Medicare Benefits Schedule Data

Page last updated: 01 November 2019

The Medicare Benefits Schedule (MBS) claims data are an administrative by-product of the Department of Human Services administration of the Medicare fee-for-service payment system which processes services that qualify for a Medicare Benefit under the Health Insurance Act 1973 and for which a claim has been processed.
The MBS data does not cover all patient activity, such as:

  • Services rendered free-of-charge in recognised hospitals;
  • Services that qualify for a benefit under the Department of Veterans' Affairs National Treatment Account;
  • Services rendered under an entitlement conferred by legislation other than the Health Insurance Act, e.g. services covered by third party or workers' compensation, where an interim benefit has not been paid, or services rendered to repatriation beneficiaries or defence personnel;
  • Services rendered for insurance or employment purposes;
  • Health screening service; and
  • Services conducted through State and Territory community controlled health centres.
The data relates to identified Medicare services for which claims data are available. The data is disaggregated by the provider’s geographic area based on their street address as recorded on the Medicare system.

MBS Data by ABS SA3 and by PHN

The Australian Institute of Health and Welfare produce a report with MBS data by Statistical Area 3 (SA3) and PHN levels.
For further information on the MBS and to search the MBS please see the MBS Online Website.