Dental fees
Effective 1 July 2025
Dental services can be invoiced online via HICAPS Digital for next business day payments.
2025/26 rates
| General | Specialist | ||
|---|---|---|---|
| Service Description | ADA Number | Maximum Payment Rate | Maximum Payment Rate |
| Diagnostic services | |||
| Comprehensive Oral Examination | 011 | $118.50 | $118.50 |
| Periodic Oral Examination | 012 | $74.91 | $74.91 |
| Consultation | 014 | $118.50 | $118.50 |
| Written report (not elsewhere included) | 018 | $164.87 | $217.03 |
| Intraoral periapical or bitewing radiograph - per exposure | 022 | $58.37 | $58.37 |
| Cone Beam Volumetric Tomography - scan acquisition - per appointment | 026 | $186.33 | $186.33 |
| Cephalometric Radiograph - per exposure | 036 | $131.73 | $131.73 |
| Panoramic radiograph - per exposure | 037 | $131.73 | $131.73 |
| Pulp Testing - per appointment | 061 | $42.37 | $42.37 |
| Diagnostic model - per model | 071 | $81.98 | $81.98 |
| Photographic records - intraoral - per appointment | 072 | $46.82 | $46.82 |
| Cone Beam Volumetric Tomography analysis and/or interpretation - maxillary or mandibular dentition (both arches) | 089 | $86.96 | $86.96 |
| Preventive Services | |||
| (Prior approval from TAC required for these services) | |||
| Removal Of Calculus - first appointment | 114 | $147.23 | $147.23 |
| Bleaching, Internal - per tooth | 117 | $261.24 | $261.24 |
| Topical application of remineralisation and/or cariostatic agents - one treatment | 121 | $53.72 | $53.72 |
| Oral hygiene instruction | 141 | $58.71 | $58.71 |
| Desensitising Procedure - per appointment | 165 | $55.31 | $55.31 |
| Odontoplasty - per tooth | 171 | $59.16 | $59.16 |
| Periodontal Debridement - per tooth | 222 | $67.08 | $77.13 |
| Periodontal Flap Surgery - per tooth - Limit of 10 per visit, 20 per 12 month period | 232 | $331.26 | $331.26 |
| Surgical treatment of Peri-implant Disease - per implant | 233 | $399.68 | $399.68 |
| Gingival Graft - per tooth, implant or extraction | 235 | $576.80 | $678.60 |
| Guided Tissue Regeneration - per tooth or implant | 236 | $576.80 | $678.60 |
| Guided Tissue Regeneration - membrane removal | 237 | $670.05 | $788.33 |
| Periodontal Surgery for Crown Lengthening - per tooth | 238 | $579.51 | $681.78 |
| Osseous Graft- per tooth or implant | 243 | $576.80 | $678.60 |
| Oral Surgery | |||
| Removal of a tooth or part(s) thereof | 311 | $245.31 | $265.29 |
| Sectional removal of tooth or part(s) thereof | 314 | $323.30 | $330.02 |
| Surgical removal of a tooth or tooth fragment not requiring removal of bone or tooth division | 322 | $363.70 | $380.77 |
| Surgical removal of a tooth or tooth fragment requiring removal of bone | 323 | $437.94 | $468.34 |
| Splinting of displaced tooth/teeth - per tooth | 386 | $241.17 | $301.92 |
| Replantation and splinting of a tooth - per tooth | 387 | $484.85 | $557.57 |
| Endodontics | |||
| (These fees include the cost of x-rays where required) | |||
| Direct Pulp Capping | 411 | $65.31 | $68.54 |
| Pulpotomy | 414 | $161.13 | $220.17 |
| Complete chemo-mechanical preparation of root canal - one canal | 415 | $376.77 | $433.27 |
| Complete chemo-mechanical preparation of root canal - each additional canal | 416 | $185.45 | $214.89 |
| Root canal obturation - one canal | 417 | $369.78 | $425.24 |
| Root canal obturation - each additional canal | 418 | $182.41 | $209.77 |
| Extirpation of pulp or debridement of root canal(s) - emergency or palliative | 419 | $258.74 | $258.74 |
| Removal Of Root Filling - Per Canal | 451 | $176.38 | $202.86 |
| Additional Visit For Irrigation And/Or Dressing Of The Root Canal System - per tooth | 455 | $195.30 | $224.60 |
| Restorative Services | |||
| Metallic Restoration - One Surface - direct | 511 | $192.69 | $221.58 |
