherapy specialist
Consider consulting with our Women's Health Physiotherapists based here at The Wesley Hospital if you haven't seen a physiotherapist befoe. Ask our friendly team to assist you with a referral. 
Dr Eddie Cheng and Dr Ajay Chauhan are both board-certified Specialist Plastic Surgeons in Brisbane, Australia.  Get to know us us via Instagram and Facebook @arplasticsurgery.




Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

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Are you a candidate for surgery?