Medicare Benefits Schedule (MBS) state/territory data extract 2013-14

Identifying and definitional attributes
Metadata item type:	Data Set Specification
METEOR identifier:	603356
Registration status:	Commonwealth Department of Health, Retired 19/10/2023
DSS type:	Data Element Cluster
Scope:	This data set specification describes the output data set made available via the Department of Health's Enterprise Data Warehouse (EDW) in relation to the ongoing operations of the Medicare Benefits Schedule (MBS). The data set contains data as presented for analysis by users of the EDW, i.e. the data has generally undergone some degree of validation or reformatting in comparison with the raw input data sets provided to the Department of Health by the Department of Human Services. In some use cases, data produced in accordance with the structure described in this data set specification may need to be suppressed, de-identified or perturbed by the Department of Health in order to protect the privacy and/or confidentiality of individual patients and service providers.

Collection and usage attributes
Collection methods:	The data described in this data set specification is administrative by-product data generated by the ongoing daily operations of the MBS. Medicare benefits are claimable for ‘clinically relevant’ services rendered by an appropriate health practitioner.
Implementation start date:	01/07/2013
Implementation end date:	30/06/2014
Source and reference attributes
Steward:	Department of Health and Aged Care
Origin:	Department of Human Services, Canberra. Viewed 27 April 2015, http://www.humanservices.gov.au/customer/subjects/ medicare-services#a3
Relational attributes

