Dental Benefits Rules 2026

EXPLANATORY STATEMENT

Dental Benefits Act 2008

Dental Benefits Rules 2026

Purpose and operation

The Dental Benefits Rules 2026 (the Rules) is made under the Dental Benefits Act 2008 (the Act).

The purpose of the Rules is to provide the operational framework and dental service items for the Child Dental Benefits Schedule (CDBS). It determines access to basic dental service items listed on the Dental Benefits Schedule, and provides for related matters (e.g. the kinds of dental providers who can render dental services, the circumstances in which dental benefits are not payable, financial consent by eligible persons, transitional arrangements, the dental benefits two-year cap, dental services rendered by states and territories and the number of occasions a dental service can be rendered).

Background

The CDBS is a central program for the provision of oral health services to eligible persons. The CDBS assists eligible families with the cost of basic dental services. The Act and Rules are the legislative basis of the CDBS, the program by which the Commonwealth provides affordable access to basic dental services for eligible persons.

Commencing the day after the instrument is registered, the Rules set out the dental items that maybe be supplied to an eligible person, the dental services rendered by an approved dental provider and other matters related to the administration of the CDBS.

The Rules repeal and replace the Dental Benefits Rules 2014 (the former Rules), which were due to sunset on 1 April 2026.

Authority

Subsection 60(1) of the Act provides that the Minister may, by legislative instrument, make Dental Benefits Rules providing for matters required, or permitted by the Act to be provided, or necessary or convenient to be provided to carry out or give effect to the Act.

Reliance on subsection 33(3) of the Acts Interpretation Act 1901

Subsection 33(3) of the Acts Interpretation Act 1901 provides that where an Act confers a power to make, grant or issue any instrument of a legislative or administrative character (including rules, regulations or by-laws), the power shall be construed as including a power exercisable in the like manner and subject to the like conditions (if any) to repeal, rescind, revoke, amend, or vary any such instrument.

Commencement

This instrument commences the day after the instrument is registered.

Consultation

Consultation was undertaken with Services Australia, who administers the CDBS, to ensure the current IT systems would continue to be able to accommodate the relevant CDBS claiming process for the CDBS.

External consultation was not necessary in respect to these Rules as the changes are machinery in nature and do not substantially alter existing arrangements.

General

This instrument is a legislative instrument for the purposes of the Legislation Act 2003.

Details of this instrument are set out in Attachment A.

This instrument is compatible with the human rights and freedoms recognised or declared under section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011. A full statement of compatibility is set out in Attachment B.

ATTACHMENT A

Details of the Dental Benefits Rules 2026

Part 1 - Preliminary

Section 1 – Name

Section 1 provides that the name of the instrument is the Dental Benefits Rules 2026

Section 2 – Commencement

Section 2 provides that the instrument commences on the day after the instrument is registered.

Section 3 – Authority

Section 3 provides that the instrument is made under section 60(1) of the Dental Benefits Act 2008.

Section 4 – Schedules

Section 4 provides that each instrument that is specified in Schedule 3 to this instrument is amended or repealed as set out in the applicable items in that Schedule, and any other item in that Schedule has effect according to its terms.

Section 5 – Definitions

Section 5 sets out the definitions for the instrument.

Several expressions used in this instrument are defined in the Act including the following:

(a) ABSTUDY scheme;

(b) dental practitioner;

(c) dental provider;

(d) FTB(A) person;

(e) Human Services Department;

(f) item;

(g) medicare number;

(h) youth allowance.

The definitions in section 5 are in many cases substantially the same as the definitions in section 4 of the former Rules (i.e. the Dental Benefits Rules 2014). The drafting of some of the definitions has been updated to reflect current drafting standards and certain definitions have been removed where these are no longer required.

New definitions added are:

-          a definition of dental cap has been included in the new Rules and this new definition is a signpost definition that refers the reader to new Schedule 2 (Dental cap).

-          a definition of Department of Veterans’ Affairs has been included in the new Rules and this is defined as the Department of State that is administered by the Minister administering the Military Rehabilitation and Compensation Act 2004.

