Changes to the Cleft Lip and Cleft Palate Scheme

You no longer need to register your patients with us before treating them under the Cleft Lip and Cleft Palate Scheme.

From 1 December 2015, you no longer need to register your patients with us before providing treatment under the Cleft Lip and Cleft Palate Scheme.

For your patient to be eligible for treatment under the scheme, they must:

  • be enrolled in Medicare
  • be certified by a health professional, before turning 22 years of age, as having
    • a cleft lift
    • a cleft palate, or
    • an other eligible condition
  • have started treatment before turning 22, and
  • be under the age of 28 when receiving treatment

Under these changes, you must certify that your patient meets all of the age and eligibility requirements of a ‘prescribed dental patient’ before you provide treatment under the scheme.

To certify your patient, you must include the text ‘certified dental patient’:

  • on your patient’s account, or
  • in the text field of a Medicare claim when billing a Medicare Benefits Schedule Category 7, cleft lip and cleft palate service

Next steps

Page last updated: 23 January 2016

This information was printed Wednesday 28 September 2016 from humanservices.gov.au/health-professionals/news/changes-cleft-lip-and-cleft-palate-scheme It may not include all of the relevant information on this topic. Please consider any relevant site notices at humanservices.gov.au/siteinformation when using this material.