Medicare Overview v1.2

Medicare Overview v1.2

Medicare Overview documents provide an overview of Medicare-sourced information stored in an individual’s My Health Record.

An individual’s My Health Record can be used to collect administrative information from Medicare records. Such records relate to the following data sets of claims and registries managed by Services Australia:

  • Medicare Benefits Scheme (MBS) and Department of Veterans’ Affairs (DVA) claims history;
  • Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS) claims history;
  • Australian Immunisation Register (AIR) records;
  • Australian Organ Donor Registry (AODR) records.


  • The Conformance Test Specification for PCEHR Views provides conformance tests for implementing Medicare Overview and is available in the Common - Clinical Document end product.
  • The Generic Clinical Document Style Sheet available in the Clinical Documents Integration Toolkit may be used for rendering Medicare Overview documents.

This specification references or contains excerpts of intellectual property (IP) owned by the Regenstrief Institute, IHTSDO, or HL7 International. Applicable IP constraints apply:

  • This material contains content from LOINCTM ( The LOINC table, LOINC codes, and LOINC panels and forms file are copyright © 1995-2015, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and available at no cost under the license at LOINC is a trademark of Regenstrief Institute, Inc., registered in the United States.
  • This material includes SNOMED Clinical TermsTM (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO). All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO, (
  • This document includes excerpts of HL7TM International standards and other HL7 International material. HL7 International is the publisher and holder of copyright in the excerpts. The publication, reproduction and use of such excerpts is governed by the HL7 IP Policy (see and the HL7 International License Agreement. HL7 and CDA are trademarks of Health Level Seven International and are registered with the United States Patent and Trademark Office.
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Product Components

Product component

This minor release provides updated versions of the PCEHR Conformance Profile and Template Package Library product components. The updates are aimed at supporting improvements introduced with PCEHR Release 5.

Product component

This document is a Structured Content Specification (SCS) for a PCEHR Medicare Overview document. It specifies the information structure of the Agency-compliant PCEHR Medicare Overview in order to support the transfer of the following Medicare information:

Product component

This document provides a guide to implementing the 'logical' model detailed by the Agency's PCEHR Medicare Overview Structured Content Specification as an HL7 Clinical Document Architecture Release 2 (CDA) XML document.

Product component

This template package library provides validation rules for Medicare Overview documents to identify points of non-conformance to the relevant specifications.

Product component

This document lists the specific conformance requirements for Medicare Overview documents that are in addition to the Common Conformance Profile for Clinical Documents.

Release history

By operation of the Public Governance, Performance and Accountability (Establishing the Australian Digital Health Agency) Rule 2016, on 1 July 2016, all the assets and liabilities of NEHTA will vest in the Australian Digital Health Agency. In this website, on and from 1 July 2016, all references to "National E-Health Transition Authority" or "NEHTA" will be deemed to be references to the Australian Digital Health Agency. PCEHR means the My Health Record, formerly the "Personally Controlled Electronic Health Record", within the meaning of the My Health Records Act 2012 (Cth), formerly called the Personally Controlled Electronic Health Records Act 2012 (Cth).

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