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Historical publications

Medicare Statistics - December Quarter 2005

Statistical data related to Medicare for the December Quarter 2005 together with data for earlier quarters and financial years.

Strengthening Medicare and Medicare Statistics

The introduction of the $5.00 and $7.50 bulk billing general practice incentive items and the introduction of four new practice nurse items have had implications for the way Medicare Statistics are presented in publication tables.

$5.00 and $7.50 Bulk Bill Incentive Items (Items 10990, 10991, 10992, 64990, 64991, 74990 and 74991)

Three $5.00 bulk billing general practice incentive items were introduced into the Medicare Benefits Schedule (MBS) on 1 February 2004. Three $7.50 bulk billing incentive items were introduced into the MBS on 1 May 2004, with a further item taking effect from 1 January 2005. Items 64990 ($5.00) and 64991 ($7.50) apply to diagnostic imaging services, Items 74990 ($5.00) and 74991 ($7.50) apply to pathology services and Items 10990 ($5.00) and 10991 ($7.50) apply to all other services in the MBS, when rendered by general practitioners. Item 10992 ($7.50) applies to selected non-referred (gp) attendance items. In broad type of service statistics, Items 64990 and 64991 are included in ‘Diagnostic Imaging’ and Items 74990 and 74991 are included in 'Pathology'. Since Items 10990 and 10991 can apply to other relevant services in the MBS provided by general practitioners, they are included in 'Other Services'. Statistics relating to Item 10992 have also been included in ‘Other Services’.

The $7.50 incentive items apply to bulk billed services provided by general practitioners, to persons under 16 years of age or Commonwealth concession card holders in Tasmania or in Rural, Remote and Metropolitan Areas 3-7, and with effect from 1 September 2004, to a number of eligible metropolitan areas. The $5.00 incentive items apply to bulk billed services provided by general practitioners to persons under 16 years of age or to Commonwealth concession card holders in other parts of Australia.

From 1 November 2005, the bulk billing incentives increased to $5.15 and $7.85 in line with indexation of Medicare Benefits Schedule fees.

Since the incentive items are supplementary payments for general practice bulk billed services to Commonwealth concession card holders and persons under 16 years, the number of items processed by Medicare Australia are not included in service counts or in bulk billing statistics. To do so, would involve double counting. However, benefits paid etc for these items, are included in 'Diagnostic Imaging', 'Pathology' and 'Other Services', as outlined above.

Tables F1 and F2 provide details of the number of items claimed and benefits paid, by bulk bill incentive item number and by patient State/Territory.

Practice Nurse Items (Items 10993, 10996, 10998 and 10999)

With effect from 1 February 2004, two practice nurse items (10993 and 10996) were introduced into the MBS covering relevant services on behalf of a general practitioner. An additional item (10998) was introduced into the MBS on 1 January 2005, with a further item(10999) introduced into the MBS on 1 May 2005. The availability of these items can free up general practitioners for other important tasks. These items have been separately identified as a component of the broad type of service group 'Non-referred (GP) attendances', in Medicare Statistics.

Allied Health Items (Items 10950 to 10977)

With effect from 1 July 2004, a number of items were introduced into the MBS covering selected services by allied health practitioners to persons with chronic and complex conditions which are being managed by a medical practitioner under an Enhanced Primary Care multidisciplinary care plan. These services are included in the broad type of service group ‘other’.