Sistema TS (Italy's Health Card System) is the legal obligation every dentist must meet to send data on dental services to the competent authorities by precise deadlines, on pain of significant penalties.
What Sistema TS (Italy's Health Card System) is and why it is mandatory
The Sistema Tessera Sanitaria, known as the Sistema TS, is the official channel for transmitting data on healthcare services provided by health professionals, including dentists.
The Ministry of Health requires this notification in order to update the Electronic Health Record (FSE 2.0) and for statistical and administrative purposes.
For private dentists and those working in dental practices, this is not optional. It is a regulatory requirement with legal and tax implications.
Transmitting the data also enables integration with the pre-filled Italian tax return system. Patients benefit from automatic tax relief on dental expenses.
Which dental services must be reported to Sistema TS (Italy's Health Card System)
Not all dental services follow the same reporting process. The Ministry of Health has issued precise guidelines on the data to be transmitted.
Diagnostic and check-up services
- Dental visits and regular check-ups
- Dental X-rays (intraoral and panoramic)
- Diagnostic photos and clinical documentation
- Specialist appointment in orthodontics or endodontics
- Instrumental examinations for diagnosing oral conditions
Dental hygiene and prevention
- Professional teeth cleaning (scaling)
- Oral hygiene sessions and hygiene instructions
- Fluoride prophylaxis and fissure sealing
- Root planing (subgingival scaling)
Conservative dentistry and root canal therapy
- Fillings (amalgam, composite, glass ionomer)
- Endodontic treatment (root canal treatment)
- Caries removal and cavity preparation
- Desensitisation treatments
Dental prosthesis
- Dental crowns (monolithic and implant-supported)
- Bridges and fixed prosthetics
- Complete and partial removable dentures
- Implant-supported dentures (overdenture)
- Denture relines and repairs
Implantology and oral surgery
- Placement of dental implants
- Tooth extractions and avulsions
- Alveolectomy and maxillary sinus lift
- Frenectomy and other surgical procedures
- Removal of intraoral lesions
Orthodontics and bite correction
- Orthodontic consultations and treatment planning
- Fitting of fixed braces (brackets)
- Removable appliances and clear aligners
- Periodic checks and activations
- Brace removal and retention
Automate transmission to Sistema TS for your dental practice
BeebeeDoc is the cloud medical practice management software that sends invoices to Sistema TS (Italy's Health Card System) in one click. Ideal for dentists and dental surgeons. Free 15-day trial, no card required.
Monthly deadlines: when to send data to Sistema TS
Reporting to Sistema TS (Italy's Health Card System) is not annual like other tax obligations. It is a monthly duty with precise deadlines.
Main deadline: the tenth day of the following month.
For example, for all services provided in January, transmission must take place by 10 February. This applies to every single month of the year.
The transmission includes the full list of services, the gross amount charged, the patient's identifying details and the description of the service.
Missing the deadline on the 10th automatically triggers the penalties set by law. There is no automatic extension.
How to count the deadline: some examples
- January services → deadline 10 February
- February services → deadline 10 March
- March services → deadline 10 April
- December services → deadline 10 January of the following year
If the tenth falls on a public holiday or a non-working day, the deadline moves to the first following working day. Even so, it is prudent to send early to avoid risk.
Penalties for failing to send data to Sistema TS
Failing to send data to the Sistema TS is not a simple administrative oversight. It carries significant financial consequences.
The Ministry of Health applies administrative penalties for every document not sent by the set deadline.
Penalty amounts
- Penalty per document: 100 euros
- Minimum total penalty: 500 euro (even for a single month late)
- Maximum annual penalty: 50,000 euros
If a dental practice does not send the January data, the minimum penalty is 500 euros regardless of the number of services provided.
If a whole month goes by with 100 services not reported, the penalty is 100 × 100 = 10.000 euro, up to the annual cap.
Penalties are notified by the Agenzia delle Entrate (Italian Revenue Agency) or by the competent regional offices. They cannot be ignored.
Other consequences of failing to send
- Exclusion from tax deductions for patients (they will not be able to claim dental costs on the 730 pre-filled Italian tax return)
- Failure to update the Electronic Health Record
- Possible tax audit by the Agenzia delle Entrate (Italian Revenue Agency)
- Reputational damage for the dental practice
How BeebeeDoc automates sending to Sistema TS
Automation is the most effective way to meet Sistema TS deadlines without organisational stress.
BeebeeDoc is a cloud practice management software built specifically for dental and medical practices. It combines administrative management with the obligation to report to Sistema TS (Italy's Health Card System).
BeebeeDoc’s automatic features
- Automatic recording of services: every procedure is catalogued with codes compatible with Sistema TS
- Automatic calculation of amounts: includes VAT and specific dental fee rules
- Patient tracking: personal details and health card number always up to date
- Send with one click: transmission to Sistema TS directly from the platform
- Transmission history: checking the status of every submission and receipt
No more filling in Excel files or complicated forms. No need to contact your accountant. One click and Sistema TS is updated.
Benefits for the dental practice
- No more risk of penalties for late submissions
- Less internal administrative work
- Full transparency on the data transmitted
- Certified traceability for tax audits
- Patients enabled for automatic tax deductions
- Easy integration with the Electronic Health Record 2.0
Integration with the Electronic Health Record (FSE 2.0)
The Electronic Health Record is the new national system that centralises the medical documentation of every Italian citizen.
When the data reaches Sistema TS, it is automatically transferred into the patient's FSE 2.0. This gives the patient a complete health history.
For dentists, this integration means sending the data once and reaching two official destinations at the same time.
Tax deductions and Sistema TS (Italy's Health Card System)
One of the main reasons Sistema TS exists is its link with tax deductions.
In the pre-filled Italian tax return, the Agenzia delle Entrate (Italian Revenue Agency) now receives the Sistema TS data automatically. This means that dental expenses reported correctly are pre-filled.
If a practice does not send the data to Sistema TS (Italy's Health Card System), the patient will not find the expense in the pre-filled Italian tax return. They have to enter it by hand, which creates inefficiency.
By contrast, with regular submission every patient automatically receives the tax deduction of up to 19% of dental expenses.
Compliance checklist for dental practices
Before closing the month, a dental practice should check these essential points:
- All the month's services have been recorded in the practice management software
- Patient personal details are complete and up to date
- Health card numbers are present (where applicable)
- The invoiced amounts include VAT and comply with regional tariffs
- The transmission to the Sistema TS was made by the 10th of the following month
- A copy of the transmission receipt has been kept for future checks
Common mistakes to avoid
- Forgetting the deadline on the 10th: triggers immediate and significant penalties
- Incomplete personal details: the transmission is rejected by Sistema TS
- Confusing included and excluded services: some services have specific rules
- Not keeping transmission receipts: essential in the event of audits
- Relying on memory alone: without an automatic system, errors grow exponentially
Conclusion: compliance made simpler with BeebeeDoc
Sistema TS is a non-negotiable obligation for dentists, but it does not have to be complicated.
With a tool like BeebeeDoc, the whole process becomes automatic and transparent. You record the service, and the system transmits it at the right time.
This reduces errors, cuts penalties, simplifies the practice's administrative work and improves the patient experience.
Try BeebeeDoc free for 15 days. See how to fully automate sending to Sistema TS with no manual effort.
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