2005 - 06 Medicare Statistical Tables - Explanatory Notes
The statistics presented in this section relate only to Medicare Australia's Medicare operations. By publishing a range of statistics, Medicare Australia hopes to ensure that the public is well informed about the Medicare program.
Interested persons and organisations may request further statistical information or clarification of data reported in the accompanying tables by contacting Medicare Australia's Health Information Section in its Canberra National Office, email statistics@medicareaustralia.gov.au
or call 1800 101 099. Requests for additional information may incur a charge.
The statistical tables which follow include only those services which qualify for Medicare benefits. Any apparent discrepancies in addition in the tables are due to rounding.
The benefit figures in the tables represent the benefit processed by Medicare Australia during the appropriate time periods. These activity-based benefit figures differ from those reported in the Medicare Australia financial reports, which have been prepared on an accrual accounting basis.
Enrolments (tables 1 and 2)
Tables 1 and 2 refer to the enrolment status of individuals as at 30 June 2006. A person must be enrolled with Medicare before a claim for Medicare benefits will be paid. Each eligible person may have his or her own card (eg a single person without dependants) or be on another person's card (eg a dependant child) or on two cards (eg a child of separated parents).
| Table | Content |
|---|---|
| Medicare 1a | The number of persons enrolled with Medicare by age, sex and State/Territory. |
| Medicare 1b | The estimated resident population by age, sex and State/Territory (figures supplied by ABS). |
| Medicare 2 | The number of active cards by number of persons enrolled on each card by State/Territory. |
Services and benefits (tables 3 to 17)
Tables 3 to 17 relate to professional services included in claims processed by Medicare Australia during 2005/06, if the services were rendered in the last eight calendar years. The time lag between the date of service and the date of processing (see table 15) makes it impossible to produce reliable statistics on services rendered in a given period until many months after the end of that period.
| Table | Content |
|---|---|
| Medicare 3 | Number and percentage of services by bill type and State/Territory - for services processed from 1 July 2005 to 30 June 2006 |
| Medicare 4 | Value and percentage of benefits by bill type and State/Territory - for services processed from 1 July 2005 to 30 June 2006 |
| Medicare 5 | Average value of benefits per service by bill type and State/Territory - for services processed from 1 July 2005 to 30 June 2006 |
| Table | Content |
|---|---|
| Medicare 6 | Number and percentage of services by broad type of service and State/Territory - for services processed from 1 July 2005 to 30 June 2006 |
| Medicare 7 | Value and percentage of benefits by broad type of service and State/Territory - for services processed from 1 July 2005 to 30 June 2006 |
| Medicare 8 | Average value of benefits per service by broad type of service and State/Territory - for services processed from 1 July 2005 to 30 June 2006 |
| Medicare 9 | Number and percentage of services bulk billed by broad type of service and State/Territory - for services processed from 1 July 2005 to 30 June 2006 |
| Table | Content |
|---|---|
| Medicare 10 | Number of services by age, sex of patient and State/Territory - for services processed from 1 July 2005 to 30 June 2006 |
| Medicare 11 | Value of benefits by age, sex of patient and State/Territory - for services processed from 1 July 2005 to 30 June 2006 |
| Medicare 12 | Percentage of services bulk billed by age, sex of patient and State/Territory - for services processed from 1 July 2005 to 30 June 2006 |
| Medicare 13 | Average number of services per Australian resident by age, sex of patient and State/Territory - for services processed from 1 July 2005 to 30 June 2006 |
| Medicare 14 | Average value of benefits per Australian resident by age, sex of patient and State/Territory - for services processed from 1 July 2005 to 30 June 2006 |
| Table | Content |
|---|---|
| Medicare 15 | Average lag between date of service, date of lodgment and date of processing by bill type and State/Territory - for services processed from 1 July 2005 to 30 June 2006 |
| Medicare 16 | Strengthening Medicare - Additional Incentive Items - Number of Items Count and Benefit Paid from 1 July 2005 to 30 June 2006 |
| Medicare 17 | Five year comparison of selected key statistics with previous financial years - for services processed in each financial year |
| Medicare 18 | New Safety Net Registrations by State and Month from 1 July 2004 to 30 June 2005 - New Safety Net Registrations by Financial Year - Safety Net Registrations as at 30 June 2005 |
Patient statistics for services rendered in the previous financial year 2004/2005 (Tables 18-22)
Tables 18 to 22 are based on services rendered during 2004/05 and processed by Medicare Australia prior to 1 July 2006. The total Medicare enrolled population is the total number of persons eligible for Medicare benefits. Patients are persons eligible for Medicare rebate during some or all of the 2004/05 financial year.
