The Medicare Teen Dental Plan will close on 31 December 2013. Eligible teens will be able to access services until this date.
From 1 January 2014, the Medicare Teen Dental Plan will be replaced by the Child Dental Benefits Schedule.
Dental providers that hold general or specialist registration with the Dental Board of Australia can provide services under the Child Dental Benefits Schedule (CDBS). The services may only be billed by a dentist or dental specialist (either a private provider or a representative public dentist) with a current Medicare provider number.
Services or part of a service may also be provided on behalf of a dentist or dental specialist by another dental practitioner. These services may be provided by dental hygienists, dental therapists, oral health therapists and dental prosthetists.
The CDBS provides eligible children with up to $1,000 in benefits for basic dental services, capped over two consecutive calendar years. A child is eligible for the CDBS if he or she is aged between 2 to 17 years for at least one day in the calendar year, is eligible for Medicare and receives, or is part of a family receiving, a relevant Australian government payment such as Family Tax Benefit Part A.
Services that receive a benefit under the CDBS include examinations, x-rays, cleaning, fissure sealing, fillings, root canals, extractions, and partial dentures. Many of these services have claiming restrictions.
Benefits are not available for orthodontic or cosmetic dental work and cannot be paid for any services provided in a hospital.
Providing services under the Child Dental Benefits Schedule
- Before starting a consultation, you should check your patient’s CDBS eligibility and balance. You can do this through Health Professional Online Services (HPOS) or by calling 132 150. To access HPOS you need a valid Medicare Public Key Infrastructure (PKI) certificate. Find out more about HPOS
- Before providing services, you must discuss and obtain consent from the patient or their parent/guardian to the basic dental services needed, and the costs associated with the services. Consent to all services and costs must be documented in writing before the end of the visit
- For privately billed services, the patient or their parent/guardian will need to document their consent by signing the relevant patient consent form - Informed Financial Consent – Non-Bulk Billing Patient Consent Form - at each visit. For bulk billed services, the relevant patient consent form - Informed Financial Consent – Bulk Billing Patient Consent Form - is only required on the first visit in each calendar year
Claiming services under the Child Dental Benefits Schedule
A service must be fully completed before you bill the patient or submit a bulk billing claim.
Dental providers must maintain adequate records for four years from the date of service including:
- patient consent forms, and
- clinical notes (including noting the particular tooth or teeth a CDBS service relates to, where relevant)
Any other relevant documents such as itemised accounts or receipts verifying the services claimed were provided should also be kept.
For application and claim forms, go to Medicare forms for dental providers.
We have a number of resources to support dental providers under the CDBS.
Refer to the CDBS Quick Reference Guide for an overview of the CDBS and the claiming and servicing requirements. This guide will be available in December 2013.
Refer to the HPOS fact sheet for dentists for an overview of HPOS and how you can use it to check a patient’s CDBS eligibility and available balance.
Complete our eLearning program for an introduction to Medicare and to help you comply with your legal obligations and requirements under the CDBS. It focuses on the conditions and obligations under the CDBS including eligibility, informed consent and claiming requirements. This eLearning module will be available in December 2013.
A Guide to the Child Dental Benefits Schedule produced by the Department of Health, explains program requirements and the list of eligible services, benefits and restrictions for each service. The Guide was updated on 6 December 2013 to include the Dental Benefits Schedule and changes to the description of sedation services.
For more information on the CDBS, go to the Department of Health website.
Information on the Dental Benefits Rules 2013 is available on the ComLaw website.
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Last updated: 9 December, 2013