-          a definition of member of a couple has been included in the new Rules and this is defined as having the same meaning as in the Social Security Act 1991.

Some definitions used in the former have been removed (i.e. the definitions of FTB(A) person, FTB recipient and relevantly provided). These concepts did not need to be defined in section 5 of the new Rules as they are defined in the Act already or are addressed elsewhere in the new Rules.

Commonwealth Acts referenced in section 5 are incorporated as in force from time to time.

Section 6 – Meaning of eligible dental patient

Section 6 specifies six classes of eligible persons who are eligible dental patients for the purposes of paragraph 5(1)(b) of the Act. ‘Eligible persons’ is defined in in section 4 of the Act to mean:

1.    a person who is an eligible person within the meaning of section 3 of the Health Insurance Act 1973; or

1.    a person who is treated as such a person because of section 6, 6A or 7 of that Act.

The classes of eligible persons specified in section 6 capture the kinds of persons outlined in subsection 23(1) of the Act (Qualification for a voucher – Persons to whom this section applies) and section 9 of the former Rules (Classes of persons who satisfy the means test (Act, s 24(1)(d)).

Unlike the former Rules, the new Rules do not refer to the term ‘voucher’. The new Rules use paragraph 5(1)(b) to determine a class of eligible dental patients rather than looking to whether a person is voucher holder.

The first class of eligible persons determined under paragraph 5(1)(b) are eligible persons who, at any time in the calendar year in which the dental service is rendered, are aged under 18 years and receive any of the following Social Security Act 1991 payments:

(i) carer payment;

(ii) disability support pension;

(iii) parenting payment;

(iv) special benefit;

(v) youth allowance.

The second class of eligible persons are eligible persons who, at any time in the calendar year in which the dental service is rendered, are aged under 18 years and either:

(i) who receive a payment under the ABSTUDY scheme; or

(ii) in respect of whom another person receives a payment under the ABSTUDY scheme.

The third class of eligible persons are eligible persons who, at any time in the calendar year in which the dental service is rendered, are aged under 18 years and are an FTB(A) person.

FTB(A) person is defined in subsection 24(2) of the Act and covers situations where FTB(A) (i.e. Family Tax Benefit Part A) is received in respect of the eligible person by a person other than the eligible person (e.g. a parent or guardian).

The fourth class of eligible persons are eligible persons who, at any time in the calendar year in which the dental service is rendered, are aged 16 or 17 years and either:

(i) who receive a payment under VCES or MRCAETS; or

(ii) in respect of whom another person receives a payment under VCES or MRCAETS.

Section 5 provides the following definitions of VCES and MRCAETS:

-          MRCAETS (short for Military Rehabilitation and Compensation Act Education and Training Scheme) means the scheme determined under section 258 of the Military Rehabilitation and Compensation Act 2004 and approved by the Minister administering that Act, as in force from time to time.

-          VCES (short for Veterans’ Children Education Scheme) means the scheme determined under subsection 117(1) of the Veterans’ Entitlements Act 1986 and approved by the Minister administering that Act, as in force from time to time.

The fifth class of eligible persons are eligible persons who, at any time in the calendar year in which the dental service is rendered, are aged under 18 years and whose parent, guardian or carer receive either of the following payments in respect of the person:

(i) double orphan pension;

(ii) parenting payment.

The sixth class of eligible persons are eligible persons who, at any time in the calendar year in which the dental service is rendered, are aged under 18 years and whose partner receives parenting payment (as defined in the Social Security Act 1991).

Section 7 – Meaning of dental provider

Section 7 operates in substantially the same way as section 6 of the former Rules. The wording has been updated to reflect current drafting conventions.

Subsection 7(1) provides that for the purposes of paragraph 6(1)(b) of the Act, the following classes of persons are dental providers in relation to a dental service:

(a) dental hygienists;

(b) dental therapists;

(c) oral health therapists.

Section 5 contains definitions of the terms ‘dental hygienist’, ‘dental therapist’ and ‘oral health therapist’.

