Data source
Medicare Benefits Schedule data
Services Australia (formerly the Australian Government Department of Human Services) collects administrative data in processing claims for benefits under the Medicare Benefits Schedule (MBS) and provides this information to the Australian Government Department of Health and Aged Care. The item number and benefits paid by Services Australia are based on the Medicare Benefits Schedule Book (Department of Health and Aged Care 2023).
The data presented in this report relate to services provided on a ‘fee-for-service’ basis for which MBS benefits were paid, and only for palliative medicine attendances and case conferencing services that are both provided by palliative medicine physicians or specialists, and are claimed under specialist palliative care MBS item numbers.
Patients who are referred to specialists or physicians in palliative medicine usually have:
- intermediate and fluctuating needs that might result in unplanned use of hospital and other services, and/or
- complex and persistent needs (physical, social, emotional, or spiritual) that are not effectively managed through established protocols (PCA 2018).
Information is also provided on the settings where the attendances were provided – in hospital or consulting room, or in other settings, such as a person’s place of residence, including home, residential aged care or institution (see Table 1). For case conferencing, it refers to community case conference and discharge case conference (see Table 2).
MBS item | MBS group and subgroup | MBS item number |
|---|---|---|
Attendance in a consulting room or hospital, initial brief video conference | Group A24 | 3003* |
Attendance in a consulting room or hospital, initial visit | Group A24 | 3005 |
Attendance in a consulting room or hospital, subsequent visit, minor, after initial attendance | Group A24 | 3014 |
Attendance in a consulting room or hospital, subsequent visit, other than a minor attendance | Group A24 | 3010 |
Attendance in a consulting room or hospital, video conference | Group A24 | 3015* |
Attendance in a place other than consulting rooms or hospital, initial visit | Group A24 | 3018 |
Attendance in a place other than consulting rooms or hospital, subsequent visit | Group A24 | 3023 |
Attendance in a place other than consulting rooms or hospital, subsequent visit, minor, after initial attendance | Group A24 | 3028 |
* Items 3003 and 3015 ceased on 31 December 2021, with telehealth services now claimed against relevant item numbers in Group A40.
Note: Refer to Medicare Benefits Schedule Book July 2023 edition for full item descriptions (pages 308–309) and further information relating to MBS Palliative care (pages 118–119).
MBS item | MBS group and subgroup | MBS item number |
|---|---|---|
Organise and coordinate a community case conference 15–<30 minutes | Group A24 | 3032 |
Organise and coordinate a community case conference 30–<45 minutes | Group A24 | 3040 |
Organise and coordinate a community case conference >=45 minutes | Group A24 | 3044 |
Participate in a community case conference 15–<30 minutes | Group A24 | 3051 |
Participate in a community case conference 30–<45 minutes | Group A24 | 3055 |
Participate in a community case conference >=45 minutes | Group A24 | 3062 |
Organise and coordinate a discharge case conference 15–<30 minutes | Group A24 | 3069 |
Organise and coordinate a discharge case conference 30–<45 minutes | Group A24 | 3074 |
Organise and coordinate a discharge case conference >=45 minutes | Group A24 | 3078 |
Participate in a discharge case conference 15–<30 minutes | Group A24 | 3083 |
Participate in a discharge case conference 30–<45 minutes | Group A24 | 3088 |
Participate in a discharge case conference >=45 minutes | Group A24 | 3093 |
Note: Refer to Medicare Benefits Schedule Book July 2023 edition for full item descriptions (pages 309–311) and further information relating to MBS Palliative care (pages 118–119).
Palliative care physicians and specialists may at times use other MBS item numbers when attending to palliative care patients. These items are not included in the data on this report, as they are not claimed specifically as a palliative care-related service under the MBS. Further, other medical practitioners (general practitioners and medical specialists) and health professionals also attend to terminally ill patients and provide palliative care, without the service being eligible to be claimed specifically as a palliative care-related service under the MBS. In other words, the reported number of patients who receive a palliative care-related service under the MBS is a known underestimate of total palliative care activity. Further, the data does not include referred attendances by palliative medicine physicians or specialists to public in-patients or public outpatients of hospitals and services funded from the Department of Veterans’ Affairs National Treatment Account.
It should be noted that a patient may access more than one type of these specific MBS items provided by palliative medicine physicians or specialists during the reporting period and that each service is counted separately in this report.
The MBS data presented in this report (2022–23 and trend data) are based on the date the service was provided rather than the date of service processing, as this more accurately reflects the date a service occurred. Note that in reports released prior to 2022, the data was based on the date the service was processed by Services Australia and as a result the data presented since 2022 releases are not comparable with previous releases.
References
Department of Health and Aged Care (2023) Medicare Benefits Schedule Book, Operating from 1 July 2023, Department of Health and Aged Care, Australian Government, accessed 30 January 2024.
PCA (Palliative Care Australia) (2018) Palliative Care Service Development Guidelines, PCA website, accessed 20 January 2024.