In table 22, the number of general practitioners is the number of providers who rendered at least one GP attendance service to the patient during the 2004/05 financial year.
| Table | Content |
|---|---|
| Medicare 18 | Percentage of enrolled people by number of services and State/Territory - for services rendered from 1 July 2004 to 30 June 2005 |
| Medicare 19 | Percentage of enrolled people by number of services, age and sex - for services rendered from 1 July 2004 to 30 June 2005 |
| Medicare 20 | Number and percentage of enrolled people, services and benefits by number of services - for services rendered from 1 July 2004 to 30 June 2005 |
| Medicare 21 | Level of bulk billing by number of services and age range of patients - for services rendered from 1 July 2004 to 30 June 2005 |
| Medicare 22 | Number and percentage of patients by number of General Practitioners consulted by State/Territory - for services rendered from 1 July 2004 to 30 June 2005 |
Additional Bulk Bill Incentive payments
Table 16 relates to a Strengthening Medicare initiative. On 1 February 2004, items 10990 General Medical Services Table (GMST), 64990 Diagnostic Imaging Services Table (DIST) and 74990 Pathology Services Table (PST) were introduced to provide an additional $5 (now $5.15) payment for each bulk billed service provided to a Commonwealth concession card holder or child under 16.
From 1 May 2004 the $5 bulk billing incentive payment was increased to $7.50 (now $7.85) for eligible services provided in regional, rural and remote areas, and in all parts of Tasmania. To receive the $7.85 incentive, medical practitioners need to claim new Medicare items 10991(GMST), 64991(DIST) or 74991(PST). These items operate in a similar manner to the bulk billing incentive items 10990, 64990 and 74990 which continue to apply to services provided in all other areas of Australia. As of 1 January 2005 the bulk billing incentive item 10992 was introduced to provide a $7.85 incentive for practitioners not based in an eligible area (as defined by item 10991), but provide out-of-surgery after-hours services within an eligible area.
The change in incentive payment rates (i.e. $5.10 to $5.15 and $7.65 to $7.85) occurred on 1 November 2005, due to the indexation of Medicare Benefits Schedule fees. As the financial year contained a period where benefits were paid at rates of $5.10 and $7.65 and a period where benefits were paid at rates of $5.15 and $7.85, the number of services multiplied by the benefit per service is not expected to equal the total benefit paid on a particular item.
Medicare Items by Broad Type of Service
| Broad Type of Service | Medicare Items |
|---|---|
| Unreferred Attendances - VR GP | 1-4, 13-14, 19-20, 23-26, 33, 35-40, 43-44, 47-51, 193, 195, 197, 199, 601-602, 2497, 2501, 2503-2504, 2506-2507, 2509, 2517-2518, 2521-2522, 2525-2526, 2546-2547, 2552-2553, 2558-2559, 2574-2575, 2577-2578, 5000, 5003, 5007, 5010, 5020-5023, 5026-5028, 5040-5043, 5046, 5049, 5060, 5063-5064, 5067 |
| Unreferred Attendances - Enhanced Primary Care | 700-746, 749, 757-759, 762, 765, 768, 771-773, 775, 778-779, 900, 903 |
| Unreferred Attendances - Other | 5-12, 15-18, 21-22, 27-32, 34, 41-42, 45-46, 52-84, 86-87, 89-93, 95-98, 101, 160-179, 444-449, 697-698, 980, 996-998, 2598, 2600, 2603, 2606, 2610, 2613, 2616, 2620, 2622-2624, 2631-2633, 2635, 2664, 2666-2668, 2673-2675, 2677, 2704-2705, 2707-2708, 2721, 2723, 2725, 2727, 5200, 5203, 5207-5208, 5220, 5223, 5227-5228, 5240, 5243, 5247-5248, 5260-5263, 5265-5267, 17600 |