Subsection 7(2) provides that for the purposes of paragraph 6(2)(a) of the Act, the class of dental practitioners that are not dental providers in relation to a dental service are dental practitioners who have not been allocated a provider number in respect of the place of practice at which the service is rendered.

The term ‘provider number’ is defined in section 5 by reference to the meaning in the Health Insurance Regulations 2018.

Section 8 – Meaning of rendered on behalf of a dental provider

Section 8 operates in substantially the same way as section 7 of the former Rules. The wording has been updated to reflect current drafting conventions.

Subsection 8(1) provides that, for the purposes of paragraph 7(a) of the Act, a dental service may be rendered on behalf of a registered dentist who is not a public sector dental provider by a person who is included in one or more of the following classes of persons:

(a) dental hygienists;

(b) dental therapists;

(c) dental prosthetists;

(d) oral health therapists.

Subsection 8(2) provides that, for the purposes of paragraph 7(a) of the Act, a dental service may be rendered on behalf of a public sector dental provider who is a registered dentist by another public sector dental provider.

Part 2 – When dental benefit is not payable

Division 1 – Dental benefit not payable unless certain conditions satisfied

Section 9 – Particulars that must be recorded on accounts etc.

Section 9 operates in substantially the same way as section 8 of the former Rules. The wording has been updated to reflect current drafting conventions.

Subsection 9(1) provides that, for the purposes of subsection 17(2) of the Act, the particulars that must be recorded on an account or receipt for fees, or on a form of an assignment, in respect of a dental service are the following:

(a)  the name of the eligible dental patient in respect of whom the dental service was rendered;

(b)  the date on which the dental service was rendered;

(c)  the item that corresponds to the dental service;

(d) the name of the dental provider by whom, or on whose behalf, the dental service is rendered;

(e) the dental provider’s provider number in respect of the place of practice at which the dental service was rendered;

(f) for:

(i) an account or receipt for fees—the amount charged by the dental provider for the dental service, and the amount paid or outstanding (if any); or

(ii)  a form of an assignment—the amount of dental benefit assigned to the dental provider.

Subsection 9(2) provides that, the particulars in subsection 9(1) are specified in relation to dental services generally.

Section 10 – Conditions that must be satisfied – certain dental services rendered by kinds of dental providers

Section 10 operates in substantially the same way as section 8AA of the former Rules. The wording has been updated to reflect current drafting conventions.

Section 10 provides that for the purposes of subsection 18(1) of the Act, dental benefit is not payable in respect of a dental service specified in an item in column 1 of the table in section 10 unless the dental service is rendered by or on behalf of a dental provider specified in column 2 of that table for the relevant item.

Section 11 – Condition that must be satisfied – consent to be provided and recorded

Section 11 operates in substantially the same way as section 15 of the former Rules. The wording has been updated to reflect current drafting conventions and the section has been made under section 18 of the Act (Dental benefit is not payable unless conditions specified in the Dental Benefits Rules are satisfied) as opposed to subsection 62(2) of the Act (Specification of items in Dental Benefits Schedule may be conditional) which was the basis for section 15 of the former Rules. The exceptions to the requirements in subsection 11(1) that are outlined in subsections 11(2) and (3) of the new Rules are based on the ‘Ministerial guidelines for the Child Dental Benefits Schedule: Extenuating circumstances for informed financial consent’ referred to in subsection 15(7) of the former Rules. Rather than incorporating the exceptions by reference to guidelines, the new Rules outline these exceptions in subsections 11(2) and (3).

Subsection 11(1) provides that, for the purposes of subsection 18(1) of the Act, dental benefit is not payable in respect of a dental service unless:

1.    the person incurring the dental expenses in respect of the service satisfies certain requirements in relation to the assignment of dental benefits (including completing the specified approved form known as the Child Dental Benefits Schedule Bulk Billing Patient Consent Form and meeting requirements around the assignment of dental benefits in section 12 of the Act); or

1.    the person incurring the dental expenses in respect of the service signs an approved form known as the Child Dental Benefits Schedule Non Bulk Billing Patient Consent Form on the day the service is rendered; or

1.    the dental provider by whom, or on whose behalf, the service is rendered:

1.                  obtains and records consent to render the service from the eligible dental patient or the patient’s parent or guardian before the service is rendered; and
2.                informs the person incurring the dental expenses in respect of the service of the amount of dental benefit likely payable for the service and any likely out of pocket costs before rendering the service; and
3.             obtains and records the consent of the person mentioned in paragraph (ii) to render the service; and
4.              obtains a signature from the person or persons providing the consents specified in subparagraph (i) and (iii) on the day the service is rendered.

