Technical notes
This report presents MBS data from published Medicare Item Reports made available online by Services Australia. The data describe the number of services provided, not the number of individuals who received a service.
Month/quarter is determined by the date the service was processed by Services Australia, not the date the service was provided. Monthly figures may vary due to the varying number of processing days in a month, which depends on the number of days in the month, public holidays, overtime worked etc. Other events impacting staffing, such as school holidays, or responding to the COVID-19 pandemic, can also impact the number of services processed in a month.
State/Territory is determined according to the address (at the time of claiming) of the patient to whom the service was rendered.
Limitations
In Australia, the planning and delivery of antenatal care services is mostly managed by state and territory governments. Antenatal care services are delivered through a combination of public hospital services, general practitioner, public and private obstetrician and midwifery services. As such, the way antenatal care services are accessed by women will vary between the states and territories and should be considered when making any comparisons using state/territory level data.
The figures in this report include only antenatal care services that are performed by a registered provider, for services that qualify for Medicare Benefit and for which a claim has been processed by Services Australia. They do not include services provided by hospital doctors to public patients in public hospitals or services that qualify for benefit under the Department of Veterans’ Affairs National Treatment Account.
As such, antenatal care provided as a public outpatient service at a public hospital is not included in this report (unless the service has been privatised) because it is not claimed on the MBS. We acknowledge that antenatal care provided through public hospital services contributes significantly to antenatal care provided in Australia.
Additionally, it is in the remit of general practitioners and other providers to deliver antenatal care. However, without specific ‘antenatal’ items or data as to the reason for the appointment, it is not possible to include these services as antenatal care.
The above limitations also apply to 2018 and 2019 data and therefore these years are provided as baselines. This report should be considered as indicative of trends in service usage in Australia during the COVID-19 pandemic.
Timeliness and completeness of data
This report uses timely data to enable comparisons of trends in antenatal care services over 2020, to explore the potential impact of the COVID-19 pandemic. Data was sourced from publicly available Medicare item reports on 15 April 2021.
When considering this report, it is important to remember the MBS data could be updated over time to reflect amendments. This means data in this report is considered preliminary.
Comparability of data
Antenatal care data in this report is not comparable to antenatal care data published in other AIHW maternal and perinatal data publications where data on antenatal care is sourced differently.
More comprehensive data on the impacts of the COVID-19 pandemic on mothers and babies will be explored in future data from the National Perinatal Data Collection in the Australia’s mothers and babies publication.
MBS items related to antenatal care used in this analysis
Several routine antenatal care items were aggregated in this report to present total antenatal care services. These routine antenatal care MBS items include:
Antenatal Service provided by a Nurse, Midwife or an Aboriginal and Torres Strait Islander health practitioner on behalf of, and under the supervision of, a medical practitioner provided at or from a regional, rural or remote area.
Items 16400, 91850 and 91855 cannot be claimed in conjunction with another antenatal attendance item for the same patient, on the same day by the same practitioner and can only be claimed 10 times per pregnancy in total.
- 16400 – Face-to-face
- 91850 – Telehealth (video-conference)
- 91855 – Telehealth (telephone - when video-conference not available)
Antenatal Attendance (medical practitioner)
- 16500 – Face-to-face
- 91853 – Telehealth (video-conference)
- 91858 – Telehealth (telephone - when video-conference not available)
Planning and management of a pregnancy, by a medical practitioner, if the pregnancy has progressed beyond 28 weeks' gestation and the service includes a mental health assessment of the patient (including screening for drug and alcohol use and domestic violence). Claimable once per pregnancy.
- 16590 – claimable where the medical practitioner is intending to undertake the birth for a privately admitted patient (and item 16591 does not apply to the same pregnancy)
- 16591 – claimable where the medical practitioner is providing shared antenatal care and is not intending to undertake the birth (and item 16590 does not apply to the same pregnancy)
Antenatal Professional Attendance by a participating midwife
- 82100 – Initial antenatal attendance by professional midwife. Payable once per pregnancy. No telehealth items were added for this attendance
- 82105 – Face-to-face short antenatal attendance
- 91211 – Telehealth (video-conference) short antenatal attendance
- 91218 – Telehealth (telephone) short antenatal attendance
- 82110 – Face-to-face long antenatal attendance
- 91212 – Telehealth (video-conference) long antenatal attendance
- 91219 – Telehealth (telephone) long antenatal attendance
Please note: additional MBS items 91211, 91212, 91218, 91219, 91850, 91853, 91855 and 91858 were developed in response to the need to provide ongoing antenatal care during the COVID-19 pandemic. These are temporary items and were introduced on 13 March, 2020.
Diagnostic imaging for pregnancy includes item numbers: 55700, 55701, 55702, 55703, 55704, 55705, 55706, 55707, 55708, 55709, 55710, 55711, 55712, 55713, 55714, 55715, 55716, 55717, 55718, 55719, 55720, 55721, 55722, 55723, 55724, 55725, 55726, 55727, 55729, 55730, 55735, 55737, 55759, 55760, 55762, 55763, 55764, 55765, 55766, 55767, 55768, 55769, 55770, 55771, 55772, 55773, 55774.
There are also several MBS items which can be rendered during the antenatal period which may relate to specific conditions or procedures but which have not been included in this report as they are very specific for a small population of pregnancies. For example:
- 16406 – Antenatal professional attendance, by an obstetrician or general practitioner, as part of a single course of treatment when the patient is referred by a participating midwife. Payable only once for a pregnancy
- 16509 – Pre-eclampsia, eclampsia or antepartum haemorrhage, treatment of - each professional attendance that is not a routine antenatal attendance