About the data measures
About the data source
Data for the report were sourced from the Medicare Benefits Schedule (MBS) data collection, which is managed by the Australian Government Department of Health, Disability and Ageing. The claims data are derived from administrative information on services that qualify for a Medicare benefit under the Health Insurance Act 1973 and for which a claim has been processed by Services Australia.
When a health practitioner provides a clinically relevant service to a Medicare-eligible person, the practitioner or patient can make a claim with Medicare. Medicare will then provide a rebate, or benefit, to cover all or part of the cost of the service. For more detailed information on the MBS services and item types, see the Department of Health, Disability and Ageing's MBS online webpage.
Scope of the MBS claims data
Under MBS arrangements, Medicare claims can be made by eligible persons. An 'eligible person' is a person who resides permanently in Australia. This includes New Zealand citizens and holders of permanent residence visas. Applicants for permanent residence may also be eligible persons, depending on their circumstances. Eligible persons must enrol with Medicare before they can receive Medicare benefits. Medicare covers services provided only in Australia. It does not refund treatment or evacuation expenses overseas. It is important to note that some Australian residents may obtain similar medical services through other arrangements.
MBS statistics only include services for which an MBS benefit was paid. They do not include services:
- provided by hospital doctors to public patients
- provided under the Department of Veterans' Affairs National Treatment Account
- covered by third party or workers' compensation
- rendered to repatriation beneficiaries or defence personnel
- rendered for insurance or employment purposes
- that are funded directly by other Australian Government programs (such as health screening services)
- funded directly by State/Territory Government programs.
Some areas and service types have a higher proportion of services that are not Medicare-subsidised than others and this may affect comparability when estimating total health care use in Australia. In particular, caution should be taken when interpreting use of Medicare-subsidised allied health services. Except for optometry, Medicare-subsidised allied health services are generally only available to patients with chronic, developmental or mental health conditions with a referral from a GP or specialist medical practitioner. Some Australians also access subsidised allied health services through their general (‘ancillary’ or ‘extras’) private health insurance or pay for services entirely out-of-pocket.