| Metallic Restoration - Two Surfaces - direct | 512 | $230.29 | $264.82 |
| Metallic Restoration - Three Surfaces - direct | 513 | $269.63 | $310.08 |
| Metallic Restoration - Four Surfaces - direct | 514 | $309.29 | $355.70 |
| Metallic Restoration - Five Surfaces - direct | 515 | $351.24 | $403.91 |
| Adhesive Restoration - One Surface - Anterior Tooth - direct | 521 | $207.18 | $238.25 |
| Adhesive Restoration - Two Surfaces - Anterior tooth - direct | 522 | $243.65 | $280.24 |
| Adhesive Restoration - Three Surfaces - Anterior tooth - direct | 523 | $285.94 | $328.84 |
| Adhesive Restoration - Four Surfaces - Anterior tooth - direct | 524 | $321.72 | $369.99 |
| Adhesive Restoration - Five Surfaces - Anterior tooth - direct | 525 | $378.42 | $435.17 |
| Adhesive Restoration - Veneer - Anterior tooth- direct | 526 | $426.41 | $468.29 |
| Adhesive restoration - one surface - posterior tooth - direct | 531 | $218.43 | $251.19 |
| Adhesive restoration - two surfaces - posterior tooth - direct | 532 | $260.20 | $299.23 |
| Adhesive restoration - three surfaces - posterior tooth - direct | 533 | $304.33 | $349.99 |
| Adhesive restoration - four surfaces - posterior tooth - direct | 534 | $342.84 | $394.28 |
| Adhesive restoration - five surfaces - posterior tooth - direct | 535 | $408.52 | $469.80 |
| Adhesive Restoration - Veneer - Posterior tooth - direct | 536 | $418.61 | $468.29 |
| Tooth coloured restoration - one surface - indirect | 551 | $1,054.58 | $1,212.79 |
| Tooth coloured restoration - two surfaces - indirect | 552 | $1,168.87 | $1,344.21 |
| Tooth coloured restoration - three surfaces - indirect | 553 | $1,350.23 | $1,552.76 |
| Tooth coloured restoration - four surfaces - indirect | 554 | $1,465.74 | $1,685.61 |
| Tooth coloured restoration - five surfaces - indirect | 555 | $1,607.35 | $1,848.45 |
| Tooth - coloured restoration - Veneer - indirect | 556 | $1,542.77 | $1,774.18 |
| Provisional (intermediate/temporary) restoration - per tooth | 572 | $113.05 | $113.05 |
| Pin retention - per pin | 575 | $51.09 | $51.09 |
| Post - Direct | 597 | $209.44 | $235.51 |
| Crown and Bridgework | |||
| (If these procedures are to be carried out in a hospital under general anaesthesia, prior approval must be obtained from the TAC) | |||
| Full crown - non metallic - indirect | 613 | $1,815.54 | $2,087.88 |
| Full crown - veneered - indirect | 615 | $1,790.94 | $2,059.58 |
| Full crown - metallic indirect | 618 | $1,802.12 | $2,072.44 |
| Post and core for crown - indirect | 625 | $566.96 | $681.78 |
| Preliminary restoration for crown - direct | 627 | $316.93 | $336.76 |
| Provisional bridge pontic - per pontic | 632 | $359.19 | $359.19 |
| Bridge pontic - direct - per pontic | 642 | $467.65 | $537.81 |
| Bridge pontic - indirect - per pontic | 643 | $1,350.56 | $1,823.25 |
| Retainer for bonded fixture - indirect - per tooth | 649 | $802.32 | $922.66 |
| Implant Procedures | |||
| Fitting of an implant abutment - per abutment | 661 | $1,158.27 | $1,158.27 |
| Prosthesis with metal frame attached to implants - fixed - per arch | 666 | $4,173.65 | $6,115.18 |
| Removal and reattachment of prosthesis fixed to implant(s) – per implant | 669 | $201.09 | $201.09 |
| Full crown attached to osseointegrated implant - veneered indirect | 672 | $2,309.17 | $3,031.34 |
| Surgical implant guide | 679 | $274.31 | $274.31 |
| Insertion of first stage of two-stage endosseous implant - per implant | 684 | $2,484.31 | $2,484.31 |
|
Insertion of one stage endosseous implant - per implant Includes the cost of hardware | 688 | $2,997.95 | $2,997.95 |
|
Second stage surgery of two stage endosseous implant - per implant Includes the cost of hardware | 691 | $513.50 | $513.50 |
| Prosthodontics | |||
| Complete Maxillary Denture | 711 | $1664.67 | $1,914.36 |
