Utilisation of mental health Medicare items
Attachment D: Key element comparison of selected Medicare services
Table 1. Existing GP Management Plan (MBS item 721) services
Table 2. Existing GP Standard Long Consultation (MBS items 36 & 44) services
Table 3. Non-referred GP VR attendance services under Medicare
Table 4. Enhanced Primary Care Allied Health (MBS items 10950 through 10970) services
Table 5. Consultant Psychiatrist, Referred Consultation (MBS items 306, 308, 316, 318, 326, 328, 336 & 338) services
Table 1. Existing GP Management Plan (MBS item 721) services by Rural, Remote and Metropolitan Area (RRMA) classification, 1 October 2006 through 31 December 2007
| Region | Total services | Bulk billed services | Bulk billing rate (%) | Fees charged | Benefits paid | Average co-payment |
|---|---|---|---|---|---|---|
| Capital city | 557,320 | 547,651 | 98.3 | $69,835,537 | $69,717,059 | $11.74 |
| Other metro | 74,662 | 73,706 | 98.7 | $9,348,832 | $9,339,317 | $8.69 |
| Large rural | 55,442 | 54,339 | 98.0 | $6,942,783 | $6,935,453 | $5.77 |
| Small rural | 68,517 | 67,360 | 98.3 | $8,587,142 | $8,572,547 | $12.45 |
| Other rural | 110,777 | 108,481 | 97.9 | $13,884,572 | $13,859,756 | $10.23 |
| Remote centre | 4,161 | 4,104 | 98.6 | $520,948 | $520,223 | $12.72 |
| Other remote | 10,180 | 10,049 | 98.7 | $1,273,966 | $1,272,064 | $14.38 |
| All of Australia | 881,064 | 865,695 | 98.3 | $110,394,409 | $110,217,050 | $10.99 |
Source: Department of Health and Ageing, unpublished data.
- This is 'date of processing' data (i.e. the date on which the claim for the service was processed by Medicare Australia, not the date the service was provided).
- The RRMA classifications have been derived from the postcode location of the patient.
- The average co-payment represents the average out-of-pocket costs incurred by those patients who contribute a co-payment for a service provided out-of-hospital, it is not the average patient cost incurred across all services.
- A negligible number of services can not be traced to a specific RRMA location, but these are so small in number, they have not been included in these tables.
- National totals for expenditure and bulk billed services may not exactly equate with the sum totals for each classification due to rounding intricacies.
- Data relating to unique provider and patient numbers is unavailable for this service.
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Table 2. Existing GP Standard Long Consultation (MBS items 36 & 44) services by Rural, Remote and Metropolitan Area (RRMA) classification, 1 October 2006 through 31 December 2007
| Region | Total services | Bulk billed services | Bulk billing rate (%) | Fees charged | Benefits paid | Average co-payment |
|---|---|---|---|---|---|---|
| Capital city | 10,029,336 | 8,124,585 | 81.0 | $688,394,622 | $641,541,923 | $24.60 |
| Other metro | 1,123,414 | 888,132 | 79.1 | $76,854,413 | $71,620,475 | $22.25 |
| Large rural | 767,583 | 604,105 | 78.7 | $52,287,521 | $48,743,665 | $21.68 |
| Small rural | 992,536 | 819,214 | 82.5 | $66,578,443 | $62,914,238 | $21.14 |
| Other rural | 1,846,904 | 1,486,400 | 80.5 | $124,608,588 | $117,217,007 | $20.50 |
| Remote centre | 122,236 | 103,279 | 84.5 | $8,387,252 | $7,852,878 | $28.19 |
| Other remote | 219,108 | 197,033 | 89.9 | $14,682,092 | $14,149,009 | $24.15 |
| All of Australia | 15,101,194 | 12,222,806 | 80.9 | $1,031,798,493 | $964,044,225 | $23.54 |
Source: Department of Health and Ageing, unpublished data.
- This is 'date of processing' data (i.e. the date on which the claim for the service was processed by Medicare Australia, not the date the service was provided).
- The RRMA classifications have been derived from the postcode location of the patient.
- The average co-payment represents the average out-of-pocket costs incurred by those patients who contribute a co-payment for a service provided out-of-hospital, it is not the average patient cost incurred across all services.
- A negligible number of services can not be traced to a specific RRMA location, but these are so small in number, they have not been included in these tables.
- National totals for expenditure and bulk billed services may not exactly equate with the sum totals for each classification due to rounding intricacies.
- Data relating to unique provider and patient numbers is unavailable for these services.
Table 3. Non-referred GP VR attendance services under Medicare by Rural, Remote and Metropolitan Area (RRMA) classification, 1 October 2006 through 31 December 2007
| Region | Total services | Bulk billed services | Bulk billing rate (%) | Fees charged | Benefits paid | Average co-payment |
|---|---|---|---|---|---|---|
| Capital city | 81,607,450 | 64,655,065 | 79.2 | $3,411,077,098 | $3,097,392,712 | $18.44 |
| Other metro | 9,349,843 | 7,026,983 | 75.2 | $398,170,439 | $354,991,690 | $18.35 |
| Large rural | 6,443,392 | 4,418,859 | 68.6 | $275,521,725 | $237,845,522 | $18.52 |
| Small rural | 7,835,684 | 5,721,062 | 73.0 | $325,607,361 | $289,266,044 | $17.06 |
| Other rural | 14,114,764 | 10,265,934 | 72.7 | $589,901,585 | $523,751,889 | $17.08 |
| Remote centre | 846,584 | 580,443 | 68.6 | $37,206,857 | $31,560,290 | $21.17 |
| Other remote | 1,202,141 | 950,260 | 79.0 | $51,867,079 | $46,952,570 | $19.42 |
| All of Australia | 121,400,264 | 93,618,887 | 77.1 | $5,089,370,698 | $4,581,776,786 | $18.19 |
Source: Department of Health and Ageing, unpublished data.