Subsection 11(2) provides for an exception to the requirements in subsection 11(1) that addresses situations in which dental services are provided in an emergency.

Subsection 11(3) provides for other exceptions to the requirements in subsection 11(1) including an exception for where the dental provider is unaware that the eligible dental patient is an eligible dental patient at the time the dental service is rendered.

The exceptions in this subsection also address situations such as where the dental provider obtains and records the consents mentioned in subparagraph 11(1)(c)(i) and (iii) (discussed above) but a person providing a consent:

1.                  refuses to provide the provider with the person’s signature; or
2.                is incapacitated or dies before the person is able to provide the provider with their signature.

A further exception to subsection 11(1) provides that an exception exists where for the purposes of paragraphs 11(1)(a), (b) or (c) (discussed above), a person purports to be a person incurring dental expense or to be a parent or guardian of an eligible dental patient, but the person is not such a person and the provider is unaware of this fact.

A further exception to subsection 11(1) provides that an exception exists where a requirement set out in subparagraph 11(1)(c)(i), (iii) or (iv) (discussed above) is not met due to an administrative error by the dental provider or a person working with the provider, where the error occurs outside the provider or person’s (as the case requires) standard operating procedures

Section 12 – Condition that must be satisfied – dental services rendered by States and Territories

Section 12 provides that for the purposes of subsection 18(1) of the Act, dental benefit is not payable in respect of a dental service rendered to an eligible dental patient by, on behalf of or under an arrangement with a State or Territory unless the service is rendered before 1 January 2027 or the Minister directs that section 12 does not apply to the arrangement. This section operates in substantially the same way as section 8A of the former Rules but has been updated to the reflect current drafting conventions.

Division 2 – Dental benefit not payable in certain circumstances

Section 13 – Dental benefit not payable if no medicare number

Section 13 provides that for the purposes of subsection 21(1) of the Act, dental benefit is not payable in respect of dental service rendered to an eligible dental patient, if, at the time the service is rendered the patient has not been assigned a medicare number. Section 11 of the former Rules was made under section 29 of the Act (When voucher is not required to be issued—circumstances specified in the Dental Benefit Rules). Section 13 of the new Rules relies instead upon section 21 of the Act (Dental Benefits Rules may provide that dental benefit is not payable). Section 13 of the new Rules produces the same outcome for a person as section 11 of the former Rules in that it makes payment of a dental benefit ultimately conditional upon the eligible dental patient having been assigned a medicare number.

Section 14 – Dental benefit not payable if certain personal information not provided

Section 14 provides that for the purposes of subsection 21(1) of the Act, the benefit is not payable in respect of a dental service rendered to an eligible dental patient if the patient or the person who receives a payment under VCES or MRCAETS in respect of the patient has not provided consent to the Department of Veterans’ Affairs to provide personal information about the patient to the Human Services Department (defined in the Act as Services Australia). This provision authorises Services Australia to access data from the Department of Veterans’ Affairs for the purpose of verifying patient eligibility for the CDBS and issuing notification of eligibility. This section operates in substantially the same way as section 11 of the former Rules but has been updated to the reflect current drafting conventions. Section 11 of the former Rules was made under section 29 of the Act (When voucher is not required to be issued—circumstances specified in the Dental Benefit Rules). Section 14 of the new Rules relies instead upon section 21 of the Act (Dental Benefits Rules may provide that dental benefit is not payable). Section 14 of the new Rules produces the same outcome for a person as section 11 of the former Rules in that it makes payment of a dental benefit ultimately conditional upon the provision of the relevant consent.