| Complete Mandibular Denture | 712 | $1664.67 | $1,914.36 |
| Complete Maxillary and Mandibular Denture | 719 | $3,018.65 | $3,471.43 |
| Partial maxillary denture - resin base | 721 | $1,068.87 | $1,068.87 |
| Partial mandibular denture - resin base | 722 | $1,068.87 | $1,068.87 |
| Partial maxillary denture - cast metal framework including rests and retainers | 727 | $1,854.53 | $2,132.74 |
| Partial mandibular denture - cast metal framework including rests and retainers | 728 | $1,854.53 | $2,132.74 |
| Additional items for Acrylic Dentures only | |||
| Retainer - Per Tooth | 731 | $66.98 | $66.98 |
| Occlusal Rest - per rest | 732 | $19.42 | $19.42 |
| Tooth/teeth partial denture | 733 | $65.85 | $65.85 |
| Immediate tooth replacement - per tooth | 736 | $13.07 | $13.07 |
| Relining - complete denture - processed | 743 | $524.20 | $524.20 |
| Relining - partial denture - processed | 744 | $510.23 | $510.23 |
| Adding tooth to partial denture to replace an extracted or decoronated tooth - per tooth | 768 | $227.20 | $264.00 |
| Splint - Resin - Indirect | 772 | $342.58 | $484.85 |
| Orthodontics | |||
| Active removable appliance therapy - per arch | 821 | $1,198.79 | $1,374.60 |
| Full arch banding - per arch | 831 | $3,305.38 | $4,724.60 |
| Minor tooth guidance - fixed | 846 | $1,071.92 | $1,071.92 |
| Complete course of orthodontic treatment | 881 | $6,828.14 | $8,841.52 |
| General | |||
| Travel to provide services | 916 | FBN* | FBN* |
| Clinical occlusal analysis, including muscle and joint palpation - limit one per three year period | 963 | $113.05 | $158.19 |
| Occlusal splint | 965 | $752.37 | $771.18 |
| Adjustment of pre-existing occlusal splint - per appointment | 966 | $107.16 | $137.07 |
2024/25 rates
| General | Specialist | ||
|---|---|---|---|
| Service Description | ADA Number | Maximum Payment Rate | Maximum Payment Rate |
| Diagnostic services | |||
| Comprehensive Oral Examination | 011 | $115.61 | $115.61 |
| Periodic Oral Examination | 012 | $73.08 | $73.08 |
| Consultation | 014 | $115.61 | $115.61 |
| Written report (not elsewhere included) | 018 | $160.85 | $211.74 |
| Intraoral periapical or bitewing radiograph - per exposure | 022 | $56.95 | $56.95 |
| Cone Beam Volumetric Tomography - scan acquisition - per appointment | 026 | $181.79 | $181.79 |
| Cephalometric Radiograph - per exposure | 036 | $128.52 | $128.52 |
| Panoramic radiograph - per exposure | 037 | $128.52 | $128.52 |
| Pulp Testing - per appointment | 061 | $41.34 | $41.34 |
| Diagnostic model - per model | 071 | $79.98 | $79.98 |
| Photographic records - intraoral - per appointment | 072 | $45.68 | $45.68 |
| Cone Beam Volumetric Tomography analysis and/or interpretation - maxillary or mandibular dentition (both arches) | 089 | $84.84 | $84.84 |
| Preventive Services | |||
| (Prior approval from TAC required for these services) | |||
| Removal Of Calculus - first appointment | 114 | $143.64 | $143.64 |
| Bleaching, Internal - per tooth | 117 | $254.87 | $254.87 |
| Topical application of remineralisation and/or cariostatic agents - one treatment | 121 | $52.41 | $52.41 |
| Oral hygiene instruction | 141 | $57.28 | $57.28 |
| Desensitising Procedure - per appointment | 165 | $53.96 | $53.96 |
| Odontoplasty - per tooth | 171 | $57.72 | $57.72 |
| Periodontal Debridement - per tooth | 222 | $65.44 | $75.25 |
| Periodontal Flap Surgery - per tooth - Limit of 10 per visit, 20 per 12 month period | 232 | $323.18 | $323.18 |
| Surgical treatment of Peri-implant Disease - per implant | 233 | $389.93 | $389.93 |
| Gingival Graft - per tooth, implant or extraction | 235 | $562.73 | $662.05 |
| Guided Tissue Regeneration - per tooth or implant | 236 | $562.73 | $662.05 |
| Guided Tissue Regeneration - membrane removal | 237 | $653.71 | $769.10 |
