MBS item

75042
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Ongoing orthodontic treatment for one dental arch using fixed appliances or aligners, covering adjustments and maintenance for each 3-month period after initial treatment, up to 33 months total.

Category 7 · Cleft and craniofacial services[Group C1](/groups/C1)

Schedule fee$248.40

100% benefitGP, out of hospital—

85% benefitOut of hospital$211.15

75% benefitIn hospital$186.30

The schedule fee for MBS item 75042 is $248.40. Medicare pays $211.15 (85%) out of hospital, or $186.30 (75%) for a privately admitted patient in hospital. Fee effective 1 July 2026.

Gap for what you charge
-----------------------

Your fee$

Out of hospitalIn hospital (private)

Medicare pays$211.15

Patient gap$37.25

Bulk billing means accepting $211.15 as full payment, with no gap and no extra charges. [Add incentives](/bulk-billing?item=75042)

Item descriptor
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Permanent dentition treatment—single arch (mandibular or maxillary) treatment (correction and alignment) using orthodontic fixed appliances or aligners, including supply of appliances and aligners—each subsequent 3 months of active treatment (including all adjustments and maintenance and removal of the appliances) after the initial three months of active treatment for a maximum of a further 33 months

[Explanatory notes and rules on MBS Online ↗](https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=75042)

Health fund and DVA rates
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Total fee each scheme recognises for this item in hospital.

StateNSWVICQLDSAWATASACTNT

Guides
------

- [How Medicare benefits work: schedule fees, 75%, 85% and 100%](/guides/how-medicare-benefits-work)
- [Medicare safety nets explained: original and extended (EMSN) thresholds for 2026](/guides/medicare-safety-nets)
- [In-hospital billing: the 75% benefit, the 25% fund benefit, and no-gap and known-gap schemes](/guides/in-hospital-billing-and-gap-cover)
- [Bulk billing incentives and BBPIP explained: 2026 amounts by MM area](/guides/bulk-billing-incentives)
- [The MBS multiple operation rule and surgical assistant fees](/guides/multiple-operation-rule)
- [Assignment of benefit for bulk billing: the changes from 1 July 2026](/guides/assignment-of-benefit-2026)
- [MBS telehealth rules: the eligible telehealth practitioner and phone items](/guides/mbs-telehealth-rules)
- [GP chronic condition management plans: items 965 and 967 explained](/guides/chronic-condition-management-plans)
- [Medicare billing compliance: claim time limits, records and the 80/20 rule](/guides/medicare-billing-compliance)

Data source: [Australian Government Medicare Benefits Schedule](https://www.mbsonline.gov.au/) · Record updated 1 September 2026. Health fund rates come from each fund's published schedule. Verify item descriptors, rules and fees on [MBS Online](https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=75042) before billing. This is a reference tool, not billing or financial advice.