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

Data Set Specification Attributes

Identifying and definitional attributes

Metadata item type:Help on this termData Set Specification
METEOR identifier:Help on this term603356
Registration status:Help on this term

Commonwealth Department of Health, Retired 19/10/2023

DSS type:Help on this termData Element Cluster
Scope:Help on this term

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:Help on this term

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:Help on this term01/07/2013
Implementation end date:Help on this term30/06/2014

Source and reference attributes

Steward:Help on this termDepartment of Health and Aged Care
Origin:Help on this term

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 Help on this term

Seq No.Help on this termMetadata itemHelp on this termObligationHelp on this termMax occursHelp on this term
1Service/care provider—Medicare service provider identifier, NNNNNN

DSS specific information:

Variable name = SPR

Mandatory1
2Service/care provider—Medicare service provider practice location identifier, text X

DSS specific information:

Variable name = SPRPRAC

Mandatory1
3Address—Australian postcode, Australian postcode code (Postcode datafile) {NNNN}

DSS specific information:

Variable name = SPRPC

This item represents the Medicare servicing provider postcode.

Mandatory1
4Service/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.

Mandatory1
5Service/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.

Mandatory1
6Service/care provider—Medicare referring provider identifier, NNNNNN

DSS specific information:

Variable name = RPR_DMSLVL1

Mandatory1
7Service/care provider—Medicare referring provider practice location identifier, X

DSS specific information:

Variable name = RPRPRAC

Mandatory1
8Address—Australian postcode, Australian postcode code (Postcode datafile) {NNNN}

DSS specific information:

Variable name = RPRPC

This item represents the Medicare requesting/referring provider postcode.

Mandatory1
9Service/care provider—specialty of requesting provider, health professional specialty group code NN

DSS specific information:

Variable name = RPR

Mandatory1
10Person—Medicare personal identifier number, N(9)

DSS specific information:

Variable name = PIN

Mandatory1
11Person—date of birth, DDMMYYYY

DSS specific information:

Variable name = PINDOB

This item represents the Medicare patient date of birth.

Mandatory1
12Person—sex, code A

DSS specific information:

Variable name = PINSEX

Mandatory1
13Address—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.

Mandatory1
14Person—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).

Mandatory1
15Service event—Medicare Benefits Schedule (MBS) item identifier, NN[NNN]

DSS specific information:

Variable name = ITEM

Mandatory1
16Service event—Medicare Benefits Schedule (MBS) category, code N[N]

DSS specific information:

Variable name = MBSCAT

Mandatory1
17Service event—Medicare Benefits Schedule (MBS) group, code ANN

DSS specific information:

Variable name = MBSGROUP

Mandatory1
18Service event—Medicare Benefits Schedule (MBS) subgroup, code ANNNN

DSS specific information:

Variable name = MBSSUBGROUP

Mandatory1
19Service event—date of Medicare service, DDMMYYYY

DSS specific information:

Variable name = DOS

Mandatory1
20Service event—Medicare Benefits Schedule (MBS) processing date, DDMMYYYY

DSS specific information:

Variable name = DOP

Mandatory1
21Record—Department of Health Broad Type of Service (BTOS) hierarchy, code NNNN

DSS specific information:

Variable name = BTOS

Mandatory1
22Service event—type of Medicare billing, code A

DSS specific information:

Variable name = BILLTYPECD

Mandatory1
23Service event—Medicare in-hospital treatment indicator, yes/no code A

DSS specific information:

Variable name = INHOSPITAL

Mandatory1
24Service/care provider—number of Medicare services provided, total number N

DSS specific information:

Variable name = NUMSERV

Mandatory1
25Service event—number of Medicare services claimed, total number N

DSS specific information:

Variable name = MDV_NUMSERV

Mandatory1
26Service event—amount of Medicare Benefit Schedule (MBS) benefit paid, Australian currency N[NNN].NN

DSS specific information:

Variable name = BENPAID

Mandatory1
27Service event—Medicare fee charged, total Australian currency N[NNN].NN

DSS specific information:

Variable name = FEECHARGED

Mandatory1
28Service event—Medicare Benefits Schedule (MBS) schedule fee, total Australian currency N[NNN].NN

DSS specific information:

Variable name = SCHEDFEE

Mandatory1
29Service 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

Conditional1
30Service 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

Conditional1
31Service 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

Conditional1
32Service 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

Conditional1
33Service/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.

Mandatory1
34Service/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.

Mandatory1
35Service event—Medicare diagnostic imaging multiple services rule, code A

DSS specific information:

Variable name = DIMSR

Mandatory1
36Service event—Medicare multiple procedure type, code A

DSS specific information:

Variable name = MULTPROC

Mandatory1
37Service event—Medicare referral reason, code N

DSS specific information:

Variable name = REQREF

Mandatory1
38Service/care provider—specialty of servicing provider, health professional specialty group code NN

DSS specific information:

Variable name = SPR_DMSLVL1

Mandatory1

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