Class Ruling CR 2011/58
Date of effect: 1 July 2010

What this ruling is about: 1. This Ruling sets out the Commissioner's opinion on the way in which the relevant provision(s) identified below apply to the defined class of entities, who take part in the scheme to which this Ruling relates. Relevant provision(s) 2. The relevant provisions dealt with in this Ruling are: All subsequent legislative references in the Ruling are to the GST Act unless otherwise indicated. 3. A reference to a dental prosthetist is a reference to a recognised professional dental prosthetist. Class of entities 4. The class of entities to which this Ruling applies consists of dental prosthetists and dental technicians who are members of the Oral Health Professionals Association (OHPA). Qualifications 5. The Commissioner makes this Ruling based on the precise scheme identified in this Ruling. 6. The class of entities defined in this Ruling may rely on its contents provided the scheme actually carried out is carried out in accordance with the scheme described in paragraphs 10 to 17 of this Ruling. 7. If the scheme actually carried out is materially different from the scheme that is described in this Ruling, then: 8. This work is copyright. Apart from any use as permitted under the Copyright Act 1968 , no part may be reproduced by any process without prior written permission from the Commonwealth. Requests and inquiries concerning reproduction and rights should be addressed to:

Class of entities or scheme: 4. The class of entities to which this Ruling applies consists of dental prosthetists and dental technicians who are members of the Oral Health Professionals Association (OHPA). | Qualifications: 5. The Commissioner makes this Ruling based on the precise scheme identified in this Ruling. 6. The class of entities defined in this Ruling may rely on its contents provided the scheme actually carried out is carried out in accordance with the scheme described in paragraphs 10 to 17 of this Ruling. 7. If the scheme actually carried out is materially different from the scheme that is described in this Ruling, then: 8. This work is copyright. Apart from any use as permitted under the Copyright Act 1968 , no part may be reproduced by any process without prior written permission from the Commonwealth. Requests and inquiries concerning reproduction and rights should be addressed to: 9. This Ruling applies to tax periods commencing on or after 1 July 2010. However, this Ruling will not apply to taxpayers to the extent that it conflicts with the terms of a settlement of a dispute agreed to before the date of issue of this Ruling (see paragraphs 75 and 76 of Taxation Ruling TR 2006/10). 10. The following description of the scheme is based on information provided by the applicant. 11. Members of the OHPA consist of dental prosthetists and dental technicians. 12. The dental prosthetists supply their services to patients and to business entities such as other dental practices, dental hospitals and laboratories. 13. Dental technicians do not provide their services directly to patients. They are restricted by the relevant State or Territory legislation from doing so. They only make supplies to other business entities such as dentists, prosthetists and other laboratories. 14. The dental prosthetists and technicians also supply customised toothbrushes for people with disabilities, dentures and artificial teeth, and mandibular advancement splints. These products are listed as medical aids and appliances in Schedule 3 to the GST Act. 15. The supplies made by the dental prosthetists and technicians also include specifically designed spare parts for the medical aids and appliances and repairs and modifications to the medical aids and appliances. 16. There are occasions when the supplies are paid for by someone other than the patient. 17. The common terminology used for goods and services in the dental industry and their meaning is from the Australian Schedule of Dental Services and Glossary which is published by the Australian Dental Association (ADA). 18. This Ruling addresses the goods and services tax (GST) consequences of the supply of goods and services by dental prosthetists and dental technicians. | Supplies of services to patients: 19. Supplies of dental services by a dental prosthetist to a patient, that is generally accepted in the dental profession as being necessary for the appropriate treatment of that patient, is GST-free under subsection 38-10(1) (see paragraphs 35 to 51 of this Class Ruling). | Supplies of goods to patients (goods other than medical aids and appliances covered by Schedule 3 to the GST Act): 20. Supplies of goods to a patient in the course of supplying that patient a GST-free dental service (including a dental prosthetist service) under subsection 38-10(1) is also GST-free under subsection 38-10(3) if the supply is made at the premises at which the GST-free service is supplied (see paragraphs 61 to 63 of this Class Ruling). | Supplies of services to third parties: 21. Supplies of dental services by a dental prosthetist to a third party (that is a person or a business that is not the patient) are not GST-free under subsection 38-10(1) as they are not for the appropriate treatment of the patient. They will be making a supply to a third party where the third party, rather than the patient, has contracted them for the supply (see paragraphs 49 to 51 and 53 to 60 of this Class Ruling). | Supplies made by dental technicians under section 38-10: 22. Supplies made by dental technicians are not GST-free under section 38-10. Dental technicians are restricted by the relevant State or Territory legislation from providing services directly to patients. As such, they only make supplies to other business entities and those supplies would not be the appropriate treatment of the recipient of the supply, that is, a patient as is required by paragraph 38-10(1)(c) ( see paragraphs 49 to 51 of this Class Ruling). | Supplies of medical aids and appliances used in the dental industry: 23. Supplies of 'customised toothbrushes for people with disabilities', 'dentures and artificial teeth', and 'mandibular advancement splints' are GST-free under subsection 38-45(1) at all points in the supply chain. Things made or consumed in the process of constructing and supplying one of these items form part of the one overall GST-free supply of that item, even if the components are itemised separately on the bill (see paragraphs 64 to 75 of this Class Ruling). | Supplies of specifically designed spare parts for medical aids and appliances: 24. The supply of a specifically designed spare part for a GST-free medical aid or appliance ('customised toothbrushes for people with disabilities', 'dentures and artificial teeth', and 'mandibular advancement splints') is GST-free under subsection 38-45(2). This will include labour services where it is merely incidental to the supply of the specifically designed spare part. 25. However, specifically designed spare parts will not be GST-free where they are merely incidental to a supply of labour services. 26. If the specifically designed spare part or the labour is not incidental to the other, the specifically designed spare part will be GST-free and the labour services will be taxable (see paragraphs 76 to 90 of this Class Ruling). 27. Generic spare parts that are not specifically designed for a GST-free medical aid or appliance are not GST-free. They are treated in the same way as labour services (see ATO ID 2001/216). | Supplies of repairs of medical aids and appliances: 28. A repair of a medical aid or appliance is only GST-free where it is the supply of specifically designed spare parts for a GST-free medical aid or appliance (see paragraphs 80 to 90 of this Class Ruling). | Supplies of modifications of medical aids and appliances: 29. The supply by a dental prosthetist to a patient of a modification to a denture or other appliance undertaken for the changing condition of the patient is GST-free under subsection 38-10(1) (see paragraph 47 of this Class Ruling). 30. The supply of a modification to a denture by a dental technician is only GST-free to the extent that a specifically designed spare part would be GST-free under subsection 38-45(2) (see paragraphs 76 to 90 of this Class Ruling). Commissioner of Taxation 15 June 2011 31. Under the GST Act, some goods and services supplied by dental prosthetists and dental technicians are GST-free where certain requirements are satisfied. Supplies that do not satisfy the GST-free requirements will be taxable, provided the suppliers are registered or required to be registered for GST. | Taxable supplies - section 9-5: 32. Under section 9-5, an entity makes a taxable supply if: 33. However, section 9-5 also provides that a supply is not taxable to the extent that it is GST-free or input taxed. 34. For the purposes of this ruling, the provisions of the GST Act dealing with input taxed supplies are not relevant to any supplies made in the dental industry. The relevant provisions of the GST Act to be considered are those that relate to GST-free supplies. | Category 1: Dental services and goods supplied together by recognised professionals to patients - section 38-10: Dental services - subsection 38-10(1) 35. Subsection 38-10(1) states that a supply is GST-free if: 36. All three of the requirements must be satisfied for a supply of professional services together with goods to be GST-free under this category. Paragraph 38-10(1)(a) Are dental services specified in the table or the regulations? 37. 'Dental' is a service specified at item 6 in the table in subsection 38-10(1). Paragraph 38-10(1)(b) Who is a recognised professional in relation to the supply of dental services? 38. Under section 195-1, a person is a recognised professional, in relation to the supply of a service of a kind specified in the table in subsection 38-10(1), if: 39. Dental prosthetists and dental technicians who are required to be registered pursuant to relevant State or Territory legislation are considered to be a 'recognised professional' in dental services pursuant to paragraph (a) above. Paragraph 38-10(1)(c) (See Issue 2.a. Section 38-10 Other health services of the Health Industry Partnership - issues register.) [1] 40. To satisfy this final requirement, the service must generally be accepted in the profession associated with supplying services of that kind (in this case, the dental profession) as being necessary for the appropriate treatment of the recipient of the supply. What is 'appropriate treatment'? 