Enhanced Primary Care Program (EPC)

Dental services under Medicare

Medicare dental items (Medicare items 85011-87777) are available for people with chronic conditions and complex care needs, on referral from a GP. Eligible patients can access up to $4,250 in Medicare benefits for dental services over two consecutive calendar years.

Important note

In line with its election commitment, the Government planned to close the Medicare chronic disease dental scheme to all patients by 1 July 2008, and to re-direct the savings to its new dental programs (Commonwealth Dental Health Program and Medicare Teen Dental Plan). However, on 19 June 2008, the Senate blocked the scheme’s closure. On 16 September 2008, the Senate blocked the Government’s second attempt to close the scheme.

Therefore, the scheme remains open and all eligible claims will be paid.

It remains the Government's intention to close the scheme in order to make funding available for its new dental programs, and the Government will continue to negotiate with the Senate in an effort to achieve this. GP groups, dentists, dental prosthetists and patients receiving services under the scheme will be advised as soon as negotiations are complete.

Information for patients

Fact sheet for Patients

Information for GPs

Fact sheet for GPs
GP referral form (PDF 134 KB)
GP referral form (Word 358 KB)

Information for dental practitioners

Fact sheet for Dentists and Dental Specialists
Fact sheet for dental prosthetists
MBS Dental Services book (including schedule of Medicare dental items)
Dental practitioner checklist (PDF 86 KB)

Further information

GPs and dental practitioners can call the Medicare Provider Enquiry Line on 132 150 for queries about provider registration, claiming/billing, and checking patient eligibility. Information is also available at www.medicareaustralia.gov.au

Patients can call the Medicare Patient Enquiry Line on 132 011.

Previous Medicare EPC dental items (Medicare items 10975-10977)

The EPC dental items 10975-10977 are no longer available. These items ceased on 31 December 2007.