Section 15 – Dental benefit not payable if cap reached

Subsection 15(1) provides that for the purpose of subsection 21(1) of the Act, dental benefit, or an amount of the dental benefit, is not payable in respect of a dental service if the payment of the benefit or amount would result in a payment in excess of the dental cap for a two year period. The dental cap for each two-year period will be outlined in Schedule 2 to the instrument (currently that schedule only has the dental cap for the 2026-2027 two-year period). Subsection 15(2) sets out how to determine an eligible dental patient’s first two-year period and sets out how all subsequent two-year periods should be determined.

This section operates in substantially the same way as section 14 of the former Rules. The wording has been updated to reflect current drafting conventions and the section has been made under section 21 of the Act (Dental Benefits Rules may provide that dental benefit is not payable) as opposed to subsection 62(2) of the Act (Specification of items in Dental Benefits Schedule may be conditional) which was the basis for the equivalent provisions in the former Rules.

Section 16 – Dental benefit not payable for certain additional dental services

Section 16 operates in substantially the same way as section 17 of the former Rules. The wording has been updated to reflect current drafting conventions and the section has been made under section 21 of the Act (Dental Benefits Rules may provide that dental benefit is not payable) as opposed to subsection 62(2) of the Act (Specification of items in Dental Benefits Schedule may be conditional) which was the basis for the equivalent provisions in the former Rules.

Section 16 provides that certain dental services items can only be rendered a specified number of times in a specified period. The full details of this are outlined in a table set out in subsection 16(1). This table outlines the dental services (by reference to their item number), the number of occasions the services can be rendered and the relevant period over which they can be rendered.

For the purposes of subsection 21(1) of the Act, dental benefit is not payable in respect of a dental service where these rules are not met.

Section 17 – Dental benefit not payable for certain additional dental services rendered by same dental practitioner

Section 17 operates in substantially the same way as section 18 of the former Rules. The wording has been updated to reflect current drafting conventions and the section has been made under section 21 of the Act (Dental Benefits Rules may provide that dental benefit is not payable) as opposed to subsection 62(2) of the Act (Specification of items in Dental Benefits Schedule may be conditional) which was the basis for the equivalent provisions in the former Rules.

Section 17 provides that for the purposes of subsection 21(1) of the Act, dental benefit is not payable for certain additional dental services rendered by the same dental practitioner.

Section 18 – Dental benefit not payable for certain diagnostic services

Section 18 operates in substantially the same way as section 19 of the former Rules. The wording has been updated to reflect current drafting conventions and the section has been made under section 21 of the Act (Dental Benefits Rules may provide that dental benefit is not payable) as opposed to subsection 62(2) of the Act (Specification of items in Dental Benefits Schedule may be conditional) which was the basis for the equivalent provisions in the former Rules.

Section 18 provides that for the purposes of subsection 21(1) of the Act, dental benefit is not payable for certain diagnostic services in circumstances detailed in subsections 18(1) and (2).

Section 19 – Dental benefit not payable for certain preventive services

Section 19 operates in substantially the same way as section 20 of the former Rules. The wording has been updated to reflect current drafting conventions and the section has been made under section 21 of the Act (Dental Benefits Rules may provide that dental benefit is not payable) as opposed to subsection 62(2) of the Act (Specification of items in Dental Benefits Schedule may be conditional) which was the basis for the equivalent provisions in the former Rules.

Section 19 provides that for the purposes of subsection 21(1) of the Act, dental benefit is not payable for certain preventive services in circumstances detailed in subsections 19(1) and (2).

Section 20 – Dental benefit not payable for certain periodontic services

Section 20 operates in substantially the same way as section 21 of the former Rules. The wording has been updated to reflect current drafting conventions and the section has been made under section 21 of the Act (Dental Benefits Rules may provide that dental benefit is not payable) as opposed to subsection 62(2) of the Act (Specification of items in Dental Benefits Schedule may be conditional) which was the basis for the equivalent provisions in the former Rules.

Section 20 provides that for the purposes of subsection 21(1) of the Act, dental benefit is not payable for certain periodontic services in circumstances detailed in section 20.