41. A dental prosthetist will provide 'appropriate treatment' to the patient where they assess the patient's state of health and determine a process to pursue in an attempt to preserve, restore or improve the physical or psychological wellbeing of that patient and includes subsequent supplies for that assessed process. 42. 'Appropriate treatment' also includes preventative medicine, for example, a periodic oral examination where there is no evidence of an ailment prior to attendance. However, this does not extend to the supply of services and goods in relation to customised mouthguards. Whilst a customised mouthguard is a device that may prevent or reduce damage sustained to the mouth and teeth in the event of an injury, it is not considered to be 'treatment' that is performed on a patient. 43. To be GST-free, the dental profession must accept that the service is necessary and acceptable treatment, taking into account the patient's individual circumstances. 44. Services provided in assessing a patient for insurance or litigation purposes, that is, medico-legal services, are not 'necessary for the appropriate treatment' of the patient and are not GST-free. 45. Services which are predominantly for the improvement of the appearance of the patient are also not 'necessary for the appropriate treatment' of the patient and therefore, are not GST-free. 46. Services that are intended to improve the health of the patient but which also comprise a 'cosmetic' component, for example, reconstruction of a badly damaged tooth, are 'necessary for the appropriate treatment' of the patient and are therefore usually GST-free. 47. A modification to a denture or other appliance undertaken for the changing condition of the patient is appropriate treatment of that patient and is GST-free where supplied by a dental prosthetist to a patient. The 'changing condition of the patient' will include situations such as: 48. Services in relation to determining that the repair is required and a subsequent service to ensure that the denture fits correctly will also be GST-free where the elements of section 38-10 are satisfied. Who is the 'recipient of the supply'? 49. For a supply of professional services together with goods to be GST-free under this category, paragraph 38-10(1)(c) requires that the supply must generally be accepted in the profession associated with supplying services of that kind as being 'necessary for the appropriate treatment of the recipient of the supply'. 50. Section 195-1 of the GST Act defines 'recipient' in relation to a supply, to mean 'the entity to which the supply was made'. 51. Where a supply is made to another business or organisation, such as another dental prosthetist, or to other parties such as a government department or insurance company, they will not be receiving 'appropriate treatment'. This means that such supplies are not GST-free under this category. The only entity who can be in receipt of 'appropriate treatment' is the patient and only those supplies that are made to patients can be GST-free under this category. Why doesn't this category apply to dental technicians? 52. Dental technicians are restricted by the relevant State or Territory legislation from providing services directly to patients. They only make supplies to other business entities, such as dentists, dental prosthetists or other laboratories. As only supplies made to patients are GST-free under this category, supplies made by dental technicians will not be GST-free under this category. Are the supplies being made to someone else who is not the patient? 53. Some arrangements involve the dental prosthetist, the patient and other people or businesses such as other dental practices, dental hospitals, insurers, government departments or employers. These other people are known as third parties. In determining whether a dental prosthetist has made a supply to a third party, it is necessary to consider the character of each arrangement. 54. It is the Australian Taxation Office's view that a dental prosthetist will be making a supply to a third party if they have entered into a binding obligation, for example, a contract, under which the dental prosthetist is required to provide something to the third party or to the patient for which the third party is required to pay the dental prosthetist. In other words, who has the dental prosthetist contracted with for that supply, the third party or the patient? If it is the third party, that third party is the recipient of the dental prosthetist's supply. 55. Any supply that a dental prosthetist makes to a third party is not a GST-free supply of dental services under subsection 38-10(1). The supply will be taxable where the requirements of section 9-5 are met. What about supplies paid for by someone else other than the patient? 56. If an arrangement does not create a binding obligation between the dental prosthetist and the third party, the dental prosthetist will not be making a supply to that third party. That is, if the dental prosthetist has not contracted with the third party but instead has contracted with the patient, the patient will be the recipient of the dental prosthetist's supply. In this scenario, the dental prosthetist is only making one supply of dental services to the patient and the third party is paying on that patient's behalf. The supply of services to the patient will be GST-free under subsection 38-10(1) where all the requirements of that subsection are met.

Ruling: 18. This Ruling addresses the goods and services tax (GST) consequences of the supply of goods and services by dental prosthetists and dental technicians. | Supplies of services to patients: 19. Supplies of dental services by a dental prosthetist to a patient, that is generally accepted in the dental profession as being necessary for the appropriate treatment of that patient, is GST-free under subsection 38-10(1) (see paragraphs 35 to 51 of this Class Ruling). | Supplies of goods to patients (goods other than medical aids and appliances covered by Schedule 3 to the GST Act): 20. Supplies of goods to a patient in the course of supplying that patient a GST-free dental service (including a dental prosthetist service) under subsection 38-10(1) is also GST-free under subsection 38-10(3) if the supply is made at the premises at which the GST-free service is supplied (see paragraphs 61 to 63 of this Class Ruling). | Supplies of services to third parties: 21. Supplies of dental services by a dental prosthetist to a third party (that is a person or a business that is not the patient) are not GST-free under subsection 38-10(1) as they are not for the appropriate treatment of the patient. They will be making a supply to a third party where the third party, rather than the patient, has contracted them for the supply (see paragraphs 49 to 51 and 53 to 60 of this Class Ruling). | Supplies made by dental technicians under section 38-10: 22. Supplies made by dental technicians are not GST-free under section 38-10. Dental technicians are restricted by the relevant State or Territory legislation from providing services directly to patients. As such, they only make supplies to other business entities and those supplies would not be the appropriate treatment of the recipient of the supply, that is, a patient as is required by paragraph 38-10(1)(c) ( see paragraphs 49 to 51 of this Class Ruling). | Supplies of medical aids and appliances used in the dental industry: 23. Supplies of 'customised toothbrushes for people with disabilities', 'dentures and artificial teeth', and 'mandibular advancement splints' are GST-free under subsection 38-45(1) at all points in the supply chain. Things made or consumed in the process of constructing and supplying one of these items form part of the one overall GST-free supply of that item, even if the components are itemised separately on the bill (see paragraphs 64 to 75 of this Class Ruling). | Supplies of specifically designed spare parts for medical aids and appliances: 24. The supply of a specifically designed spare part for a GST-free medical aid or appliance ('customised toothbrushes for people with disabilities', 'dentures and artificial teeth', and 'mandibular advancement splints') is GST-free under subsection 38-45(2). This will include labour services where it is merely incidental to the supply of the specifically designed spare part. 25. However, specifically designed spare parts will not be GST-free where they are merely incidental to a supply of labour services. 26. If the specifically designed spare part or the labour is not incidental to the other, the specifically designed spare part will be GST-free and the labour services will be taxable (see paragraphs 76 to 90 of this Class Ruling). 27. Generic spare parts that are not specifically designed for a GST-free medical aid or appliance are not GST-free. They are treated in the same way as labour services (see ATO ID 2001/216). | Supplies of repairs of medical aids and appliances: 28. A repair of a medical aid or appliance is only GST-free where it is the supply of specifically designed spare parts for a GST-free medical aid or appliance (see paragraphs 80 to 90 of this Class Ruling). | Supplies of modifications of medical aids and appliances: 29. The supply by a dental prosthetist to a patient of a modification to a denture or other appliance undertaken for the changing condition of the patient is GST-free under subsection 38-10(1) (see paragraph 47 of this Class Ruling). 30. The supply of a modification to a denture by a dental technician is only GST-free to the extent that a specifically designed spare part would be GST-free under subsection 38-45(2) (see paragraphs 76 to 90 of this Class Ruling). Commissioner of Taxation 15 June 2011

