Use the Child Dental Benefit Schedule item numbers on the Department of Health and Aged Care’s website for your claims. They are Dental Benefits Schedule items 88011-88943.
You can bulk bill or provide your patient an account for your services. You must complete services before you bill your patient or submit a bulk billing claim. Service restrictions are in the Guide to the Child Dental Benefits Schedule on the Department of Health and Aged Care website.
Read more about online options for health professionals.
Lodge claims directly with us from your surgery using electronic claiming channels. They include Medicare Online and Medicare Easyclaim.
You can also submit your Medicare bulk bill claims electronically using either:
- your practice software
- Medicare Bulk Bill Webclaim.
You can access Medicare Bulk Bill Webclaim using Health Professional Online Services (HPOS). If you don’t have HPOS access, you need to apply for a Provider Digital Access (PRODA) first.
If you’re unable to submit an electronic claim, you can submit claims manually, but these take longer to process.
You can order approved bulk billing Medicare claim forms using the Medicare stationery order form (DB6Ba).
You must complete the assignment of benefit form in full and include:
- your patient’s name
- the date of the service
- the Dental Benefits Schedule item number that corresponds to the service
- your name and provider number
- the amount of the dental benefit assigned to you
- your patient’s or their parent’s or guardian’s signature.
If you privately bill with an account, your patient can claim their Medicare benefit electronically at your surgery if you offer Medicare Online or Medicare Easyclaim. If you don’t offer electronic claiming options, your patient can claim their benefit through us.
For us to pay your patient, the account or receipt you issue must include:
- your patient’s name
- the date of service
- the Dental Benefits Schedule item number that corresponds to the service
- your name and provider number
- amount charged for the service, total amount paid and any amount outstanding in relation to the service.
A service is complete once you’ve provided all parts of the service.
To provide services, you must be recognised to provide dental services under Medicare.
You can provide services under the Child Dental Benefits Schedule (CDBS) if you have a Medicare provider number.
Read more about provider numbers and Medicare benefits.
You must have both:
- general or specialist registration 112 or 106
- a Medicare provider number, associated with specialty code 107.
There are separate administrative arrangements for dentists working in public dental clinics. Contact your state or territory government for more information.
Before performing any services, you must:
- confirm the patient is eligible
- confirm the patient’s balance amount through Health Professional Online Services (HPOS) or by calling us
- discuss the patient’s treatment, costs and if there are any item restrictions
- get consent from the patient, or their parent or guardian using the informed financial consent form from the Department of Health and Aged Care website.
You must discuss the treatment and costs for basic dental services with your patient before providing the service. If the patient, or their parent or guardian, agrees to the services and cost, they must sign the consent form.
How you bill your patient determines the consent form they must complete. The forms are on the Department of Health and Aged Care website:
- For privately billed services, the patient, or their parent or guardian, must sign the Informed Financial Consent - non-bulk billing patient consent form at each visit.
- For bulk billed services, your patient, or their parent or guardian, must sign the Informed Financial Consent - bulk billing patient consent form on the first visit each year. If your patient is seeing multiple dentists in a single practice, they must complete a form for each dentist.
Translated Informed Financial Consent Forms are available on the Department of Health and Aged Care website.
You must keep adequate records for audit purposes for 4 years from the date of service, including:
- patient consent forms - the type of form depends on how you bill your patient
- clinical notes including notes about the particular tooth or teeth a CDBS service relates to
- any other relevant documents, such as itemised accounts or receipts showing you provided the claimed services.