Section 21 – Dental benefit not payable for certain oral surgery

Section 21 operates in substantially the same way as section 22 of the former Rules. The wording has been updated to reflect current drafting conventions and the section has been made under section 21 of the Act (Dental Benefits Rules may provide that dental benefit is not payable) as opposed to subsection 62(2) of the Act (Specification of items in Dental Benefits Schedule may be conditional) which was the basis for the equivalent provisions in the former Rules.

Section 21 provides that for the purposes of subsection 21(1) of the Act, dental benefit is not payable for certain oral surgery services in circumstances detailed in paragraphs 21(a) to (g).

Section 22 – Dental benefit not payable for certain endodontic services

Section 22 operates in substantially the same way as sections 23 and 26 of the former Rules. The wording has been updated to reflect current drafting conventions and the section has been made under section 21 of the Act (Dental Benefits Rules may provide that dental benefit is not payable) as opposed to subsection 62(2) of the Act (Specification of items in Dental Benefits Schedule may be conditional) which was the basis for the equivalent provisions in the former Rules.

Section 22 provides that for the purposes of subsection 21(1) of the Act, dental benefit is not payable for certain endodontic services in circumstances detailed in subsections 22(1) to (3).

Section 23 – Dental benefit not payable for certain restorative services

Section 23 operates in substantially the same way as sections 24, 27, 27A and 28 of the former Rules. The wording has been updated to reflect current drafting conventions and the section has been made under section 21 of the Act (Dental Benefits Rules may provide that dental benefit is not payable) as opposed to subsection 62(2) of the Act (Specification of items in Dental Benefits Schedule may be conditional) which was the basis for the equivalent provisions in the former Rules.

Section 23 provides that for the purposes of subsection 21(1) of the Act, dental benefit is not payable for certain restorative services in circumstances detailed in paragraphs 23(a) to (g).

Section 24 – Dental benefit not payable for certain prosthodontic services

Section 24 operates in substantially the same way as section 24A of the former Rules. The wording has been updated to reflect current drafting conventions and the section has been made under section 21 of the Act (Dental Benefits Rules may provide that dental benefit is not payable) as opposed to subsection 62(2) of the Act (Specification of items in Dental Benefits Schedule may be conditional) which was the basis for the equivalent provisions in the former Rules.

Section 24 provides that for the purposes of subsection 21(1) of the Act, dental benefit is not payable for certain prosthodontic services in circumstances detailed in paragraphs 24(a) to (d).

Section 25 – Dental benefit not payable for certain other prosthodontic services

Section 25 operates in substantially the same way as section 25 of the former Rules. The wording has been updated to reflect current drafting conventions and the section has been made under section 21 of the Act (Dental Benefits Rules may provide that dental benefit is not payable) as opposed to subsection 62(2) of the Act (Specification of items in Dental Benefits Schedule may be conditional) which was the basis for the equivalent provisions in the former Rules.

Section 25 provides that for the purposes of subsection 21(1) of the Act, dental benefit is not payable for certain other prosthodontic services in circumstances detailed in paragraphs 25(a) to (d).

Section 26 – Dental benefit not payable for certain general service

Section 26 operates in substantially the same way as section 29 of the former Rules. The wording has been updated to reflect current drafting conventions and the section has been made under section 21 of the Act (Dental Benefits Rules may provide that dental benefit is not payable) as opposed to subsection 62(2) of the Act (Specification of items in Dental Benefits Schedule may be conditional) which was the basis for the equivalent provisions in the former Rules.

Section 26 provides that for the purposes of subsection 21(1) of the Act, dental benefit is not payable for dental services item 88911 (i.e. the general service in Subgroup 1 of Group U9 of the Dental Benefits Schedule) in certain circumstances.

Part 3 – Dental Benefits Schedule

Section 27 – Dental Benefits Schedule

Section 27 provides that, for the purposes of the subsection 61(1) of the Act, the Dental Benefits Schedule is in Schedule 1 to this instrument.

Part 4 – Application, savings and transitional provisions

Division 1 – Dental Benefits Rules 2026

Section 28 – Definitions

Section 28 sets out two definitions for use in interpreting Part 4:

-          commencement time which means the time this section commences; and

-          old rules which means the Dental Benefits Rules 2014 (i.e. the former Rules).