Examples: Example 1: third party paying on a patient's behalf 57. Susie is a dental prosthetist. Andrew makes an appointment to see Susie to have his dentures repaired. At the initial consultation, Andrew tells Susie that he sustained the damage to his tooth whilst at work and that she can bill his employer for her costs. Susie confirms with Andrew's employer that she can send the bill to them. 58. Susie is making a GST-free supply to Andrew. That GST-free supply is paid for by Andrew's employer. Susie is not making any supply to Andrew's employer - they are merely paying the bill on Andrew's behalf. The fact that another entity is paying for a service does not alter its GST-free status. | Example 2: taxable supply to a third party 59. Susie is contracted by a Government agency to provide denture repair services to a certain group of people in her local community under the Government's dental health care program. Before providing any services, Susie enters into a written agreement with the Government agency which requires Susie to provide the denture repair services and specifies the amount that she will receive from the Government agency in return for those services. The agreement creates a binding obligation on Susie to perform the services and creates a binding obligation on the Government agency to pay. Under the agreement, any services Susie provides to patients beyond what is specified in the agreement must be paid for by the patients themselves. The Government agency then advises people under that scheme that they must go to Susie for their free denture repairs. 60. Susie is making a taxable supply to the Government agency. Any services that she is asked by the patient to perform but which are not covered by the agreement with the Government agency are supplies by Susie to the patient which may be GST-free. Dental goods - subsection 38-10(3) 61. Dental prosthetists who are making GST-free supplies of dental services under subsection 38-10(1) are also capable of supplying GST-free goods together with those services under subsection 38-10(3). 62. If a dental prosthetist supplies goods as part of a GST-free dental service, those goods are also GST-free if they are supplied to the patient in the course of supplying a dental service and the supply is made at the premises at which the service is supplied. 63. The phrase 'in the course of supplying' means that the goods are supplied at the same time as the dental service and they are: Category 2: Certain medical aids and appliances and their specifically designed spare parts - section 38-45 Medical aids and appliances - subsection 38-45(1) 64. Subsection 38-45(1) states: 65. A supply that satisfies all the requirements in subsection 38-45(1) will be GST-free at all points in the supply chain. The supply remains GST-free no matter who supplies it or who the supply is made to. 66. In determining whether a medical aid and appliance is specifically designed for people with an illness or disability, reference should be made to the designer's/manufacturer's intention of how the good is to be used and its features. Indicators of the designer's/manufacturer's intention of how a good is to be used include how the good is marketed and the type of retail outlets at which the goods can be purchased (see Issue 1.c of the GST Pharmaceutical Health Forum - Issues Register.) [2] 67. In determining whether a medical aid or appliance is used by people without an illness or disability, reference should be made to how the wider community uses these goods. That is, the common purpose for which the goods are purchased. Subsection 38-45(1) does not require the GST treatment of a medical aid or appliance to be determined by reference to the actual use for which an item is being purchased but rather focuses on the purpose for which the wider community purchases these products. Accordingly, irregular and uncommon use of a medical aid or appliance in a way contrary to its manufactured purpose will not prevent the good from being GST-free (see Issue 1.d of the GST Pharmaceutical Health Forum - Issues Register). [3] 68. The items in the table in Schedule 3 that are of relevance to the dental industry are: 69. For GST purposes, 'customised toothbrushes for people with disabilities' are considered to be toothbrushes that have been adapted, for example, contoured, to suit the needs of a class of disabled persons. 70. 'Dentures', for GST purposes, are considered to be an artificial restoration of several teeth (partial denture) or of all of the teeth of either jaw (full denture). 'Artificial teeth' are considered to be those which are fabricated and replace natural teeth in form and function. The phrase 'artificial teeth' includes one single tooth as well as a multiple of teeth. Full crowns and bridges are artificial teeth. 71. A 'mandibular advancement splint' is a small device made of plastic or similar material that is worn in the mouth whilst sleeping (similar in appearance to a mouthguard). It is designed to help or assist to stop some types of snoring. The splint is designed to push the mandible (lower jaw) forward helping to keep the tongue clear of the pharynx (the back of the throat). The splints are also sometimes used for the treatment of temporomandibular joint disorder (TMJ). Consumables 72. Where, in the course of supplying one of the products listed at item 29, item 30 or item 75 in the table in Schedule 3 to the GST Act, a dental prosthetist or dental technician consumes various other things, there is only one overall supply of the listed product. Things made and consumed in the process of constructing and supplying a listed product form part of the one overall GST-free supply of that product, even if the components are separately itemised in the bill. 73. Examples of things consumed in the process of constructing and supplying a GST-free medical aid or appliance include oil, lubricant, glue and generic parts like screws and wires. Consumable items are acquired with the intention that they will be destroyed, consumed or expended. They do not retain their individual character or nature when a new medical aid or appliance is supplied or when a repaired medical aid or appliance is returned to its owner. | Example 3: goods used/consumed in the process of constructing and/or supplying a GST-free medical aid or appliance 74. David (a dental technician) is contracted by Owen (a dentist) to make a crown for Owen's patient. In order to make the crown, David must first create a plaster model. David itemises the crown and plaster model separately on his bill to Owen. The plaster model is integral to the manufacturing process and is not used for any other purpose. The plaster model forms part of the overall supply of the crown, all of which is GST-free. Goods made and consumed in the process of constructing and supplying a GST-free medical aid or appliance form part of the overall GST-free supply of that item. 75. However, where these things are supplied separately to the medical aid or appliance, for example, in the course of a repair service or as spare parts themselves, they will only be GST-free if they are specifically designed spare parts of that medical aid or appliance. Generic spare parts which do not form part of the initial GST-free supply of the aid or appliance but which are supplied separately on their own will not be GST-free. Spare parts for GST-free medical aids and appliances - subsection 38-45(2) 76. Under subsection 38-45(2), a spare part for a GST-free medical aid or appliance is also GST-free if it is specifically designed as a spare part for a GST-free medical aid or appliance and is supplied for that purpose. 77. For GST purposes, a 'spare part' is a part that can be used to replace a faulty, worn or broken part of another thing. To be GST-free, the part need only be capable of replacing the faulty, worn or broken part. It does not actually have to be used for that purpose. 78. Spare parts that are not specifically designed to replace a faulty, worn or broken part of a GST-free medical aid or appliance are not GST-free. This means that things like generic screws which are not specifically designed for a GST-free medical aid or appliance are not GST-free spare parts. However, as explained in paragraphs 66 to 69, things used and/or consumed in the construction and overall supply of a GST-free medical aid or appliance are part of that overall GST-free supply. Therefore, whilst a generic screw when supplied on its own is not a GST-free spare part for a denture because it is not specifically designed for that purpose, would be GST-free if that screw formed part of the initial supply of the denture. | Example 4: a part that cannot be used as a spare part for a GST-free medical aid or appliance 79. A chrome/cobalt casting frame is the internal framework for a denture. Dentures are covered by item 30 in the table in Schedule 3 to the GST Act and are GST-free. Whilst the framework is a component for a denture, it is not a 'spare-part' for a denture. This is because if the framework is broken, it is either repaired or a completely new denture is supplied. A new framework is never actually supplied to replace a faulty, worn or broken framework or the denture. Therefore, it is not a GST-free spare part. Repair services 80. There is no specific exemption in the GST Act for the supply of any labour services relating to the installation, fitting or repair of medical aids or appliances or their spare parts. 