Data source

Medicare Benefits Schedule data

The MBS data presented relate to services provided on a fee-for-service basis for which MBS benefits were paid. The year is determined from the date the service was processed by Medicare, rather than the date the service was provided. The state or territory is determined according to the postcode of the patient’s mailing address at the time of making the claim. In some cases, this will not be the same as the postcode of the patient’s residential address. To avoid double counting, patient counts for demographic characteristics (e.g. sex, age, postcode etc.) are derived from the last service processed in the reference period.

The Department of Human Services collects data on the activity of all persons making claims through the Medicare Benefits Scheme and provides this information to the Department of Health. Information collected includes the type of service provided (MBS item number) and the benefit paid by Medicare for the service. The item numbers and benefits paid by Medicare are based on the Medicare benefits schedule  (DoHA 2015 ). Services that are not included in the MBS are not included in the data. The table below lists all MBS items that have been defined as mental health-specific. 

Data source MBS.1: Medicare-subsidised mental health-related items
Provider type Item group MBS Group & Subgroup MBS item numbers
Psychiatrists Initial consultation new patient(a) Group A8 296, 297, 299
Patient attendances—consulting room Group A8 291(a), 293(a), 300, 302, 304, 306, 308, 310, 312, 314, 316, 318, 319
Patient attendances—hospital Group A8 320, 322, 324, 326, 328
Patient attendances—other locations Group A8 330, 332, 334, 336, 338
Group psychotherapy Group A8 342, 344, 346
Interview with non‑patient Group A8 348, 350, 352
Telepsychiatry Group A8 288, 353, 355, 356, 357, 358, 359(b), 361(b), 364, 366, 367, 369, 370
Case conferencing   855, 857, 858, 861, 864, 866
Electroconvulsive therapy(c) Group T1, Subgroup 13 14224
Referred consultation for assessment, diagnosis and development of a treatment and management plan for autism or any other pervasive developmental disorder
(PDD)(d)
Group A8 289
General practitioners GP Mental Health Treatment Plan—accredited Group A20, Subgroup 1 2710(a)(f), 2715(g),
2717(g)
GP Mental Health Treatment Plan—non-accredited Group A20, Subgroup 1 2700(g), 2701(g), 2702(e)(f)
GP Mental Health Treatment Plan—other Group A20, Subgroup 1 2712(a), 2713(a),
2719(g)(h)
Focussed Psychological Strategies Group A20, Subgroup 2 2721, 2723, 2725, 2727
Family Group Therapy Group A6 170, 171, 172
Electroconvulsive therapy(i) Group T10 20104
3 Step Mental Health Process—GP(j) Group A18, Subgroup 4 2574, 2575, 2577, 2578
3 Step Mental Health Process—other
medical professional(j)
Group A19, Subgroup 4 2704, 2705, 2707, 2708
Clinical psychologists Psychological Therapy Services(a) Group M6 80000, 80005, 80010, 80015, 80020
Other psychologists Enhanced Primary Care Group M3 10968
Focussed Psychological Strategies (Allied Mental
Health)(a)
Group M7 80100, 80105, 80110, 80115, 80120
Assessment and treatment of PDD(c) Group A10 82000, 82015
Follow-up allied health service for Indigenous
Australians(k)
Group M11 81355
Other allied health providers Enhanced Primary Care—mental health worker Group M3 10956
Focussed Psychological Strategies (Allied Mental Health)—occupational therapist(a) Group M7 80125, 80130, 80135, 80140, 80145
Focussed Psychological Strategies (Allied Mental Health)—social worker(a) Group M 80150, 80155, 80160, 80165, 80170
Follow-up allied health services for Indigenous
Australians—mental health worker(k)
Group M11 81325

(a) Items introduced 1 November 2006.

(b) Items introduced 1 November 2007.

(c) Items may include services provided by medical practitioners other than psychiatrists. The item is related to 2014 – see footnote (i) for more information.

(d) Items introduced 1 July 2008.

(e) Item introduced 1 January 2010.

(f) Items discontinued after 31 October 2011.

(g) Items introduced 1 November 2011.

(h) Items discontinued after 30 April 2012.

(i) Item is for the initiation of anaesthesia for electroconvulsive therapy and includes services provided by medical practitioners
other than GPs. The item is associated with item 14224 which means that a single event may be billed as two separated services against both items.

(j) Items discontinued after 30 April 2007.

(k) Items introduced 1 November 2008.

 

Provider type important notes:

  • General practitioners includes services provided by Medical practitioners, including General practitioners, but excluding specialists or consultant physicians. 
  • Clinical psychologist includes item numbers that can only be claimed by eligible Clinical psychologists.
  • Other psychologist includes item numbers that can be claimed by any eligible psychologist, clinical and other. The proportion of activity claimed by against these items by Clinical psychologists has not been estimated in the presented data. That is, the services rendered by Clinical psychologists will be present in both the Clinical psychologist and Other psychologist categories.

 

Psychiatrist items—pre 1996

Restructuring of Group A8 items occurred as of 1 November 1996. Item numbers 134, 136, 138, 140 and 142 were discontinued as of 31 Oct 1996. Historical Psychiatrist data includes services claimed against these item numbers.

Indigenous data

A Voluntary Indigenous Identifier (VII) was introduced into the Medicare database from November 2002. By July 2016 approximately 484,000 people had identified as Aboriginal, Torres Strait Islander, or both (approximately 66% of the estimated Indigenous population). Indigenous rates have been adjusted for under-identification in the Department of Human Services (DHS) VII database. Indigenous rates are therefore modelled and should be interpreted with caution.


References

DoHA 2015. Medicare Benefits Schedule Book, effective 01 January 2015. Canberra: Commonwealth of Australia.

Australian Health Ministers’ Advisory Council, 2017, Aboriginal and Torres Strait Islander Health Performance Framework 2017 Report: Technical Appendix, AHMAC, Canberra.