| Periodontal Surgery for Crown Lengthening - per tooth | 238 | $565.38 | $665.15 |
| Osseous Graft- per tooth or implant | 243 | $562.73 | $662.05 |
| Oral Surgery | |||
| Removal of a tooth or part(s) thereof | 311 | $239.33 | $258.82 |
| Sectional removal of tooth or part(s) thereof | 314 | $315.41 | $321.97 |
| Surgical removal of a tooth or tooth fragment not requiring removal of bone or tooth division | 322 | $354.83 | $371.48 |
| Surgical removal of a tooth or tooth fragment requiring removal of bone | 323 | $427.26 | $456.92 |
| Splinting of displaced tooth/teeth - per tooth | 386 | $235.29 | $294.56 |
| Replantation and splinting of a tooth - per tooth | 387 | $473.02 | $543.97 |
| Endodontics | |||
| (These fees include the cost of x-rays where required) | |||
| Direct Pulp Capping | 411 | $63.72 | $66.87 |
| Pulpotomy | 414 | $157.20 | $214.80 |
| Complete chemo-mechanical preparation of root canal - one canal | 415 | $367.58 | $422.70 |
| Complete chemo-mechanical preparation of root canal - each additional canal | 416 | $180.93 | $209.65 |
| Root canal obturation - one canal | 417 | $360.76 | $414.87 |
| Root canal obturation - each additional canal | 418 | $177.96 | $204.65 |
| Extirpation of pulp or debridement of root canal(s) - emergency or palliative | 419 | $252.43 | $252.43 |
| Removal Of Root Filling - Per Canal | 451 | $172.08 | $197.91 |
| Additional Visit For Irrigation And/Or Dressing Of The Root Canal System - per tooth | 455 | $190.54 | $219.12 |
| Restorative Services | |||
| Metallic Restoration - One Surface - direct | 511 | $187.99 | $216.18 |
| Metallic Restoration - Two Surfaces - direct | 512 | $224.67 | $258.36 |
| Metallic Restoration - Three Surfaces - direct | 513 | $263.05 | $302.52 |
| Metallic Restoration - Four Surfaces - direct | 514 | $301.75 | $347.02 |
| Metallic Restoration - Five Surfaces - direct | 515 | $342.67 | $394.06 |
| Adhesive Restoration - One Surface - Anterior Tooth - direct | 521 | $202.13 | $232.44 |
| Adhesive Restoration - Two Surfaces - Anterior tooth - direct | 522 | $237.71 | $273.40 |
| Adhesive Restoration - Three Surfaces - Anterior tooth - direct | 523 | $278.97 | $320.82 |
| Adhesive Restoration - Four Surfaces - Anterior tooth - direct | 524 | $313.87 | $360.97 |
| Adhesive Restoration - Five Surfaces - Anterior tooth - direct | 525 | $369.19 | $424.56 |
| Adhesive Restoration - Veneer - Anterior tooth- direct | 526 | $416.01 | $456.87 |
| Adhesive restoration - one surface - posterior tooth - direct | 531 | $213.10 | $245.06 |
| Adhesive restoration - two surfaces - posterior tooth - direct | 532 | $253.85 | $291.93 |
| Adhesive restoration - three surfaces - posterior tooth - direct | 533 | $296.91 | $341.45 |
| Adhesive restoration - four surfaces - posterior tooth - direct | 534 | $334.48 | $384.66 |
| Adhesive restoration - five surfaces - posterior tooth - direct | 535 | $398.56 | $458.34 |
| Adhesive Restoration - Veneer - Posterior tooth - direct | 536 | $408.40 | $456.87 |
| Tooth coloured restoration - one surface - indirect | 551 | $1,028.86 | $1,183.21 |
| Tooth coloured restoration - two surfaces - indirect | 552 | $1,140.36 | $1,311.42 |
| Tooth coloured restoration - three surfaces - indirect | 553 | $1,317.30 | $1,514.89 |
| Tooth coloured restoration - four surfaces - indirect | 554 | $1,429.99 | $1,644.50 |
| Tooth coloured restoration - five surfaces - indirect | 555 | $1,568.15 | $1,803.37 |
| Tooth - coloured restoration - Veneer - indirect | 556 | $1,505.14 | $1,730.91 |
| Provisional (intermediate/temporary) restoration - per tooth | 572 | $110.29 | $110.29 |
| Pin retention - per pin | 575 | $49.84 | $49.84 |
| Post - Direct | 597 | $204.33 | $229.77 |
| Crown and Bridgework | |||