Metadata items in this Data Set Specification

Seq No.	Metadata item	Obligation	Max occurs
1	Service/care provider—Medicare service provider identifier, NNNNNN *DSS specific information:* Variable name = SPR	Mandatory	1
2	Service/care provider—Medicare service provider practice location identifier, text X *DSS specific information:* Variable name = SPRPRAC	Mandatory	1
3	Address—Australian postcode, Australian postcode code (Postcode datafile) {NNNN} *DSS specific information:* Variable name = SPRPC This item represents the Medicare servicing provider postcode.	Mandatory	1
4	Service/care provider—Australian state/territory identifier, ACT-prioritised Australian state/territory code N *DSS specific information:* Variable name = SPRST In the context of MBS data, this data element describes the location (physical address) of the servicing provider.	Mandatory	1
5	Service/care provider—Australian state/territory identifier, ACT-prioritised Australian state/territory code N *DSS specific information:* Variable name = RPRST In the context of MBS data, this data element describes the location (physical address) of the referring provider.	Mandatory	1
6	Service/care provider—Medicare referring provider identifier, NNNNNN *DSS specific information:* Variable name = RPR_DMSLVL1	Mandatory	1
7	Service/care provider—Medicare referring provider practice location identifier, X *DSS specific information:* Variable name = RPRPRAC	Mandatory	1
8	Address—Australian postcode, Australian postcode code (Postcode datafile) {NNNN} *DSS specific information:* Variable name = RPRPC This item represents the Medicare requesting/referring provider postcode.	Mandatory	1
9	Service/care provider—specialty of requesting provider, health professional specialty group code NN *DSS specific information:* Variable name = RPR	Mandatory	1
10	Person—Medicare personal identifier number, N(9) *DSS specific information:* Variable name = PIN	Mandatory	1
11	Person—date of birth, DDMMYYYY *DSS specific information:* Variable name = PINDOB This item represents the Medicare patient date of birth.	Mandatory	1
12	Person—sex, code A *DSS specific information:* Variable name = PINSEX	Mandatory	1
13	Address—Australian postcode, Australian postcode code (Postcode datafile) {NNNN} *DSS specific information:* SAS variable name = PINPC In the context of MBS data, this data element describes the Medicare patient's enrolment postcode at the time the claim was processed. A patient can have more than one enrolment within a period. This data element can be used to identify individual patients and may, in some cases, need to be suppressed or de-identified.	Mandatory	1
14	Person—Australian state/territory identifier, ACT-prioritised code N *DSS specific information:* Variable name = PINST In the context of MBS data, this data element describes the Medicare patient's enrolment state, and not the location of an establishment, e.g. the practice or postal address of the servicing or referring provider. It is based on the most recent patient address reported to the Department of Human Services (DHS).	Mandatory	1
15	Service event—Medicare Benefits Schedule (MBS) item identifier, NN[NNN] *DSS specific information:* Variable name = ITEM	Mandatory	1
16	Service event—Medicare Benefits Schedule (MBS) category, code N[N] *DSS specific information:* Variable name = MBSCAT	Mandatory	1
17	Service event—Medicare Benefits Schedule (MBS) group, code ANN *DSS specific information:* Variable name = MBSGROUP	Mandatory	1
18	Service event—Medicare Benefits Schedule (MBS) subgroup, code ANNNN *DSS specific information:* Variable name = MBSSUBGROUP	Mandatory	1
19	Service event—date of Medicare service, DDMMYYYY *DSS specific information:* Variable name = DOS	Mandatory	1
20	Service event—Medicare Benefits Schedule (MBS) processing date, DDMMYYYY *DSS specific information:* Variable name = DOP	Mandatory	1
21	Record—Department of Health Broad Type of Service (BTOS) hierarchy, code NNNN *DSS specific information:* Variable name = BTOS	Mandatory	1
22	Service event—type of Medicare billing, code A *DSS specific information:* Variable name = BILLTYPECD	Mandatory	1
23	Service event—Medicare in-hospital treatment indicator, yes/no code A *DSS specific information:* Variable name = INHOSPITAL	Mandatory	1
24	Service/care provider—number of Medicare services provided, total number N *DSS specific information:* Variable name = NUMSERV	Mandatory	1
25	Service event—number of Medicare services claimed, total number N *DSS specific information:* Variable name = MDV_NUMSERV	Mandatory	1
26	Service event—amount of Medicare Benefit Schedule (MBS) benefit paid, Australian currency N[NNN].NN *DSS specific information:* Variable name = BENPAID	Mandatory	1
27	Service event—Medicare fee charged, total Australian currency N[NNN].NN *DSS specific information:* Variable name = FEECHARGED	Mandatory	1
28	Service event—Medicare Benefits Schedule (MBS) schedule fee, total Australian currency N[NNN].NN *DSS specific information:* Variable name = SCHEDFEE	Mandatory	1
29	Service event—number of radiotherapy fields for radiotherapy items, total number N *Conditional obligation:* This item will be reported if Medicare Benefits Schedule (MBS) item identifier is: Group T02 (Radiation oncology). *DSS specific information:* Variable name = RTFIELDS	Conditional	1
30	Service event—number of time periods for epidural anaesthetic items, total number N *Conditional obligation:* This item will be reported if Medicare Benefits Schedule (MBS) item identifier is: MBS Group T07 (Regional or field nerve blocks) MBS item numbers 18219 and 18227 *DSS specific information:* Variable name = EATIMPER	Conditional	1
31	Service event—Number of patients seen for non-referred attendance items, total number N *Conditional obligation:* This item will be reported if Medicare Australia Broad Type of Service (BTOS) hierarchy is: Broad type of service (BTOS) Category A (Non-referred attendances GP/VR GP) Category B (Non-referred attendances - Other) *DSS specific information:* Variable name = PATSEEN	Conditional	1
32	Service event—number of foetal tests done for foetal intervention items, total number N *Conditional obligation:* This item will be reported if Medicare Benefits Schedule (MBS) item identifier is: MBS Group T04 (Obstetrics) MBS item numbers 16600, 16603, 16606, 16609, 16612, 16615, 16618, 16621, 16624, 16627, 16633 and 16636 *DSS specific information:* Variable name = FITESTS	Conditional	1
33	Service/care provider—geographic remoteness, Medicare remoteness classification (ASGS-RA) N *DSS specific information:* Variable name = SPRRA This item represents the Medicare servicing provider's geographic remoteness.	Mandatory	1
34	Service/care provider—geographic remoteness, Medicare remoteness classification (ASGS-RA) N *DSS specific information:* Variable name = RPRRA This item represents the Medicare referring provider's geographic remoteness.	Mandatory	1
35	Service event—Medicare diagnostic imaging multiple services rule, code A *DSS specific information:* Variable name = DIMSR	Mandatory	1
36	Service event—Medicare multiple procedure type, code A *DSS specific information:* Variable name = MULTPROC	Mandatory	1
37	Service event—Medicare referral reason, code N *DSS specific information:* Variable name = REQREF	Mandatory	1
38	Service/care provider—specialty of servicing provider, health professional specialty group code NN *DSS specific information:* Variable name = SPR_DMSLVL1	Mandatory	1

Medicare Benefits Schedule (MBS) state/territory data extract 2013-14

Identifying and definitional attributes

Collection and usage attributes

Source and reference attributes

Relational attributes

Metadata items in this Data Set Specification

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Medicare Benefits Schedule (MBS) state/territory data extract 2013-14

Data Set Specification Attributes

Identifying and definitional attributes

Collection and usage attributes

Source and reference attributes

Relational attributes

Metadata items in this Data Set Specification

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