This guide is for dentists and explains the arrangements and requirements for the Child Dental Benefits Schedule.
This guide is not a legal document.
In cases of discrepancy the legislation
will be the source document for the requirements of the program.
This guide is periodically updated. For the most current version of the guide please refer to the Department of Human Services’ Medicare website at http://www.humanservices.gov.au/health-professionals/services/child-dental-benefits-schedule/
Am I eligible to provide Child Dental Benefits Schedule services? 5
Which children are eligible for dental services? 6
How does the patient’s benefit cap of $1,000 work? 7
What dental services are covered by the Child Dental Benefits Schedule? 8
Do I have to quote for services? 10
How do I charge, and bill/claim for dental services? 16
Can private health insurance be used for Child Dental Benefits Schedule services? 20
Attachment A: Example of Non-Bulk Billing Patient Consent Form 22
Attachment B: Example of Bulk Billing Patient Consent Form 23
What is the Child Dental Benefits Schedule?
The Child Dental Benefits Schedule is a dental benefits program for eligible children aged 2-17 years that provides up to $1,000 in benefits to the child for basic dental services.
Services that receive a benefit under the program include examinations, x-rays, cleaning, fissure sealing, fillings, root canals, extractions and partial dentures. Many of these services have claiming restrictions. Services can be provided in a public or private setting. Benefits are not available for orthodontic or cosmetic dental work and cannot be paid for any services provided in a hospital.
The payment of benefits under the Child Dental Benefits Schedule is administered through the Department of Human Services.
Am I eligible to provide Child Dental Benefits Schedule services?
You are eligible to provide Child Dental Benefits Schedule services if you are a dentist or dental specialist in either the public and private dental sectors. In order to satisfy the provider eligibility requirements, you must:
You can check your registration with the Dental Board of Australia online at:
If you already have a Medicare provider number (as most dentists already do) you do not need to reregister to use the Child Dental Benefits Scheduleservice items.
Application forms for Medicare provider numbers can be obtained from the Department of Human Services by either calling 132 150 (call charges may apply) or from the Department of Human Services website (www.humanservices.gov.au), then Health professionals > Forms > Form by Title> Application for an initial Medicare provider/registration number for a Dentist, Dental Specialist or Dental Prosthetist form (3301). The link to this form is http://www.humanservices.gov.au/health-professionals/forms/3301
There are separate arrangements for dentists who work in public dental clinics. Information about these arrangements can be obtained from state and territory government dental services.
Who can perform services on behalf of a dentist or dental specialist?
Dental hygienists, dental therapists, oral health therapists and dental prosthetists who have general registration with the Dental Board of Australia are eligible to provide Child Dental Benefits Schedule services on behalf of a dentist or dental specialist. These services must be performed in accordance with relevant state and territory law, conform to accepted dental practice and be provided under appropriate supervision or oversight.
What constitutes appropriate supervision or oversight is a matter for the individual dental practice or clinic in accordance with the Dental Board of Australia’s accepted dental practice.
If you are a public dental provider you may provide services on behalf of a Representative Public Dentist. If you are a public dental provider you should contact your state or territory government for further information.