Pap smear costs 'decision for companies'

The head of the federal health department concedes women could be charged up front for pap smears because of government cuts to pathology bulk-billing incentive payments.

Pathologists warn women will be forced to fork out $30 for the cervical cancer screening test if the government goes ahead with the $650 million savings measure from July 1.

Changes to bulk-billing incentives for magnetic resonance imaging services and diagnostic imaging are also on the cards, prompting warnings patients will face hefty costs for X-rays and ultrasounds.

Martin Bowles told a Senate estimates hearing in Canberra on Wednesday the department doesn't believe the cuts will have a significant impact, given the high levels of competition in both pathology and diagnostic imaging.

About 98 per cent of patients who get pathology done are bulk-billed and that isn't expected to change.

But asked whether women could be charged up front for pap smears as a result of the cuts, he said it would be a decision for individual companies to make.

"We don't control the charging behaviour of private businesses," he said.

"If a provider decides to not bulk bill, yes of course there is a cost."

Rural Health Minister Fiona Nash said despite the scaremongering, bulk-billing rates weren't expected to decrease.

Bulk-billing rates were continuing to rise in general practice, despite fears they would drop in response to the government's Medicare rebate indexation freeze, she said.

The hearing was told incentive payments being removed are worth between $1 and $3, but pathologists say they can't absorb the costs.

Mr Bowles admitted the department didn't consult the sectors before announcing the cuts, but insisted that was standard practice when it comes to budget measures.