81. However, where the specifically designed spare parts are supplied together with a labour service component as part of one single transaction, the GST treatment of that transaction will depend on how the supply is characterised. What does integral, ancillary or incidental mean? 82. Some indicators that something may be integral, ancillary or incidental to another thing are: 83. Therefore, a part of a supply will be integral, ancillary or incidental to another part of the supply where it is insignificant in value or function, or merely complements the dominant part of the supply. | Example 5: GST-free supply of spare parts to which labour services are integral, ancillary or incidental 84. A tooth is added to a denture to replace a broken or missing tooth under a 'supply and fit' contract. The fitting of the tooth will be integral, ancillary or incidental to the supply of the tooth itself. The whole supply is GST-free as the supply of an 'artificial tooth'. See Type A in the table in paragraph 81. | Example 6: taxable supply of labour services to which the spare parts are integral, ancillary or incidental 85. A denture is in poor condition and is sent to be restored which involves a significant amount of labour services. As part of that restoration, a clasp is replaced. Of itself, the clasp is a GST-free spare part for a denture. However, in this case, the supply of the clasp is integral, ancillary or incidental to the supply of the restoration service. The supply of the clasp merely contributes to the proper performance of the contract to restore the denture, takes up a marginal proportion of the total value of the service package, and the customer does not seek the supply of the clasp as an aim in itself, but merely as part of the supply of the restoration service. The whole supply is taxable. See Type B in the table in paragraph 81. | Example 7: GST-free supply of spare parts and taxable supply of labour services as neither is integral, ancillary or incidental 86. A tooth is added to a denture to replace a broken or missing tooth under a 'supply and fit' contract. At the same time, the technician discovers a small crack in the denture base and repairs this also. An extra or increased charge is made for the repair of the crack. The supply of the service of repairing the crack is taxable. The supply of the fitted tooth is a separately identifiable supply in which the fitting of the tooth is integral, incidental or ancillary to the GST-free supply of the tooth itself. The supply is partly taxable and partly GST-free. See Type C in the table in paragraph 81. Apportionment A supply that is partly taxable and partly GST-free 87. When a dental prosthetist or dental technician makes a supply which is partly taxable and partly GST-free (a mixed supply), they will need to apportion the consideration charged for the supply between the GST-free and taxable parts pursuant to section 9-80. 88. A reasonable basis for apportionment must be used and each case must be determined on its own facts. Records must be kept that explain the method of apportionment used. Goods and Services Tax Ruling GSTR 2001/8: apportioning the consideration for a supply that includes taxable and non-taxable parts gives further guidance on mixed supplies and apportionment. Charging GST on a GST-free medical aid or appliance or a specifically designed spare part 89. In some circumstances, it may be difficult to determine those parts of a supply that are GST-free and those parts that are taxable or it may be difficult to work out those supplies that are GST-free and those that are taxable. 90. Subsection 38-45(3) allows a supplier and recipient to agree not to treat supplies, or a particular supply, as GST-free. In other words, where a supply is made to another business, both businesses can agree to treat the supply as taxable. This reduces the administrative burden while allowing the other business to claim a GST credit. 91. The following is a detailed contents list for this Ruling: Flowchart: Supplies by Dental Technicians GST STATUS OF SUPPLIES BY DENTAL TECHNICIANS AND DENTAL PROSTHETISTS The item numbers and descriptions used are those used by the Australian Dental Association and its members as a common point of reference for supplies made by technicians. It is acknowledged that these item numbers and descriptions are specific to dentists and dental prosthetists and include a number of supplies (particularly those described as 'direct') that are not made by technicians because they do not perform any work directly in the patient's mouth. Industry has advised us of those items from the ADA's Australian Schedule of Dental Services and Glossary which are relevant to technicians and prosthetists respectively. It is acknowledged that the item description is written from the perspective of the dentist or dental prosthetist and as such, ask that technicians read and interpret the item description by reference to the part that a technician would play in delivering that service. NOTE: 'indirect' = work done outside the patient's mouth and 'direct' = work done inside the patient's mouth Notes to the GST Schedule of Supplies by Dental Technicians and Dental Prosthetists For dental prosthetists, refer also to the detailed explanation regarding what is 'necessary for the appropriate treatment of the patient'. For dental prosthetists, refer also to the detailed explanation regarding what is 'necessary for the appropriate treatment of the patient'. Not previously issued as a draft

Appendix: 31. Under the GST Act, some goods and services supplied by dental prosthetists and dental technicians are GST-free where certain requirements are satisfied. Supplies that do not satisfy the GST-free requirements will be taxable, provided the suppliers are registered or required to be registered for GST. | Taxable supplies - section 9-5: 32. Under section 9-5, an entity makes a taxable supply if: 33. However, section 9-5 also provides that a supply is not taxable to the extent that it is GST-free or input taxed. 34. For the purposes of this ruling, the provisions of the GST Act dealing with input taxed supplies are not relevant to any supplies made in the dental industry. The relevant provisions of the GST Act to be considered are those that relate to GST-free supplies. | Category 1: Dental services and goods supplied together by recognised professionals to patients - section 38-10: Dental services - subsection 38-10(1) 35. Subsection 38-10(1) states that a supply is GST-free if: 36. All three of the requirements must be satisfied for a supply of professional services together with goods to be GST-free under this category. Paragraph 38-10(1)(a) Are dental services specified in the table or the regulations? 37. 'Dental' is a service specified at item 6 in the table in subsection 38-10(1). Paragraph 38-10(1)(b) Who is a recognised professional in relation to the supply of dental services? 38. Under section 195-1, a person is a recognised professional, in relation to the supply of a service of a kind specified in the table in subsection 38-10(1), if: 39. Dental prosthetists and dental technicians who are required to be registered pursuant to relevant State or Territory legislation are considered to be a 'recognised professional' in dental services pursuant to paragraph (a) above. Paragraph 38-10(1)(c) (See Issue 2.a. Section 38-10 Other health services of the Health Industry Partnership - issues register.) [1] 40. To satisfy this final requirement, the service must generally be accepted in the profession associated with supplying services of that kind (in this case, the dental profession) as being necessary for the appropriate treatment of the recipient of the supply. What is 'appropriate treatment'? 41. A dental prosthetist will provide 'appropriate treatment' to the patient where they assess the patient's state of health and determine a process to pursue in an attempt to preserve, restore or improve the physical or psychological wellbeing of that patient and includes subsequent supplies for that assessed process. 42. 'Appropriate treatment' also includes preventative medicine, for example, a periodic oral examination where there is no evidence of an ailment prior to attendance. However, this does not extend to the supply of services and goods in relation to customised mouthguards. Whilst a customised mouthguard is a device that may prevent or reduce damage sustained to the mouth and teeth in the event of an injury, it is not considered to be 'treatment' that is performed on a patient. 43. To be GST-free, the dental profession must accept that the service is necessary and acceptable treatment, taking into account the patient's individual circumstances. 44. Services provided in assessing a patient for insurance or litigation purposes, that is, medico-legal services, are not 'necessary for the appropriate treatment' of the patient and are not GST-free. 45. Services which are predominantly for the improvement of the appearance of the patient are also not 'necessary for the appropriate treatment' of the patient and therefore, are not GST-free. 46. Services that are intended to improve the health of the patient but which also comprise a 'cosmetic' component, for example, reconstruction of a badly damaged tooth, are 'necessary for the appropriate treatment' of the patient and are therefore usually GST-free. 47. A modification to a denture or other appliance undertaken for the changing condition of the patient is appropriate treatment of that patient and is GST-free where supplied by a dental prosthetist to a patient. The 'changing condition of the patient' will include situations such as: 48. Services in relation to determining that the repair is required and a subsequent service to ensure that the denture fits correctly will also be GST-free where the elements of section 38-10 are satisfied. Who is the 'recipient of the supply'? 49. For a supply of professional services together with goods to be GST-free under this category, paragraph 38-10(1)(c) requires that the supply must generally be accepted in the profession associated with supplying services of that kind as being 'necessary for the appropriate treatment of the recipient of the supply'. 50. Section 195-1 of the GST Act defines 'recipient' in relation to a supply, to mean 'the entity to which the supply was made'. 51. Where a supply is made to another business or organisation, such as another dental prosthetist, or to other parties such as a government department or insurance company, they will not be receiving 'appropriate treatment'. This means that such supplies are not GST-free under this category. The only entity who can be in receipt of 'appropriate treatment' is the patient and only those supplies that are made to patients can be GST-free under this category. Why doesn't this category apply to dental technicians? 