| (If these procedures are to be carried out in a hospital under general anaesthesia, prior approval must be obtained from the TAC) | |||
| Full crown - non metallic - indirect | 613 | $1,771.26 | $2,036.96 |
| Full crown - veneered - indirect | 615 | $1,747.26 | $2,009.35 |
| Full crown - metallic indirect | 618 | $1,758.17 | $2,021.89 |
| Post and core for crown - indirect | 625 | $553.13 | $665.15 |
| Preliminary restoration for crown - direct | 627 | $309.20 | $328.55 |
| Provisional bridge pontic - per pontic | 632 | $350.43 | $350.43 |
| Bridge pontic - direct - per pontic | 642 | $456.24 | $524.69 |
| Bridge pontic - indirect - per pontic | 643 | $1,317.62 | $1,778.78 |
| Retainer for bonded fixture - indirect - per tooth | 649 | $782.75 | $900.16 |
| Implant Procedures | |||
| Fitting of an implant abutment - per abutment | 661 | $1,130.02 | $1,130.02 |
| Prosthesis with metal frame attached to implants - fixed - per arch | 666 | $4,071.85 | $5,966.03 |
| Removal and reattachment of prosthesis fixed to implant(s) – per implant | 669 | $196.19 | $196.19 |
| Full crown attached to osseointegrated implant - veneered indirect | 672 | $2,252.85 | $2,957.40 |
| Surgical implant guide | 679 | $267.62 | $267.62 |
| Insertion of first stage of two-stage endosseous implant - per implant | 684 | $2,423.72 | $2,423.72 |
|
Insertion of one stage endosseous implant - per implant Includes the cost of hardware | 688 | $2,924.83 | $2,924.83 |
|
Second stage surgery of two stage endosseous implant - per implant Includes the cost of hardware | 691 | $500.98 | $500.98 |
| Prosthodontics | |||
| Complete Maxillary Denture | 711 | $1624.07 | $1,867.67 |
| Complete Mandibular Denture | 712 | $1624.07 | $1,867.67 |
| Complete Maxillary and Mandibular Denture | 719 | $2,945.02 | $3,386.76 |
| Partial maxillary denture - resin base | 721 | $1,042.80 | $1,042.80 |
| Partial mandibular denture - resin base | 722 | $1,042.80 | $1,042.80 |
| Partial maxillary denture - cast metal framework including rests and retainers | 727 | $1,809.30 | $2,080.72 |
| Partial mandibular denture - cast metal framework including rests and retainers | 728 | $1,809.30 | $2,080.72 |
| Additional items for Acrylic Dentures only | |||
| Retainer - Per Tooth | 731 | $65.35 | $65.35 |
| Occlusal Rest - per rest | 732 | $18.95 | $18.95 |
| Tooth/teeth partial denture | 733 | $64.24 | $64.24 |
| Immediate tooth replacement - per tooth | 736 | $12.75 | $12.75 |
| Relining - complete denture - processed | 743 | $511.41 | $511.41 |
| Relining - partial denture - processed | 744 | $497.79 | $497.79 |
| Adding tooth to partial denture to replace an extracted or decoronated tooth - per tooth | 768 | $221.66 | $257.56 |
| Splint - Resin - Indirect | 772 | $334.22 | $473.02 |
| Orthodontics | |||
| Active removable appliance therapy - per arch | 821 | $1,169.55 | $1,341.07 |
| Full arch banding - per arch | 831 | $3,224.76 | $4,609.37 |
| Minor tooth guidance - fixed | 846 | $1,045.78 | $1,045.78 |
| Complete course of orthodontic treatment | 881 | $6,661.60 | $8,625.87 |
| General | |||
| Travel to provide services | 916 | FBN* | FBN* |
| Clinical occlusal analysis, including muscle and joint palpation - limit one per three year period | 963 | $110.29 | $154.33 |
| Occlusal splint | 965 | $734.02 | $752.37 |
| Adjustment of pre-existing occlusal splint - per appointment | 966 | $104.55 | $133.73 |
2025/26 rates
| General | Specialist | ||
|---|---|---|---|
| Service Description | ADA Number | Maximum Payment Rate | Maximum Payment Rate |
| Diagnostic services | |||
| Comprehensive Oral Examination | 011 | $118.50 | $118.50 |
| Periodic Oral Examination | 012 | $74.91 | $74.91 |
| Consultation | 014 | $118.50 | $118.50 |
| Written report (not elsewhere included) | 018 | $164.87 | $217.03 |
