How do I use the ASCII file?

The ASCII file is a text file and the ASCII Specifications provides information on the structure of this file.

Page last updated: 15 April 2014

ASCII file Specifications


Specifications

The data is provided in a number of record types per item number:
Record typeDescriptionMandatory/Optional
10Item detailsMandatory
20Fee detailsMandatory if the item is a normal item
25Extended Medicare Safety NetOptional
26Extended Medicare Safety Net (EMSN) derived fee descriptionOptional
30Derived fee detailsMandatory if the item is a derived fee item
40Anaesthetic detailsOptional
50Description detailsMandatory

For each item there will be:
  • 1 item details record
  • 1 fee details record OR a number of derived fee detail records describing the manner in which the fee is calculated
  • 1 anaesthetic detail record (optional)
  • a number of description detail records describing the service. The item description will be the full description of the service that appears in the Regulations of the Health Insurance Act 1973.

Record Specifications

LEGEND
A – Alphanumeric
N – Numeric
M – Mandatory
O – Optional

Record Type 10 – Item Details Record

FieldFormatDescription
Record typeN2 M10
Item#N5 MItem number
Sub-item #N3 OSub-item number for precedent items (ie 30000 items)
Start dateA10 dd.mm.yyyy MDate item commenced
End dateA10 dd.mm.yyyy ODate item ceased
CategoryA3 MThe Category the item relates to
GroupA3 MThe Group the items relates to
SubgroupA3 MThe Subgroup the item relates to
Item typeA1 MThe item type (ie S for standard, P for precedent or D for Ministerial Determination)
Fee typeA1 MN – Normal fee
D – Derived fee
Provider typeA3 Othe provider category applicable to the item
New item indicatorA1 OY – if the item is a new item
Item change indicatorA1 OY – if the item number changed
Anaesthetic changeA1 OY – if a change has occurred in the Indicator - anaesthetic units
Descriptor changeA1 OY – if a change has occurred in the Item indicator description
Fee change indicatorA1 OY – if a change has occurred in the fee
Benefit indicatorA1 OA – benefit paid at 75% only
B - benefit paid at 85% only
C - benefit paid at 75% & 85%
D - benefit paid at 75% & 100%
E - benefit paid at 100%
Benefit Start dateA10 dd.mm.yyyyDate which benefit level/s changed
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Record Type 20 – Fee Details Record

This record must be present if the item is a normal fee item (Fee type “N”)
FieldFormatDescription
Record typeN2 O20
Start dateA10 dd.mm.yyyy MDate current Schedule fee commenced
Schedule feeN5.2 MThe Schedule fee
Benefit 1N5.2 MThe 75% benefit
Benefit 2N5.2 MThe 85% benefit
Benefit 3N5.2 MThe 100% benefit
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Record Type 25 – Extended Medicare Safety Net (EMSN) Details Record

This record must be present if the item has an Extended Medicare Safety Net Cap
FieldFormatDescription
Record typeN2 O25
EMSN Cap Start dateA10 dd.mm.yyyy MDate EMSN cap commenced
EMSN Cap end dateA10 dd.mm.yyyy ODate the EMSN cap ended
Fixed EMSN Cap amountN5.2 OEMSN Fixed cap
Cap percentageN5.2 OEMSN Percentage cap
Maximum capN5.2 OEMSN Maximum cap amount
Cap change dateA10 dd.mm.yyyy OEMSN Cap change date
Cap change indicatorA1 OY – if a change has occurred to the cap
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Record Type 26 – EMSN Derived Fee Description Details Record

This record must be present if the item has an Extended Medicare Safety Net Cap
FieldFormatDescription
Record typeN2 O26
EMSN Cap Start dateA10 dd.mm.yyyy MDate EMSN derived cap commenced
EMSN DescriptionA80 MEMSN derived fee description

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Record Type 30 – Derived Fee Details Record

Records of this type must be present if the item is derived fee item (Fee type “D”)
FieldFormatDescription
Record typeN2 O30
Start dateA10 dd.mm.yyyy MDate current derived fee commenced
DescriptionA80 MDerived fee description

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Record Type 40 – Anaesthetic Details Record

FieldFormatDescription
Record typeN2 O40
Start dateA10 dd.mm.yyyy MDate current anaesthetic details commenced
Anaesthetic indicatorA8 M(Anaes.) – indicates that item attracts an anaesthetic

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Record Type 50 – Description Details Record

FieldFormatDescription
Record typeN2 M50
Start dateA10 dd.mm.yyyy MDate current description commenced
DescriptionA80 MItem description (as appears in the Regulations of the Health Insurance Act 19733)

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Provider types

Provider typeDescription
ADAccredited Dental Practitioner
AOAccredited Orthodontist
AOSApproved Oral Surgeon
CComputerised facilities
GGeneral Practitioner
HRHospital Recognised
NCNon-computerised facilities
OPOther (non-specialist pathologist)
SSpecialist
SPSpecialist Pathologist

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