52. Dental technicians are restricted by the relevant State or Territory legislation from providing services directly to patients. They only make supplies to other business entities, such as dentists, dental prosthetists or other laboratories. As only supplies made to patients are GST-free under this category, supplies made by dental technicians will not be GST-free under this category. Are the supplies being made to someone else who is not the patient? 53. Some arrangements involve the dental prosthetist, the patient and other people or businesses such as other dental practices, dental hospitals, insurers, government departments or employers. These other people are known as third parties. In determining whether a dental prosthetist has made a supply to a third party, it is necessary to consider the character of each arrangement. 54. It is the Australian Taxation Office's view that a dental prosthetist will be making a supply to a third party if they have entered into a binding obligation, for example, a contract, under which the dental prosthetist is required to provide something to the third party or to the patient for which the third party is required to pay the dental prosthetist. In other words, who has the dental prosthetist contracted with for that supply, the third party or the patient? If it is the third party, that third party is the recipient of the dental prosthetist's supply. 55. Any supply that a dental prosthetist makes to a third party is not a GST-free supply of dental services under subsection 38-10(1). The supply will be taxable where the requirements of section 9-5 are met. What about supplies paid for by someone else other than the patient? 56. If an arrangement does not create a binding obligation between the dental prosthetist and the third party, the dental prosthetist will not be making a supply to that third party. That is, if the dental prosthetist has not contracted with the third party but instead has contracted with the patient, the patient will be the recipient of the dental prosthetist's supply. In this scenario, the dental prosthetist is only making one supply of dental services to the patient and the third party is paying on that patient's behalf. The supply of services to the patient will be GST-free under subsection 38-10(1) where all the requirements of that subsection are met. | Example 1 - third party paying on a patient's behalf: 57. Susie is a dental prosthetist. Andrew makes an appointment to see Susie to have his dentures repaired. At the initial consultation, Andrew tells Susie that he sustained the damage to his tooth whilst at work and that she can bill his employer for her costs. Susie confirms with Andrew's employer that she can send the bill to them. 58. Susie is making a GST-free supply to Andrew. That GST-free supply is paid for by Andrew's employer. Susie is not making any supply to Andrew's employer - they are merely paying the bill on Andrew's behalf. The fact that another entity is paying for a service does not alter its GST-free status. | Example 2 - taxable supply to a third party: 59. Susie is contracted by a Government agency to provide denture repair services to a certain group of people in her local community under the Government's dental health care program. Before providing any services, Susie enters into a written agreement with the Government agency which requires Susie to provide the denture repair services and specifies the amount that she will receive from the Government agency in return for those services. The agreement creates a binding obligation on Susie to perform the services and creates a binding obligation on the Government agency to pay. Under the agreement, any services Susie provides to patients beyond what is specified in the agreement must be paid for by the patients themselves. The Government agency then advises people under that scheme that they must go to Susie for their free denture repairs. 60. Susie is making a taxable supply to the Government agency. Any services that she is asked by the patient to perform but which are not covered by the agreement with the Government agency are supplies by Susie to the patient which may be GST-free. | Dental goods - subsection 38-10(3): 61. Dental prosthetists who are making GST-free supplies of dental services under subsection 38-10(1) are also capable of supplying GST-free goods together with those services under subsection 38-10(3). 62. If a dental prosthetist supplies goods as part of a GST-free dental service, those goods are also GST-free if they are supplied to the patient in the course of supplying a dental service and the supply is made at the premises at which the service is supplied. 63. The phrase 'in the course of supplying' means that the goods are supplied at the same time as the dental service and they are: | Category 2: Certain medical aids and appliances and their specifically designed spare parts - section 38-45: Medical aids and appliances - subsection 38-45(1) 64. Subsection 38-45(1) states: 65. A supply that satisfies all the requirements in subsection 38-45(1) will be GST-free at all points in the supply chain. The supply remains GST-free no matter who supplies it or who the supply is made to. 66. In determining whether a medical aid and appliance is specifically designed for people with an illness or disability, reference should be made to the designer's/manufacturer's intention of how the good is to be used and its features. Indicators of the designer's/manufacturer's intention of how a good is to be used include how the good is marketed and the type of retail outlets at which the goods can be purchased (see Issue 1.c of the GST Pharmaceutical Health Forum - Issues Register.) [2] 67. In determining whether a medical aid or appliance is used by people without an illness or disability, reference should be made to how the wider community uses these goods. That is, the common purpose for which the goods are purchased. Subsection 38-45(1) does not require the GST treatment of a medical aid or appliance to be determined by reference to the actual use for which an item is being purchased but rather focuses on the purpose for which the wider community purchases these products. Accordingly, irregular and uncommon use of a medical aid or appliance in a way contrary to its manufactured purpose will not prevent the good from being GST-free (see Issue 1.d of the GST Pharmaceutical Health Forum - Issues Register). [3] 68. The items in the table in Schedule 3 that are of relevance to the dental industry are: 69. For GST purposes, 'customised toothbrushes for people with disabilities' are considered to be toothbrushes that have been adapted, for example, contoured, to suit the needs of a class of disabled persons. 70. 'Dentures', for GST purposes, are considered to be an artificial restoration of several teeth (partial denture) or of all of the teeth of either jaw (full denture). 'Artificial teeth' are considered to be those which are fabricated and replace natural teeth in form and function. The phrase 'artificial teeth' includes one single tooth as well as a multiple of teeth. Full crowns and bridges are artificial teeth. 71. A 'mandibular advancement splint' is a small device made of plastic or similar material that is worn in the mouth whilst sleeping (similar in appearance to a mouthguard). It is designed to help or assist to stop some types of snoring. The splint is designed to push the mandible (lower jaw) forward helping to keep the tongue clear of the pharynx (the back of the throat). The splints are also sometimes used for the treatment of temporomandibular joint disorder (TMJ). | Consumables: 72. Where, in the course of supplying one of the products listed at item 29, item 30 or item 75 in the table in Schedule 3 to the GST Act, a dental prosthetist or dental technician consumes various other things, there is only one overall supply of the listed product. Things made and consumed in the process of constructing and supplying a listed product form part of the one overall GST-free supply of that product, even if the components are separately itemised in the bill. 73. Examples of things consumed in the process of constructing and supplying a GST-free medical aid or appliance include oil, lubricant, glue and generic parts like screws and wires. Consumable items are acquired with the intention that they will be destroyed, consumed or expended. They do not retain their individual character or nature when a new medical aid or appliance is supplied or when a repaired medical aid or appliance is returned to its owner. | Example 3 - goods used/consumed in the process of constructing and/or supplying a GST-free medical aid or appliance: 74. David (a dental technician) is contracted by Owen (a dentist) to make a crown for Owen's patient. In order to make the crown, David must first create a plaster model. David itemises the crown and plaster model separately on his bill to Owen. The plaster model is integral to the manufacturing process and is not used for any other purpose. The plaster model forms part of the overall supply of the crown, all of which is GST-free. Goods made and consumed in the process of constructing and supplying a GST-free medical aid or appliance form part of the overall GST-free supply of that item. 75. However, where these things are supplied separately to the medical aid or appliance, for example, in the course of a repair service or as spare parts themselves, they will only be GST-free if they are specifically designed spare parts of that medical aid or appliance. Generic spare parts which do not form part of the initial GST-free supply of the aid or appliance but which are supplied separately on their own will not be GST-free. | Spare parts for GST-free medical aids and appliances - subsection 38-45(2): 76. Under subsection 38-45(2), a spare part for a GST-free medical aid or appliance is also GST-free if it is specifically designed as a spare part for a GST-free medical aid or appliance and is supplied for that purpose. 77. For GST purposes, a 'spare part' is a part that can be used to replace a faulty, worn or broken part of another thing. To be GST-free, the part need only be capable of replacing the faulty, worn or broken part. It does not actually have to be used for that purpose. 