| Intraoral periapical or bitewing radiograph - per exposure | 022 | $58.37 | $58.37 |
| Cone Beam Volumetric Tomography - scan acquisition - per appointment | 026 | $186.33 | $186.33 |
| Cephalometric Radiograph - per exposure | 036 | $131.73 | $131.73 |
| Panoramic radiograph - per exposure | 037 | $131.73 | $131.73 |
| Pulp Testing - per appointment | 061 | $42.37 | $42.37 |
| Diagnostic model - per model | 071 | $81.98 | $81.98 |
| Photographic records - intraoral - per appointment | 072 | $46.82 | $46.82 |
| Cone Beam Volumetric Tomography analysis and/or interpretation - maxillary or mandibular dentition (both arches) | 089 | $86.96 | $86.96 |
| Preventive Services | |||
| (Prior approval from TAC required for these services) | |||
| Removal Of Calculus - first appointment | 114 | $147.23 | $147.23 |
| Bleaching, Internal - per tooth | 117 | $261.24 | $261.24 |
| Topical application of remineralisation and/or cariostatic agents - one treatment | 121 | $53.72 | $53.72 |
| Oral hygiene instruction | 141 | $58.71 | $58.71 |
| Desensitising Procedure - per appointment | 165 | $55.31 | $55.31 |
| Odontoplasty - per tooth | 171 | $59.16 | $59.16 |
| Periodontal Debridement - per tooth | 222 | $67.08 | $77.13 |
| Periodontal Flap Surgery - per tooth - Limit of 10 per visit, 20 per 12 month period | 232 | $331.26 | $331.26 |
| Surgical treatment of Peri-implant Disease - per implant | 233 | $399.68 | $399.68 |
| Gingival Graft - per tooth, implant or extraction | 235 | $576.80 | $678.60 |
| Guided Tissue Regeneration - per tooth or implant | 236 | $576.80 | $678.60 |
| Guided Tissue Regeneration - membrane removal | 237 | $670.05 | $788.33 |
| Periodontal Surgery for Crown Lengthening - per tooth | 238 | $579.51 | $681.78 |
| Osseous Graft- per tooth or implant | 243 | $576.80 | $678.60 |
| Oral Surgery | |||
| Removal of a tooth or part(s) thereof | 311 | $245.31 | $265.29 |
| Sectional removal of tooth or part(s) thereof | 314 | $323.30 | $330.02 |
| Surgical removal of a tooth or tooth fragment not requiring removal of bone or tooth division | 322 | $363.70 | $380.77 |
| Surgical removal of a tooth or tooth fragment requiring removal of bone | 323 | $437.94 | $468.34 |
| Splinting of displaced tooth/teeth - per tooth | 386 | $241.17 | $301.92 |
| Replantation and splinting of a tooth - per tooth | 387 | $484.85 | $557.57 |
| Endodontics | |||
| (These fees include the cost of x-rays where required) | |||
| Direct Pulp Capping | 411 | $65.31 | $68.54 |
| Pulpotomy | 414 | $161.13 | $220.17 |
| Complete chemo-mechanical preparation of root canal - one canal | 415 | $376.77 | $433.27 |
| Complete chemo-mechanical preparation of root canal - each additional canal | 416 | $185.45 | $214.89 |
| Root canal obturation - one canal | 417 | $369.78 | $425.24 |
| Root canal obturation - each additional canal | 418 | $182.41 | $209.77 |
| Extirpation of pulp or debridement of root canal(s) - emergency or palliative | 419 | $258.74 | $258.74 |
| Removal Of Root Filling - Per Canal | 451 | $176.38 | $202.86 |
| Additional Visit For Irrigation And/Or Dressing Of The Root Canal System - per tooth | 455 | $195.30 | $224.60 |
| Restorative Services | |||
| Metallic Restoration - One Surface - direct | 511 | $192.69 | $221.58 |
| Metallic Restoration - Two Surfaces - direct | 512 | $230.29 | $264.82 |
| Metallic Restoration - Three Surfaces - direct | 513 | $269.63 | $310.08 |
| Metallic Restoration - Four Surfaces - direct | 514 | $309.29 | $355.70 |
| Metallic Restoration - Five Surfaces - direct | 515 | $351.24 | $403.91 |
| Adhesive Restoration - One Surface - Anterior Tooth - direct | 521 | $207.18 | $238.25 |
| Adhesive Restoration - Two Surfaces - Anterior tooth - direct | 522 | $243.65 | $280.24 |