| Unreferred Attendances - Practice Nurse Items | 10988-10989, 10993-10999 |
| Other Allied Health | 10950-10977 |
| Specialist Attendances | 85, 88, 94, 100, 102-152, 154-159, 291-293, 300-338, 342-353, 355-358, 364, 366-367, 369-370, 385-388, 410-417, 501-503, 507, 511, 515, 519-520, 530, 532, 534, 536, 801, 803, 805, 807-809, 811, 813, 815, 820, 822-823, 825-826, 828, 830, 832, 834-835, 837-838, 851-852, 855, 857-858, 861, 864, 866, 880, 887-893, 2801, 2806, 2814, 2824, 2832, 2840, 2946-2949, 2954, 2958, 2972-2978, 2984-3000, 3005, 3010, 3014, 3018, 3023, 3028-3032, 3040, 3044, 3051-3055, 3062, 3069, 3074-3078, 3083, 3088, 3093, 10801-10816, 17603 |
| Obstetrics | 190-192, 194, 196, 198, 200-290, 295-298, 354, 360-363, 365, 368, 374-383, 9011, 15999, 16400-16636 |
| Anaesthetics | 401-409, 443, 450-500, 505-506, 509-510, 513-514, 517-518, 521-529, 531, 533, 535, 537-577, 748, 751-756, 760, 764, 767, 787-790, 9021-9051, 13006-13009, 17500-17506, 17701-18298, 20100-25205 |
| Pathology Collection Items | 73901-73921 |
| Pathology Tests | 1001-2399, 65001-73844, 74990-74991 |
| Diagnostic Imaging | 791-794, 910-911, 913-914, 990-993, 995, 999, 2400-2496, 2498-2500, 2502, 2505, 2508, 2512-2516, 2520, 2524, 2528-2545, 2548-2551, 2554-2557, 2560-2573, 2576, 2579-2597, 2599, 2601, 2604, 2607-2609, 2611, 2614, 2617, 2621, 2625-2630, 2634, 2638-2662, 2665, 2672, 2676, 2678-2703, 2706, 2709-2720, 2722, 2724, 2726, 2728-2800, 2802-2805, 2807-2813, 2815-2823, 2825-2831, 2833-2839, 2841-2860, 2960-2971, 2980-2981, 5861, 8712-8713, 8716-8717, 8720-8721, 8723-8724, 8727-8849, 8851-8874, 9066, 9341-9344, 55000-55054, 55056-64991 |
| Operations | 924, 3004, 3006, 3012, 3016, 3022, 3027, 3033-3039, 3041, 3046-3050, 3058, 3063, 3073, 3082, 3087, 3092, 3098-3101, 3104-3113, 3116, 3120-3124, 3130, 3135-3142, 3148-3173, 3178-3183, 3194-3228, 3233-3237, 3247-3253, 3261-3265, 3271-3281, 3289, 3295-3330, 3332-3384, 3391, 3399, 3404-3425, 3431-3455, 3459, 3465, 3468-3472, 3477-3480, 3495-3496, 3505, 3509-3516, 3526-4000, 4009-4838, 4844-4860, 4864-4999, 5002, 5006, 5009, 5015-5018, 5024, 5029-5038, 5045, 5048, 5050-5059, 5062, 5066, 5068-5196, 5201, 5205, 5210-5217, 5221, 5225, 5229-5237, 5241-5242, 5245, 5254, 5264, 5268-5270, 5277-5280, 5284, 5288, 5292-5857, 5864-6918, 6922-7126, 7129-7133, 7135-7143, 7147-7397, 7410-7483, 7505-7719, 7721-7722, 7725, 7727-7728, 7739-7743, 7749, 7764-7766, 7774-7803, 7808-7809, 7815-7817, 7821-7823, 7828, 7834, 7839, 7844-7847, 7853-7886, 7898-7902, 7911-8003, 8009-8173, 8179-8458, 8462, 8466-8467, 8470-8478, 8480-8481, 8483-8504, 8508-8512, 8515-8519, 8521-8557, 8560, 8564, 8568-8570, 8574, 8578, 8582-8636, 8640, 8644, 8648, 8652, 8655-8658, 8660, 8662, 8664, 8666, 8668, 8670, 8672, 8674-8699, 9401-9409, 9415-9435, 9438, 9440-9449, 9458, 9476-9478, 30000-30524, 30526-30632, 30634-41868, 41870-42824, 42833-50952 |
| Assistance at Operations | 2951-2953, 2955-2957, 51300-51318 |
| Optometry | 180-186, 10900-10943 |
| Radiotherapy and Therapeutic Nuclear Medicine | 2861-2945, 2950, 8850, 8875-8886, 9381-9392, 15000-15600, 16000-16018 |