Section 29 – Application – dental service provided on or after commencement

Section 29 is an application provision which provides that this instrument (i.e. the new Rules) applies in relation to dental services rendered to an eligible dental patient on or after the commencement of this section.

Section 30 – Transitional – dental benefit two-year cap

Section 30 is a transitional provision that aims to deal with the transition of eligible dental patients.

Subsection 30(1) provides that if a relevant two-year period was in effect in relation to an eligible dental patient under section 14 of the former Rules immediately before the commencement of this section, the relevant two-year period continues to be in effect:

1.    in relation to the eligible dental patient; and
2.    after commencement;

as if it were a two-year period specified in subsection 15(2) of the new Rules.

Subsection 30(2) provides that the period remains in force for the balance of the relevant two-year period.

Section 31 – Something done under the old rules

Subsection 31(1) provides that if a something was done for a particular purpose under the former Rules as in force immediately before the commencement time and the thing could be done for that purpose under this instrument the something has effect for the purposes of this instrument as if it had been done for that purpose under this instrument.

Subsection 31(2) provides that without limiting subsection 31(1), a reference in that subsection to something being done includes a reference to a notice, application or other instrument being given or made.

Schedule 1 – Dental Benefits Schedule

Schedule 1 provides for the Dental Benefits Schedule which sets out the various item numbers that can be claimed under the Child Dental Benefits Scheme (with descriptions of the dental services to which the item numbers relate). The amounts payable for each item are also outlined in the Dental Benefits Schedule. The drafting of the Dental Benefits Schedule in Schedule 1 to the former Rules has been updated based on current drafting conventions but is otherwise intended to operate in the same way as the Dental Benefits Schedule in the former Rules. Indexation for 2026 has been factored into the amounts of dental benefit payable for each item.

Schedule 2 – Dental cap

Schedule 2 provides the dental cap for the two-year periods in the table in Schedule 2 (relevant for the purposes of section 15 of the new Rules and the definition of ‘dental cap’ in section 5 of the new Rules. Currently, the table in Schedule 2 only provides the dental cap of $1,158 for the two-year period beginning on 1 January 2026 and ending on 31 December 2027 but future two-year caps for future two-year periods could be added to the table by way of amendments.

Schedule 3 – Repeal

Schedule 3 repeals the Dental Benefits Rules 2014, which sunset on 1 April 2026, and replaces with the new Rules.

ATTACHMENT B

Statement of Compatibility with Human Rights

Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011

Dental Benefits Rules 2026

This Disallowable Legislative Instrument is compatible with the human rights and freedoms recognised or declared in the international instruments listed in section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011.

Overview of the Disallowable Legislative Instrument

The Dental Benefits Rules 2026 (the Rules) replaces the Dental Benefits Rules 2014 (the former Rules) which sunset on 1 April 2026. The purpose of the Rules is to provide the operational framework and dental service items for the Child Dental Benefits Schedule (CDBS). It determines access to basic dental service items listed on the Dental Benefits Schedule, and provides for related matters (e.g. the kinds of dental providers who can render dental services, the circumstances in which dental benefits are not payable, financial consent by eligible persons, transitional arrangements, the dental benefits two-year cap, dental services rendered by states and territories and the number of occasions a dental service can be rendered in a time period).

Human rights implications

This Disallowable Legislative Instrument engages the following rights:

• the right to social security under Article 9 of the International Covenant on Economic, Social and Cultural Rights (ICESCR);
• the rights of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health, under Article 24 of the International Convention on the Rights of the Child (ICRC);
• the right to the enjoyment of the highest attainable standard of physical and mental health under Article 12 of the ICESCR; and
• the right to privacy under Article 17 of the International Covenant on Civil and Political Rights (ICCPR).

The Right to Health

The right to the enjoyment of the highest attainable standard of physical and mental health is contained in Article 12(1) of the ICESCR. The UN Committee on Economic Social and

Cultural Rights (the Committee) has stated the right to health is not a right for each individual to be healthy but is a right to a system of health protection which provides equality of opportunity for people to enjoy the highest attainable level of health.