78. Spare parts that are not specifically designed to replace a faulty, worn or broken part of a GST-free medical aid or appliance are not GST-free. This means that things like generic screws which are not specifically designed for a GST-free medical aid or appliance are not GST-free spare parts. However, as explained in paragraphs 66 to 69, things used and/or consumed in the construction and overall supply of a GST-free medical aid or appliance are part of that overall GST-free supply. Therefore, whilst a generic screw when supplied on its own is not a GST-free spare part for a denture because it is not specifically designed for that purpose, would be GST-free if that screw formed part of the initial supply of the denture. | Example 4 - a part that cannot be used as a spare part for a GST-free medical aid or appliance: 79. A chrome/cobalt casting frame is the internal framework for a denture. Dentures are covered by item 30 in the table in Schedule 3 to the GST Act and are GST-free. Whilst the framework is a component for a denture, it is not a 'spare-part' for a denture. This is because if the framework is broken, it is either repaired or a completely new denture is supplied. A new framework is never actually supplied to replace a faulty, worn or broken framework or the denture. Therefore, it is not a GST-free spare part. | Repair services: 80. There is no specific exemption in the GST Act for the supply of any labour services relating to the installation, fitting or repair of medical aids or appliances or their spare parts. 81. However, where the specifically designed spare parts are supplied together with a labour service component as part of one single transaction, the GST treatment of that transaction will depend on how the supply is characterised. | What does integral, ancillary or incidental mean?: 82. Some indicators that something may be integral, ancillary or incidental to another thing are: 83. Therefore, a part of a supply will be integral, ancillary or incidental to another part of the supply where it is insignificant in value or function, or merely complements the dominant part of the supply. | Example 5 - GST-free supply of spare parts to which labour services are integral, ancillary or incidental: 84. A tooth is added to a denture to replace a broken or missing tooth under a 'supply and fit' contract. The fitting of the tooth will be integral, ancillary or incidental to the supply of the tooth itself. The whole supply is GST-free as the supply of an 'artificial tooth'. See Type A in the table in paragraph 81. | Example 6 - taxable supply of labour services to which the spare parts are integral, ancillary or incidental: 85. A denture is in poor condition and is sent to be restored which involves a significant amount of labour services. As part of that restoration, a clasp is replaced. Of itself, the clasp is a GST-free spare part for a denture. However, in this case, the supply of the clasp is integral, ancillary or incidental to the supply of the restoration service. The supply of the clasp merely contributes to the proper performance of the contract to restore the denture, takes up a marginal proportion of the total value of the service package, and the customer does not seek the supply of the clasp as an aim in itself, but merely as part of the supply of the restoration service. The whole supply is taxable. See Type B in the table in paragraph 81. | Example 7 - GST-free supply of spare parts and taxable supply of labour services as neither is integral, ancillary or incidental: 86. A tooth is added to a denture to replace a broken or missing tooth under a 'supply and fit' contract. At the same time, the technician discovers a small crack in the denture base and repairs this also. An extra or increased charge is made for the repair of the crack. The supply of the service of repairing the crack is taxable. The supply of the fitted tooth is a separately identifiable supply in which the fitting of the tooth is integral, incidental or ancillary to the GST-free supply of the tooth itself. The supply is partly taxable and partly GST-free. See Type C in the table in paragraph 81. | A supply that is partly taxable and partly GST-free: 87. When a dental prosthetist or dental technician makes a supply which is partly taxable and partly GST-free (a mixed supply), they will need to apportion the consideration charged for the supply between the GST-free and taxable parts pursuant to section 9-80. 88. A reasonable basis for apportionment must be used and each case must be determined on its own facts. Records must be kept that explain the method of apportionment used. Goods and Services Tax Ruling GSTR 2001/8: apportioning the consideration for a supply that includes taxable and non-taxable parts gives further guidance on mixed supplies and apportionment. | Charging GST on a GST-free medical aid or appliance or a specifically designed spare part: 89. In some circumstances, it may be difficult to determine those parts of a supply that are GST-free and those parts that are taxable or it may be difficult to work out those supplies that are GST-free and those that are taxable. 90. Subsection 38-45(3) allows a supplier and recipient to agree not to treat supplies, or a particular supply, as GST-free. In other words, where a supply is made to another business, both businesses can agree to treat the supply as taxable. This reduces the administrative burden while allowing the other business to claim a GST credit.


What this Ruling is about | NOT LEGALLY BINDING SECTION: | Attachment B: GST status of supplies by dental technicians and prosthetists | A public ruling is an expression of the Commissioner's opinion about the way in which a relevant provision applies, or would apply, to entities generally or to a class of entities in relation to a particular scheme or a class of schemes. | If you rely on this ruling, the Commissioner must apply the law to you in the way set out in the ruling (unless the Commissioner is satisfied that the ruling is incorrect and disadvantages you, in which case the law may be applied to you in a way that is more favourable for you - provided the Commissioner is not prevented from doing so by a time limit imposed by the law). You will be protected from having to pay any underpaid tax, penalty or interest in respect of the matters covered by this ruling if it turns out that it does not correctly state how the relevant provision applies to you. | What is the character of the supply? | Integral, ancillary or incidental component | A single GST-free supply of specifically designed spare parts | A single taxable supply of labour services | Separately identifiable supplies of spare parts and labour services | Neither is integral, ancillary or incidental to the other | A partly taxable and partly GST-free supply - GST is only payable on the taxable part - use a reasonable basis for apportionment | Supplies made by dental prosthetists under section 38-10 | GST-free supplies: section 38-10 and section 38-45 | Appendix 2 - Detailed contents list | ADA Comprehensive Description | GST Status for technicians | Preventative, Prophylactic and bleaching services | Provision of a mouthguard - indirect | Construction, using a model(s) prepared from an impression(s) of the teeth, and insertion of a mouthguard to protect teeth and the investing tissues in contact sports and hazardous activities. | Bi-maxillary mouthguard - indirect | Construction, using models prepared from impressions of the teeth, and insertion of a bimaxillary mouthguard to protect teeth and their investing tissues in contact sports and hazardous activities. The appliance covers the teeth of both mandibular and maxillary arches. | Restorative Services - when supplied by laboratories | Metallic restoration - one surface | Direct metallic restoration of a cavity involving one surface of a tooth. | Metallic restoration - two surfaces | Direct metallic restoration of a cavity involving two surfaces of a tooth. | Metallic restoration - three surfaces | Direct metal restoration of a cavity involving three surfaces of a tooth. | Metallic restoration - four surfaces | Direct metal restoration of a cavity involving four surfaces of a tooth. | Metallic restoration - five surfaces | Direct metal restoration of a cavity involving five surfaces of a tooth. | Inlay/onlay - metallic - one surface | Insertion of a metallic inlay or only to restore one surface of a tooth. | Inlay/onlay - metallic - two surfaces | Insertion of a metallic inlay or onlay to restore two surfaces of a tooth. | Inlay/onlay - metallic - three or more surfaces | Insertion of a metallic inlay or onlay to restore three or more surfaces of a tooth. | Inlay/onlay - tooth-coloured - one surface | Insertion of a resin-based or porcelain inlay or onlay to restore one surface of a tooth. | Inlay/onlay - tooth-coloured - two surfaces | Insertion of a resin-based or porcelain inlay or onlay to restore two surfaces of a tooth. | Inlay/onlay - tooth-coloured - three or more surfaces | Insertion of a resin-based or porcelain inlay or onlay to restore three or more surfaces of a tooth. | The attachment of a tooth-coloured veneer to the surface of a tooth. The veneer is constructed indirectly. | Direct bonding of a veneer of adhesive tooth-coloured material to the surface of a tooth. | Insertion of a post into a prepared root canal to provide an anchor for an artificial crown or other restoration. | Full crown - acrylic resin - indirect | An artificial crown constructed with an acrylic-based material, restoring a natural tooth or osseointegrated implant. | Full crown - non-metallic - indirect | An artificial crown constructed of tooth-coloured material, restoring a natural tooth or osseointegrated implant. | Full crown - veneered - indirect | An artificial crown constructed with a metallic base veneered with a tooth-coloured material, restoring a natural tooth or osseointegrated implant. | Full crown - metallic - indirect | An artificial crown constructed of cast metal, restoring a natural tooth or osseointegrated implant. | Three-quarter crown - metallic - indirect | An artificial crown constructed of cast metal covering three of the four axial surfaces in addition to the occlusal or