# Provider Connect Australia (PCA)

25.1.0.0 - active

Provider Connect Australia (PCA) - Local Development build (v25.1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## Data Type Profile: PCA Medicare Provider Number

Official URL: http://pca.digitalhealth.gov.au/fhir/4.0/StructureDefinition/pca-medicareprovidernumber | Version: 25.1.0.0
Active as of 2025-05-14 | Computable Name: PcaMedicareProviderNumber
Copyright/Legal: Copyright © 2024 Australian Digital Health Agency - All rights reserved. This content is licensed under a Creative Commons Attribution 4.0 International License. See https://creativecommons.org/licenses/by/4.0/.

This identifier profile defines a Medicare provider number in an Australian context and is used by the PCA service to additionally indicate if the Medicare provider number has been validated with the Medicare system of record. A Medicare provider number is assigned by Services Australia under the Medicare program to practitioners who provide services that are eligible for a Medicare benefit. A practitioner may have more than one Medicare provider number if they deliver health services in different locations or are registered in multiple health professions.

A practitioner may have more than one Medicare provider number if they deliver health services in different locations or are registered in multiple health professions.

### Must support

The meaning of the presence or absence of the must support flag is described in Must support.

### Extensions

Extensions introduced in this profile:

- Identifier: PCA Medicare Provider Number Status

Usage:

- Use this DataType Constraint: PCA Practitioner Role

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Identifier |  | 0..* | AUMedicareProviderNumber | Medicare Provider Number ele-1: All FHIR elements must have a @value or children
Slices for extension |  |  |  | Content/Rules for all slices
extension:mpnStatus |  | 0..1 | Coding | Medicare Provider Number Status URL: http://pca.digitalhealth.gov.au/fhir/4.0/StructureDefinition/pca-medicareprovidernumber-status Binding: PCA Medicare Provider Number Status (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . ele-1: All FHIR elements must have a @value or children
type | Σ | 1..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org.au/CodeSystem/v2-0203
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: UPIN
system | Σ | 1..1 | uri | The namespace for the identifier value ele-1: All FHIR elements must have a @value or children Fixed Value: http://ns.electronichealth.net.au/id/medicare-provider-number
value | Σ | 1..1 | string | Medicare provider number ele-1: All FHIR elements must have a @value or children Example General: 123456 Example Medicare provider number: 2426621B
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Identifier.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` from the FHIR Standard
Identifier.type | extensible | Pattern: UPIN `http://hl7.org/fhir/ValueSet/identifier-type` from the FHIR Standard

This structure is derived from AUMedicareProviderNumber

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Identifier |  | 0..* | AUMedicareProviderNumber | Medicare Provider Number
Slices for extension |  |  |  | Content/Rules for all slices
extension:mpnStatus |  | 0..1 | Coding | Medicare Provider Number Status URL: http://pca.digitalhealth.gov.au/fhir/4.0/StructureDefinition/pca-medicareprovidernumber-status Binding: PCA Medicare Provider Number Status (required)
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Identifier |  | 0..* | AUMedicareProviderNumber | Medicare Provider Number
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:mpnStatus |  | 0..1 | Coding | Medicare Provider Number Status URL: http://pca.digitalhealth.gov.au/fhir/4.0/StructureDefinition/pca-medicareprovidernumber-status Binding: PCA Medicare Provider Number Status (required)
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 1..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org.au/CodeSystem/v2-0203
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: UPIN
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
system | Σ | 1..1 | uri | The namespace for the identifier value Fixed Value: http://ns.electronichealth.net.au/id/medicare-provider-number
value | Σ | 1..1 | string | Medicare provider number Example General: 123456 Example Medicare provider number: 2426621B
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Identifier.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` from the FHIR Standard
Identifier.type | extensible | Pattern: UPIN `http://hl7.org/fhir/ValueSet/identifier-type` from the FHIR Standard

This structure is derived from AUMedicareProviderNumber

Summary

Extensions

This structure refers to these extensions:

- http://pca.digitalhealth.gov.au/fhir/4.0/StructureDefinition/pca-medicareprovidernumber-status

Key Elements View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Identifier |  | 0..* | AUMedicareProviderNumber | Medicare Provider Number ele-1: All FHIR elements must have a @value or children
Slices for extension |  |  |  | Content/Rules for all slices
extension:mpnStatus |  | 0..1 | Coding | Medicare Provider Number Status URL: http://pca.digitalhealth.gov.au/fhir/4.0/StructureDefinition/pca-medicareprovidernumber-status Binding: PCA Medicare Provider Number Status (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . ele-1: All FHIR elements must have a @value or children
type | Σ | 1..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org.au/CodeSystem/v2-0203
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: UPIN
system | Σ | 1..1 | uri | The namespace for the identifier value ele-1: All FHIR elements must have a @value or children Fixed Value: http://ns.electronichealth.net.au/id/medicare-provider-number
value | Σ | 1..1 | string | Medicare provider number ele-1: All FHIR elements must have a @value or children Example General: 123456 Example Medicare provider number: 2426621B
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Identifier.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` from the FHIR Standard
Identifier.type | extensible | Pattern: UPIN `http://hl7.org/fhir/ValueSet/identifier-type` from the FHIR Standard

Differential View

This structure is derived from AUMedicareProviderNumber

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Identifier |  | 0..* | AUMedicareProviderNumber | Medicare Provider Number
Slices for extension |  |  |  | Content/Rules for all slices
extension:mpnStatus |  | 0..1 | Coding | Medicare Provider Number Status URL: http://pca.digitalhealth.gov.au/fhir/4.0/StructureDefinition/pca-medicareprovidernumber-status Binding: PCA Medicare Provider Number Status (required)
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Identifier |  | 0..* | AUMedicareProviderNumber | Medicare Provider Number
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:mpnStatus |  | 0..1 | Coding | Medicare Provider Number Status URL: http://pca.digitalhealth.gov.au/fhir/4.0/StructureDefinition/pca-medicareprovidernumber-status Binding: PCA Medicare Provider Number Status (required)
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 1..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org.au/CodeSystem/v2-0203
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: UPIN
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
system | Σ | 1..1 | uri | The namespace for the identifier value Fixed Value: http://ns.electronichealth.net.au/id/medicare-provider-number
value | Σ | 1..1 | string | Medicare provider number Example General: 123456 Example Medicare provider number: 2426621B
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Identifier.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` from the FHIR Standard
Identifier.type | extensible | Pattern: UPIN `http://hl7.org/fhir/ValueSet/identifier-type` from the FHIR Standard

This structure is derived from AUMedicareProviderNumber

Summary

Extensions

This structure refers to these extensions:

- http://pca.digitalhealth.gov.au/fhir/4.0/StructureDefinition/pca-medicareprovidernumber-status

Other representations of profile: CSV, Excel, Schematron

### Notes:

No additional search parameters defined for this resource profile.