| Adhesive Restoration - Three Surfaces - Anterior tooth - direct | 523 | $285.94 | $328.84 |
| Adhesive Restoration - Four Surfaces - Anterior tooth - direct | 524 | $321.72 | $369.99 |
| Adhesive Restoration - Five Surfaces - Anterior tooth - direct | 525 | $378.42 | $435.17 |
| Adhesive Restoration - Veneer - Anterior tooth- direct | 526 | $426.41 | $468.29 |
| Adhesive restoration - one surface - posterior tooth - direct | 531 | $218.43 | $251.19 |
| Adhesive restoration - two surfaces - posterior tooth - direct | 532 | $260.20 | $299.23 |
| Adhesive restoration - three surfaces - posterior tooth - direct | 533 | $304.33 | $349.99 |
| Adhesive restoration - four surfaces - posterior tooth - direct | 534 | $342.84 | $394.28 |
| Adhesive restoration - five surfaces - posterior tooth - direct | 535 | $408.52 | $469.80 |
| Adhesive Restoration - Veneer - Posterior tooth - direct | 536 | $418.61 | $468.29 |
| Tooth coloured restoration - one surface - indirect | 551 | $1,054.58 | $1,212.79 |
| Tooth coloured restoration - two surfaces - indirect | 552 | $1,168.87 | $1,344.21 |
| Tooth coloured restoration - three surfaces - indirect | 553 | $1,350.23 | $1,552.76 |
| Tooth coloured restoration - four surfaces - indirect | 554 | $1,465.74 | $1,685.61 |
| Tooth coloured restoration - five surfaces - indirect | 555 | $1,607.35 | $1,848.45 |
| Tooth - coloured restoration - Veneer - indirect | 556 | $1,542.77 | $1,774.18 |
| Provisional (intermediate/temporary) restoration - per tooth | 572 | $113.05 | $113.05 |
| Pin retention - per pin | 575 | $51.09 | $51.09 |
| Post - Direct | 597 | $209.44 | $235.51 |
| Crown and Bridgework | |||
| (If these procedures are to be carried out in a hospital under general anaesthesia, prior approval must be obtained from the TAC) | |||
| Full crown - non metallic - indirect | 613 | $1,815.54 | $2,087.88 |
| Full crown - veneered - indirect | 615 | $1,790.94 | $2,059.58 |
| Full crown - metallic indirect | 618 | $1,802.12 | $2,072.44 |
| Post and core for crown - indirect | 625 | $566.96 | $681.78 |
| Preliminary restoration for crown - direct | 627 | $316.93 | $336.76 |
| Provisional bridge pontic - per pontic | 632 | $359.19 | $359.19 |
| Bridge pontic - direct - per pontic | 642 | $467.65 | $537.81 |
| Bridge pontic - indirect - per pontic | 643 | $1,350.56 | $1,823.25 |
| Retainer for bonded fixture - indirect - per tooth | 649 | $802.32 | $922.66 |
| Implant Procedures | |||
| Fitting of an implant abutment - per abutment | 661 | $1,158.27 | $1,158.27 |
| Prosthesis with metal frame attached to implants - fixed - per arch | 666 | $4,173.65 | $6,115.18 |
| Removal and reattachment of prosthesis fixed to implant(s) – per implant | 669 | $201.09 | $201.09 |
| Full crown attached to osseointegrated implant - veneered indirect | 672 | $2,309.17 | $3,031.34 |
| Surgical implant guide | 679 | $274.31 | $274.31 |
| Insertion of first stage of two-stage endosseous implant - per implant | 684 | $2,484.31 | $2,484.31 |
|
Insertion of one stage endosseous implant - per implant Includes the cost of hardware | 688 | $2,997.95 | $2,997.95 |
|
Second stage surgery of two stage endosseous implant - per implant Includes the cost of hardware | 691 | $513.50 | $513.50 |
| Prosthodontics | |||
| Complete Maxillary Denture | 711 | $1664.67 | $1,914.36 |
| Complete Mandibular Denture | 712 | $1664.67 | $1,914.36 |
| Complete Maxillary and Mandibular Denture | 719 | $3,018.65 | $3,471.43 |
| Partial maxillary denture - resin base | 721 | $1,068.87 | $1,068.87 |
| Partial mandibular denture - resin base | 722 | $1,068.87 | $1,068.87 |
| Partial maxillary denture - cast metal framework including rests and retainers | 727 | $1,854.53 | $2,132.74 |
| Partial mandibular denture - cast metal framework including rests and retainers | 728 | $1,854.53 | $2,132.74 |
