Medicare Benefits Schedule - Note CN.1.1

The Medicare Benefits Schedule includes certain professional services in respect of the treatment of cleft lip and craniofacial conditions for which Medicare benefits are payable. These services are normally described as dental services. However, for the purposes of these Notes the word "medical" is to be interpreted to include "dental". The definition of professional service as contained in the Health Insurance Act 1973 provides that such a service must be "clinically relevant". A clinically relevant service means a service rendered by a medical or dental practitioner or optometrist that is generally accepted in the medical, dental or optometrical profession (as the case may be) as being necessary for the appropriate treatment of the patient to whom it is rendered. 

Medicare benefits are payable in respect of services listed in Schedule 2 of the Health Insurance (Section 3C General Medical Services - Cleft and Craniofacial Services) Determination 2024, when the services are rendered by an eligible dental practitioner to patients who have been diagnosed with an eligible cleft or craniofacial condition. 

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