The Department of Health has announced changes to Medicare coverage for Cone Beam Computed Tomography (CBCT) which in effect means many patients who have been receiving a rebate for CBCT scans will no longer do so as of next week. The move comes despite submissions from the Royal Australian New Zealand College of Radiologists (RANZCR) and then from the ADA recommending the rebate stay.
“What the Government has done is removed the rebate as a cost containment measure,” explains ADA President Dr Karin Alexander.
“The immediate impact for dentists will be their patients will be annoyed and disappointed that they won’t get a rebate.”
Bite understands that the number of claims for rebates for CBCT has been increasing, which is why the Department of Health has targeted it for cost-containment.
The changes, which come into effect on November 1st, are designed to: restrict co-claims for more than one CBCT per day are excluded from eligibility for rebate; restrict co-claiming for two-dimensional imaging in the same attendance and with CT in the same attendance; and c) restricting access to “Dental and temporo-mandibular joint imaging for diagnosis and management of mandibular and dento-alveolar fractures, dental implant planning, orthodontics, endodontic, periodontal and temporo-mandibular joint conditions:without contrast medium.”
The changes will also limit eligibility to Medicare rebates for CBCT to patients who were referred to radiologists by dental specialists only. Items 56025 and 56026 have now been removed from the category of services that can be requested by dental practitioners in the Medicare Benefits Schedule and replaced with items 57362 and 57363 which can only be requested by dental specialists under Medicare.
“It will still be possible for some patients to claim through private health insurance, but not all patients have private health insurance,” Dr Alexander said. “But what we are hoping is that, through the ADA, that further discussions will have the government see the importance of CBCT as a diagnostic tool. I hope that they will eventually see sense in re-allowing the rebate, because it improves the service and safety for the patient.”