incisal surface of a tooth. | Three-quarter crown - non-metallic - indirect | An artificial crown constructed of tooth-coloured material covering three of the four axial surfaces in addition to the occlusal or incisal surface of a tooth. | Post and core for crown - indirect | A post and core fabricated accurately to the dimension of the prepared root canal(s) and the desired coronal anatomy to provide an anchor foundation for an artificial crown. | Post and root cap - indirect | A post and capping fitted to the root of a tooth. The post provides an anchor in the root canal of the tooth and the capping may provide support for an over-denture. It may incorporate a precision or magnetic attachment which should be separately itemised. | Temporary (provisional) crown | Temporary (provisional) restoration of a tooth with a crown which is designed to last until a permanent crown can be constructed or the tooth is removed. This item should only be used where a temporary (provisional) crown is not an intrinsic part of another service. It should not be used for a temporary (provisional) restoration between appointments during crown construction. | Temporary (provisional) bridge - per pontic | Placement of a bridge designed to last until a permanent bridge can be constructed and inserted. The temporary (provisional) restorations of the abutments are itemised separately. This item should only be used where a temporary (provisional) bridge is not an intrinsic part of the treatment being provided. It should not be used for a temporary (provisional) bridge between appointments during bridge construction. | Bridge pontic - indirect - per pontic | The provision of an artificial replacement tooth joined to a retainer(s) on an abutment tooth or osseointegrated implant. The number of pontics should be indicated and the retainers should be appropriately itemised. | The preparation within a restoration of a mechanical lock or keyway matched by a complementary portion on a bridge or prosthetic appliance. The other components of the bridge or prosthetic appliance should be appropriately itemised. | Taxable - unless part of the overall supply of a GST-free denture or artificial tooth or comprises specifically designed spare parts for a denture or artificial tooth | Precision or magnetic attachment | Incorporated as part of a restoration, a magnetic or precision retention device matched by a complementary attachment on a bridge or other prosthetic appliance. The other components of the bridge or prosthetic appliance should be indicated. The number of pontics should be separately itemised. | Retainer for bonded bridge - indirect - per tooth | A bridge retainer and framework to be bonded to the abutment tooth/teeth for support of the bridge pontic(s). The number of abutment teeth involved should be indicated. The number of pontics used should be separately itemised. | Taxable - unless part of the overall supply of a GST-free artificial tooth or comprises specifically designed spare parts for artificial tooth | Prosthesis with metal frame attached to implants - per tooth | A prosthesis carrying denture teeth on a cast metal frame, supported entirely on the implants to which it is attached. | Provision of an appliance which indicates the ideal location and angulation for insertion of implants. | Complete maxillary denture | Provision of a removable dental prosthesis replacing the natural teeth and adjacent tissues in the maxilla. | Complete mandibular denture | Provision of a removable dental prosthesis replacing the natural teeth and adjacent tissues in the mandible. | A reinforcing cast metal section added to a resin denture base. The other denture components should be appropriately itemised. | Complete maxillary and mandibular dentures | Provision of removable dental prostheses for the natural teeth and adjacent tissues in both the maxilla and mandible. | Partial maxillary denture - resin base | Provision of a resin base for a removable dental prosthesis for the maxilla where some natural teeth remain. Other components of the denture such as teeth, rests and clasps should be appropriately itemised. | Partial mandibular denture - resin base | Provision of a resin base for a removable dental prosthesis for the mandible where some natural teeth remain. Other components of the denture such as teeth, rests and clasps should be appropriately itemised. | Partial maxillary denture - cast metal framework | Provision of the framework for a removable dental prosthesis made with a cast metal, which usually incorporates the clasps and retainers, on which to replace teeth from the maxilla where some natural teeth remain. Other components of the denture such as teeth, wrought clasps or rests and immediate replacements should be appropriately itemised. | Taxable - unless part of the overall supply of a GST-free denture | Partial mandibular denture - cast metal framework | Provision of the framework for a removable dental prosthesis made with a cast metal, which usually incorporates the clasps and retainers, on which to replace teeth from the mandible where some natural teeth remain. Other components of the denture such as teeth, wrought clasps or rests and immediate replacements should be appropriately itemised. | A retainer or attachment fitted to a tooth to aid retention of a partial denture. The number of retainers should be indicated. | A unit of a partial denture that rests upon a tooth surface to provide support for the denture. The number of rests used should be indicated. | An item to describe the tooth/teeth added to the base of a new partial denture. The number of teeth should be indicated. | An extension of a denture covering the occlusal surface of remaining teeth or deliberately retained roots. The number of overlays should be indicated. | A preformed device consisting of two complementary parts, one incorporated within the denture and the other attached to a natural tooth, root or osseointegrated implant, to provide support and retention for the denture. | Immediate tooth replacement - per tooth | Provision within a denture to allow immediate replacement of an extracted tooth. The number of teeth so replaced should be indicated. | Provision of a resilient tissue-bearing surface for a removable prosthesis. This item may be used with the provision of new, or maintenance of pre-existing, prostheses. Complementary services should be appropriately itemised. | A wrought bar joining sections of a partial prosthesis. | Taxable - unless part of the overall supply of a GST-free denture or is specifically designed spare parts for a denture | Metal backing - per backing | An extension of the casting of a cast metal partial denture to provide a backing for the denture tooth. The number of backings should be indicated. | Adjustment of pre-existing denture | Adjustment of a denture to improve comfort, function or aesthetics. This item does not apply to routine adjustments following the insertion of a new denture or the maintenance or repair of an existing denture. | Relining - complete denture - processed | Replacement of the tissue fitting surface of a complete denture to improve its accuracy and fit. The procedure requires multiple appointments. | Relining - partial denture - processed | Replacement of the tissue fitting surface of a partial denture to improve its accuracy and fit. The procedure requires multiple appointments. | Remodelling - complete denture | Replacement of the resin base of a complete denture, with or without rearrangement of the teeth, to improve its accuracy and fit. The procedure requires multiple appointments. | Remodelling - partial denture | Replacement of the resin base of a partial denture, with or without rearrangement of the teeth, to improve its accuracy and fit. The procedure requires multiple appointments. | Cleaning and polishing of pre-existing denture | The cleaning and polishing of a pre-existing denture not associated with any other item of maintenance or repair of the denture. | Denture base modification | Structural addition to a denture base to enhance aesthetics or function. | Taxable - unless comprises specifically designed spare parts for a denture | Reattaching pre-existing tooth or clasp to denture | Repair, insertion and adjustment of a denture involving re-attachment of a pre-existing tooth or clasp. | Replacing/adding clasp on denture - per clasp | Repair, insertion and adjustment of a denture involving replacement or addition of a clasp or clasps. | Repairing broken base of a complete denture | Repair, insertion and adjustment of a broken resin denture base. | Repairing broken base of a partial denture | Replacing tooth on denture - per tooth | Repair, insertion and adjustment of a denture where a new tooth is needed. | Adding tooth to partial denture to replace an extracted or decoronated tooth - per tooth | Modification, insertion and adjustment of a partial denture involving an addition to accommodate the loss of a natural tooth or its coronal section. | Repair or addition to metal casting | Repair of or addition to the cast metal frame of a denture. This is a complex procedure requiring the dismantling of the denture. Other complementary services should be appropriately itemised. | Splint - resin - indirect | A resin appliance attached to the teeth for stabilising mobile or displaced teeth. A resin splint may also be used to stabilise a fractured jaw. This item includes the subsequent removal of the splint. | Splint - metal - indirect | A cast metal appliance bonded to the teeth to stabilise mobile or displaced teeth. Metal splints may also be used to stabilise a fractured jaw. This item includes the subsequent removal of the splint. | A prosthesis attached to a denture or osseointegrated implant(s) which is used to close an opening in the palate or to replace other lost tissues. | Taxable - unless part of the overall supply of a GST-free denture or comprises specifically designed spare parts for a denture | Characterisation of denture base | Stippling, staining, festooning or shaping rugae on the appropriate surface(s) of a denture. | Marking a dental appliance with a patient's name or other form of enduring patient identification. | Provision