To provide services under the Medicare Benefits Schedule you have to be recognised in your field as a dental practitioner.
We recognise dental practitioners under the Health Insurance (Dental Services) Determination 2007. The determination is under subsection 3C(1) of the Health Insurance Act 1973.
To be recognised as a dental practitioner for Medicare you must:
- be registered or licensed with the Australian Health Practitioner Regulation Agency (AHPRA) or the Dental Board of Australia
- meet the eligibility requirements set out in Part 3 of the Health Insurance (Dental Services) Determination 2007.
There are also specific eligibility criteria for different types of dental practitioners.
Eligibility for recognition as a dental practitioner
Dental specialists are dentists who have completed additional specialised training and education. They register with both AHPRA and the Dental Board of Australia. They must register specifically for their specialist area to access Medicare benefits for specialist dental services.
Eligibility for recognition as a dental prosthetist for Medicare purposes depends on the type of recognition you’re seeking.
Short-term, interim or provisional registration
We only recognise dental prosthetists licensed to practice for a short-term, interim or provisional periods for the stated period. After this time, they must give us evidence of their current licence so we can continue to recognise them.
We can’t recognise dental prosthetists who are registered or licenced to practise in the name of a company. They need to practise under relevant state or territory law, as an individual, for us to recognise them.
We can’t recognise dental prosthetists who are non-practising.
Limited, specific or special purpose registration
For us to recognise them, dental prosthetists need to give us evidence if they are providing services under a:
- specific, or
- special purpose registration or licence.
This could be advice from the relevant state or territory registration board.
Claim Medicare benefits as dental practitioner
If you meet the recognition criteria, you can apply for your initial Medicare provider number.
Read more about Medicare benefits for health professionals.
Removal of recognition
We’ll remove your recognition if we’re notified by the registering body that you no longer meet Medicare eligibility requirements.
To ask us to no longer recognise you for Medicare purposes, send us a written request. This can be an email or a letter and must include your:
- provider number
- full name, and
- date of birth.
You must to send the request yourself. No one can send it on your behalf.