Oral Health Therapists, Dental Therapists and Hygienists might be confused as to why with independent scope of practice as provided last July they  – unlike prosthetists- do not have access to the provider number that they (presumably) seek.

The term ‘provider number ‘can be tricky to track down in legislation. It is important to know the basis for this (if not the policy) because the provider number which is a creation of Medicare is clearly adopted by other third parties.

There are a number of reasons this curious inconsistency may exist – including administration regulation or some other less transparent policy reason.

Curiously, the the decision as to whether to allocate a provider number seems to be at the discretion of the Chief Executive of Medicare.

The Health Insurance Regulation 4 (2018) defines a provider number as follows:

” provider number ” means a number that:

(a)  is allocated by the Chief Executive Medicare to a medical practitioner, dental practitioner, approved pathology practitioner, optometrist, participating midwife or participating nurse practitioner; and

(b)  identifies the person and a place where the person practises the person’s profession.

The Dental Benefits Rules 2014 provides at section 6 that  “A dental practitioner is not a dental provider in relation to a dental service if the dental practitioner has not been allocated a provider number by the Chief Executive Medicare.

Clearly OHTs, Dental Therapists and Hygienists are dental practitioners. But it can be presumed that presently the Chef Executive Medicare would not allocate them a provider number.

See https://www.servicesaustralia.gov.au/sites/default/files/hw093-2009en-f.pdf