The change to use paragraph 5(1)(b) of the Act to define eligible dental patients, rather than relying on voucher holders, has minimal human rights impact, as CDBS eligibility remains contingent on Medicare status and meeting the same criteria as applied under the former Rules.

The Rights of the Child

The rights of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health is contained in Article 24 of the ICRC. It requires that a country must, ensure that no child is deprived of his or her right of access to such healthcare services.

The Dental Benefits Rules 2026, support the right to the child by ensuring eligible individuals - children and young people from families receiving government payments—have access to essential dental services through the CDBS.

The Right to Social Security

The right to social security is contained in Article 9 of the ICESCR. It requires that a country must, within its maximum available resources, ensure access to a social security scheme that provides a minimum essential level of benefits to all individuals and families that will enable them to acquire at least essential health care. Countries are obliged to demonstrate every effort has been made to use all resources that are at their disposal in an effort to satisfy, as a matter of priority, this minimum obligation.

The Dental Benefits Rules 2026 support the right to social security by ensuring eligible individuals—children and young people from families receiving government payments—have access to essential dental services through the CDBS. This framework guarantees that those who qualify for social security benefits can also obtain necessary oral health care, helping to meet their basic health needs and reduce financial barriers to treatment. By providing this safety net, the instrument aligns with the principle that social security should enable individuals and families to access essential healthcare services.

The Right to Privacy

The protection against arbitrary or unlawful interference with privacy is contained in Article 17 of the ICCPR. Article 17 provides that no one shall be subjected to arbitrary or unlawful interference with his or her privacy, family, home or correspondence, nor to unlawful attacks on their honour or reputation, and that everyone has the right to the protection of the law against such interference or attacks.

The right to privacy under Article 17 can be permissibly limited in order to achieve a legitimate objective and where the limitations are lawful and not arbitrary. The term ‘unlawful’ in Article 17 of the ICCPR means that no interference can take place except as authorised under domestic law. Additionally, the term ‘arbitrary’ in Article 17(1) of the ICCPR means that any interference with privacy must be in accordance with the provisions, aims and objectives of the ICCPR and should be reasonable in the particular circumstances. The Committee has interpreted ‘reasonableness’ to mean that any limitation must be proportionate and necessary in the circumstances.

Section 14 of the new Rules (Dental benefit not payable if certain personal information not provided) requires recipients of VCES and MRCAETS payments to provide consent for Services Australia to share information with the Department of Veterans’ Affairs. If consent is not provided as required by that provision, dental benefits are not payable under section 21 of the Act. Personal information is disclosed to Services Australia solely for the purpose of verifying eligibility for dental benefits under the Act. This process is conducted in accordance with the Privacy Act 1988 (Cth) and the Australian Privacy Principles, which mandate that personal data is collected, used, and disclosed only as necessary and with appropriate safeguards.

By limiting access to information strictly to what is required for administering entitlements, the provision upholds the right to privacy and complies with relevant human rights obligations. The Department of Veterans’ Affairs obtains consent from recipients of VCES and MRCAETS before information about those recipients is shared with Services Australia. This is the way that Services Australia can identify that a person is eligible for dental benefits.

To the extent that these requirements authorise the collection, use or disclosure of personal or health information or may interfere with the right to privacy, such measures are lawful and non-arbitrary. The measure aims to achieve the legitimate objective of ensuring that Services Australia can access information about individuals to determine their eligibility for dental benefits under the Act and to only do so if consent has been provided to the sharing of personal information. 

Conclusion

This Disallowable Legislative Instrument is compatible with human rights. To the extent that section 14 engages the right to privacy it does so for the legitimate objective of promoting better access to health services and to the extent that the right to privacy is limited, this is reasonable, necessary and proportionate in the circumstances. This Disallowable Legislative Instrument also promotes the right to health, the rights of the child and provides access to social security.

Mark Roddam

First Assistant Secretary

Primary Care Division

Department of Health, Disability and Ageing