| Miscellaneous | 153, 340, 770, 774, 777, 780-786, 795-800, 802, 804, 806, 810, 812, 814, 816-819, 821, 824, 827, 829, 831, 833, 836, 839-850, 853-854, 856, 859-860, 862-863, 865, 870-879, 882-886, 895-899, 902, 904-909, 912, 915-923, 925-979, 981-989, 994, 3059, 3068, 3095, 3103, 3114, 3117, 3128, 3134, 3147, 3175, 3187-3189, 3229-3230, 3245, 3258, 3268, 3284, 3290, 3331, 3386-3389, 3393-3395, 3400-3401, 3427, 3456, 3462, 3466, 3475, 3483-3493, 3500, 3507, 3521, 4003, 4841, 4862, 5249, 5259, 5274, 5282, 5286, 5291, 6920, 7128, 7134, 7146, 7402-7408, 7485, 7720, 7723-7724, 7726, 7729-7737, 7745, 7753-7761, 7770, 7804, 7812, 7818, 7824, 7831, 7836, 7841, 7849, 7888, 7907, 8006, 8175, 8460, 8464, 8468, 8479, 8482, 8506, 8514, 8520, 8558, 8562, 8566, 8572, 8576, 8580, 8638, 8642, 8646, 8650, 8654, 8659, 8661, 8663, 8665, 8667, 8669, 8671, 8673, 8700-8711, 8714-8715, 8718-8719, 8722, 8725-8726, 8901-9003, 9061-9065, 9067-9310, 9410-9414, 9436-9437, 9439, 9450-9457, 9459-9475, 10990-10992, 11000-13003, 13012-14242, 18350-18371, 30525, 30633, 41869, 42827-42830, 51700-53706, 55055, 75000-75854 |
*Broad Type of Service definitions as at 1 May 2006.
For more information please refer to the Medicare Benefits Schedule
Population
The population figures are customised population projections for 30 June 2006 prepared by ABS according to assumptions agreed to by the Department of Health and Ageing.
Copyright in ABS data resides with the Commonwealth of Australia. Used with permission.
Definitions
Bill type: the method by which the Medicare benefit was paid.
Bulk bill: the service provider claims Medicare benefits directly for the services rendered. In this case, the provider must accept the benefits as full payment. There is no cost to the patient.
Cheque to claimant: the person who incurred the expense (usually the cardholder) pays the account raised by the service provider, presents a claim and receives a cheque for the Medicare benefit.
Cheque to provider via claimant: the claimant does not pay the account raised by the service provider, presents a claim, and a cheque for the Medicare benefit, payable to the provider, is posted to the claimant. The claimant then sends this cheque, together with the balance of the account, if any, to the provider.
Cash: the claimant pays the account raised by the service provider, presents a claim and the Medicare benefit is paid in cash to the claimant.
Date of lodgment: the date on which Medicare Australia received the claim for Medicare benefit.
Date of processing: the date on which Medicare Australia processed the payment of a claim for Medicare benefit.
Date of service: the date on which the provider performed the service.
EFT: the claimant pays the account raised by the service provider, presents a claim and the Medicare benefit is paid by Electronic Funds Transfer to the claimants bank account.
EPC: Enhanced Primary Care.
GP: General Practitioner.
Simplified bill: enables private hospital patients to be advised of their out-of-pocket expenses before treatment is received and to simplify the claiming process. At the conclusion of a hospital visit the accounts associated with the visit are collected and claimed from Medicare and health funds on behalf of the patient.
State/Territory: determined according to the address (at the time of claiming) of the patient to whom the service was rendered unless otherwise indicated at the foot of the table.
VR GP: Vocationally Registered General Practitioner.
Disclaimer: view the Medicare Australia statistical information disclaimer.
Last updated: 30 July, 2009