of an inlay in a denture tooth. | Surgical guide for an immediate denture | Provision of an appliance which indicates the final ridge contours following extraction of teeth prior to immediate denture insertion. | Passive removable appliance - per arch | A removable, one arch appliance attached to the dentition by metal clasps or similar device designed to maintain the position of the teeth in the dentition. The appliance does not provide pressure directed at tooth movement. Sometimes used following orthodontic active treatment to maintain a correction. | Active removable appliance - per arch | A removable, one arch appliance attached to the dentition by clasps or similar device which contains some elements capable of exerting pressure on either individual teeth or parts of the arch to achieve tooth or dental arch movement. | Functional orthopaedic appliance | An appliance whose primary action involves orthopaedic change of jaw shape or relationship utilising and modifying the effect of the environmental tissues. Many are bi-maxillary appliances involving upper and lower arches. Bi-maxillary appliances are regarded as single appliances. | Partial banding - per arch | Application of bands and/or brackets to six teeth or fewer in the maxillary or mandibular arch, which can be attached to a resilient arch wire. | Full arch banding - per arch | Application of bands and brackets for attachment of resilient arch wires to most of the teeth of the maxillary or mandibular arch to correct the position of teeth or to correct the arch form. This procedure includes the removal of the appliance and the provision and supervision of the initially provided fixed or removable retention appliance. | Fixed palatal or lingual arch appliance | Insertion of an appliance, fixed to the palatal or lingual aspect of the dentition by bands, frequently applied in the molar region. It is aimed at either changing or maintaining the arch form and can also be designed to uncross or straighten individual teeth. | Partial banding for inter-maxillary elastics (cross elastics) | Application of bands and brackets to two or more teeth in maxillary and mandibular arches. Resilient arch wires may be attached to the brackets and also inter-maxillary elastics between the two arches. The resulting appliances are designed to correct the position of teeth or arch form. | Maxillary expansion appliance | Insertion of an appliance fixed to the maxillary dentition by partial banding which exerts a force to expand or widen the maxillary arch and/or teeth. | A passive appliance fixed to one or more teeth, designed to prevent movement of the teeth relative to each other or to the segment of the arch. The appliance can be used to maintain a space from the loss of a tooth. | Minor tooth guidance - fixed | A procedure using an appliance attached directly to teeth which provides movement or guidance to correct the position of a tooth. | This item describes a number of appliances worn extraorally. Some appliances are worn to correct mandibular protrusion and are not attached directly to the dentition. Other appliances in this category are attached to the dentition by either full or partial banding. Most of these appliances have a harness which is passed behind the head to provide a reaction for the forces required. They are usually worn for a limited time each day. | Adjustment of an orthodontic appliance, either fixed or removable. This is often associated with ongoing treatment anticipated at the time of insertion of the appliance. This item should not be used with item 881. | Repair of removable appliance, resin base | Repair of resin base of a removable appliance. Where an impression is required it should be appropriately itemised. | Repair of removable appliance - clasp, spring or tooth | Repair or replacement of a clasp, spring or tooth on a removable appliance. Where an impression is required, it should be appropriately itemised. | Addition to removable appliance - clasp, spring or tooth | Addition of a clasp, spring or tooth to a removable appliance. Where an impression is required, it should be appropriately itemised. | Relining - removable appliance - processed | Replacement of the tissue fitting surface of a removable appliance to improve its accuracy and fit. | Individually made tray - medicament(s) | A tray made for the application of medicaments to the teeth or supporting tissues. | Registration and mounting of models for occlusal analysis | This item describes the clinical procedures for accurate mounting of models of the maxillary and mandibular teeth on an adjustable calculator. | Taxable - unless part of the overall supply of a GST-free denture or artificial tooth | An appliance made to fit over the functional surfaces of either the upper or lower teeth to relieve abnormal pressures on the temporomandibular joint, its supporting structures and associated muscles. This item also describes and appliance made to locate the dentition and the jaws in predetermined positions when orthognathic jaw surgery is performed. | Repair/addition occlusal splint | The repair/addition, reinsertion and adjustment of an occlusal splint. An impression(s) if required should be itemised. | GST Status for prosthetists' supplies to patients | Comprehensive oral examination | Evaluation of all teeth, their supporting tissues and the oral tissues in order to record the condition of these structures. This evaluation includes recording an appropriate medical history and any other relevant information. | An evaluation performed on a patient of record to determine any changes in the patient's dental and medical health status since a previous comprehensive or periodic examination. | Oral examination - limited | A limited problem-focused oral evaluation carried out immediately prior to required treatment. This evaluation includes recording an appropriate medical history and any other relevant information. | A consultation to seek advice or discuss treatment options regarding a specific dental or oral condition. This consultation includes recording an appropriate medical history and any other relevant information. | Consultation - extended (30 minutes or more) | An extended consultation to seek advice or discuss treatment options regarding a specific dental or oral complaint. This consultation includes recording an appropriate medical history and any other relevant information. | A consultation with a patient referred by a dental or medical practitioner for an opinion or management of a specific dental disorder. The consultation may not necessarily be with a specialist. The referring practitioner should be provided with a report from the consultant, included within the item number. | Consultation by referral - extended (30 minutes) | An extended consultation with a patient referred by a dental or medical practitioner for an opinion or management of a specific dental disorder. The consultation may not necessarily be with a specialist. The referring practitioner should be provided with a report from the consultant, included within the item number. | Written report (not elsewhere included) | A written report not addressed to a referring practitioner involved in the patient's care. | A letter from a dentist referring a patient to another practitioner and providing appropriate information to the consultant. | Instruction in techniques for the removal of bacterial plaque. Advice of appropriate toothpaste and medicaments may be included. | A code number for Department of Veteran's Affairs use only | Code used to identify the actual cost of the cast alloy framework of a partial denture. Its use is usually supported by the provision of an invoice or copy thereof. | Relining - complete denture - direct | Addition to the tissue fitting surface of a complete denture to improve its accuracy and fit, using a self or light cured material. | Relining - partial denture - direct | Addition to the tissue fitting surface of a partial denture to improve its accuracy and fit, using a self or light cured material. | Taxable - if repair, GST-free if addition | Impression - dental appliance repair/modification | An item to describe taking an impression where required for the repair or modification of a dental appliance. | Taxable - if repair, GST-free - if addition/modification | Taxable - if to an existing denture or other appliance, GST-free - if to a new denture or other appliance | An additional item to describe the provision of treatment required after hours. Treatment provided should be itemised. | Travel to provide services | An additional item to describe travel from the usual place of practice, to provide treatment. Treatment provided should be itemised. | Services that may not be GST-free as they may not be 'necessary for the appropriate treatment'. Refer to the discussion of this in the detailed explanation. | Services that may not be GST-free as they may be for medico-legal purposes. Refer to the detailed explanation concerning the 'recipient of the supply'. | Item numbers where the description of the item covers both taxable and GST-free supplies. Refer to the detailed explanation concerning repairs. | The Medicare Benefits Schedule provides that a medicare benefit is payable in relation to a repair to the cast metal base of a partial denture for certain persons suffering from a cleft lip or cleft palate condition.


Related rulings: GSTR 2001/8 TR 2006/10
Legislative references: ANTS(GST)A99 9-5 ANTS(GST)A99 9-80 ANTS(GST)A99 38-10 ANTS(GST)A99 38-10(1) ANTS(GST)A99 38-10(3) ANTS(GST)A99 38-10(1)(a) ANTS(GST)A99 38-10(1)(b) ANTS(GST)A99 38-10(1)(c) ANTS(GST)A99 38-10(3) ANTS(GST)A99 38-45 ANTS(GST)A99 38-45(1) ANTS(GST)A99 38-45(2) ANTS(GST)A99 38-45(3) ANTS(GST)A99 195-1 ANTS(GST)A99 Schedule 3 TAA 1953 Hearing Services Administration Act 1997 Copyright Act 1968
Subject references: GST section 38-10 - other health services section 38-45 - medical aids and appliances
Other references: ATO ID 2001/216 Issue 1.c of the GST Pharmaceutical Health Forum - Issues Register Issue 1.d of the GST Pharmaceutical Health Forum - Issues Register Issue 2.a. Section 38-10 Other health services of the Health Industry Partnership - issues register