- This is 'date of processing' data (i.e. the date on which the claim for the service was processed by Medicare Australia, not the date the service was provided).
- The RRMA classifications have been derived from the postcode location of the patient.
- The average co-payment represents the average out-of-pocket costs incurred by those patients who contribute a co-payment for a service provided out-of-hospital, it is not the average patient cost incurred across all services.
- A negligible number of services can not be traced to a specific RRMA location, but these are so small in number, they have not been included in these tables.
- National totals for expenditure and bulk billed services may not exactly equate with the sum totals for each classification due to rounding intricacies.
-Data relating to unique provider and patient numbers is unavailable for these services
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Table 4. Enhanced Primary Care Allied Health (MBS items 10950 through 10970) services by Rural, Remote and Metropolitan Area (RRMA) classification, 1 October 2006 through 31 December 2007
| Region | Total services | Bulk billed services | Bulk billing rate (%) | Fees charged | Benefits paid | Average co-payment |
|---|---|---|---|---|---|---|
| Capital city | 895,122 | 540,736 | 60.4 | $45,703,082 | $42,186,984 | $9.92 |
| Other metro | 117,159 | 49,289 | 42.1 | $6,006,641 | $5,509,353 | $7.33 |
| Large rural | 75,999 | 37,920 | 49.9 | $3,940,105 | $3,565,138 | $9.85 |
| Small rural | 98,370 | 57,501 | 58.5 | $4,954,411 | $4,609,170 | $8.45 |
| Other rural | 127,934 | 79,957 | 62.5 | $6,390,479 | $5,992,551 | $8.29 |
| Remote centre | 2,025 | 1,361 | 67.2 | $101,490 | $94,845 | $10.01 |
| Other remote | 6,058 | 4,826 | 79.7 | $295,720 | $283,472 | $9.94 |
| All of Australia | 1,322,674 | 771,596 | 58.3 | $67,392,264 | $62,241,846 | $9.35 |
Source: Department of Health and Ageing, unpublished data.
- This is 'date of processing' data (i.e. the date on which the claim for the service was processed by Medicare Australia, not the date the service was provided).
- The RRMA classifications have been derived from the postcode location of the patient.
- The average co-payment represents the average out-of-pocket costs incurred by those patients who contribute a co-payment for a service provided out-of-hospital, it is not the average patient cost incurred across all services.
- A negligible number of services can not be traced to a specific RRMA location, but these are so small in number, they have not been included in these tables.
- National totals for expenditure and bulk billed services may not exactly equate with the sum totals for each classification due to rounding intricacies.
- Data relating to unique provider and patient numbers is unavailable for these services.
Table 5. Consultant Psychiatrist, Referred Consultation (MBS items 306, 308, 316, 318, 326, 328, 336 & 338) services by Rural, Remote and Metropolitan Area (RRMA) classification, 1 October 2006 through 31 December 2007
| Region | Total services | Bulk billed services | Bulk billing rate (%) | Fees charged | Benefits paid | Average co-payment |
|---|---|---|---|---|---|---|
| Capital city | 866,053 | 263,077 | 30.4 | $156,475,602 | $133,627,309 | $35.23 |
| Other metro | 46,441 | 18,653 | 40.2 | $8,043,384 | $6,867,855 | $38.71 |
| Large rural | 20,105 | 6,428 | 32.0 | $3,612,817 | $2,973,701 | $43.60 |
| Small rural | 18,213 | 6,575 | 36.1 | $3,205,837 | $2,668,659 | $41.78 |
| Other rural | 40,353 | 16,603 | 41.1 | $6,874,852 | $5,811,518 | $40.43 |
| Remote centre | 911 | 312 | 34.2 | $167,904 | $128,938 | $62.31 |
| Other remote | 1,803 | 852 | 47.3 | $307,869 | $252,922 | $55.04 |
| All of Australia | 993,879 | 312,500 | 31.4 | $178,688,265 | $152,330,902 | $35.84 |
Source: Department of Health and Ageing, unpublished data.
- This is 'date of processing' data (i.e. the date on which the claim for the service was processed by Medicare Australia, not the date the service was provided).
- The RRMA classifications have been derived from the postcode location of the patient. The average co-payment represents the average out-of-pocket costs incurred by those patients who contribute a co-payment for a service provided out-of-hospital, it is not the average patient cost incurred across all services.
- A negligible number of services can not be traced to a specific RRMA location, but these are so small in number, they have not been included in these tables.
- National totals for expenditure and bulk billed services may not exactly equate with the sum totals for each classification due to rounding intricacies.
- Data relating to unique provider and patient numbers is unavailable for these services.