| Additional items for Acrylic Dentures only | |||
| Retainer - Per Tooth | 731 | $66.98 | $66.98 |
| Occlusal Rest - per rest | 732 | $19.42 | $19.42 |
| Tooth/teeth partial denture | 733 | $65.85 | $65.85 |
| Immediate tooth replacement - per tooth | 736 | $13.07 | $13.07 |
| Relining - complete denture - processed | 743 | $524.20 | $524.20 |
| Relining - partial denture - processed | 744 | $510.23 | $510.23 |
| Adding tooth to partial denture to replace an extracted or decoronated tooth - per tooth | 768 | $227.20 | $264.00 |
| Splint - Resin - Indirect | 772 | $342.58 | $484.85 |
| Orthodontics | |||
| Active removable appliance therapy - per arch | 821 | $1,198.79 | $1,374.60 |
| Full arch banding - per arch | 831 | $3,305.38 | $4,724.60 |
| Minor tooth guidance - fixed | 846 | $1,071.92 | $1,071.92 |
| Complete course of orthodontic treatment | 881 | $6,828.14 | $8,841.52 |
| General | |||
| Travel to provide services | 916 | FBN* | FBN* |
| Clinical occlusal analysis, including muscle and joint palpation - limit one per three year period | 963 | $113.05 | $158.19 |
| Occlusal splint | 965 | $752.37 | $771.18 |
| Adjustment of pre-existing occlusal splint - per appointment | 966 | $107.16 | $137.07 |
2024/25 rates
| General | Specialist | ||
|---|---|---|---|
| Service Description | ADA Number | Maximum Payment Rate | Maximum Payment Rate |
| Diagnostic services | |||
| Comprehensive Oral Examination | 011 | $115.61 | $115.61 |
| Periodic Oral Examination | 012 | $73.08 | $73.08 |
| Consultation | 014 | $115.61 | $115.61 |
| Written report (not elsewhere included) | 018 | $160.85 | $211.74 |
| Intraoral periapical or bitewing radiograph - per exposure | 022 | $56.95 | $56.95 |
| Cone Beam Volumetric Tomography - scan acquisition - per appointment | 026 | $181.79 | $181.79 |
| Cephalometric Radiograph - per exposure | 036 | $128.52 | $128.52 |
| Panoramic radiograph - per exposure | 037 | $128.52 | $128.52 |
| Pulp Testing - per appointment | 061 | $41.34 | $41.34 |
| Diagnostic model - per model | 071 | $79.98 | $79.98 |
| Photographic records - intraoral - per appointment | 072 | $45.68 | $45.68 |
| Cone Beam Volumetric Tomography analysis and/or interpretation - maxillary or mandibular dentition (both arches) | 089 | $84.84 | $84.84 |
| Preventive Services | |||
| (Prior approval from TAC required for these services) | |||
| Removal Of Calculus - first appointment | 114 | $143.64 | $143.64 |
| Bleaching, Internal - per tooth | 117 | $254.87 | $254.87 |
| Topical application of remineralisation and/or cariostatic agents - one treatment | 121 | $52.41 | $52.41 |
| Oral hygiene instruction | 141 | $57.28 | $57.28 |
| Desensitising Procedure - per appointment | 165 | $53.96 | $53.96 |
| Odontoplasty - per tooth | 171 | $57.72 | $57.72 |
| Periodontal Debridement - per tooth | 222 | $65.44 | $75.25 |
| Periodontal Flap Surgery - per tooth - Limit of 10 per visit, 20 per 12 month period | 232 | $323.18 | $323.18 |
| Surgical treatment of Peri-implant Disease - per implant | 233 | $389.93 | $389.93 |
| Gingival Graft - per tooth, implant or extraction | 235 | $562.73 | $662.05 |
| Guided Tissue Regeneration - per tooth or implant | 236 | $562.73 | $662.05 |
| Guided Tissue Regeneration - membrane removal | 237 | $653.71 | $769.10 |
| Periodontal Surgery for Crown Lengthening - per tooth | 238 | $565.38 | $665.15 |
| Osseous Graft- per tooth or implant | 243 | $562.73 | $662.05 |
| Oral Surgery | |||
| Removal of a tooth or part(s) thereof | 311 | $239.33 | $258.82 |
| Sectional removal of tooth or part(s) thereof | 314 | $315.41 | $321.97 |
| Surgical removal of a tooth or tooth fragment not requiring removal of bone or tooth division | 322 | $354.83 | $371.48 |
| Surgical removal of a tooth or tooth fragment requiring removal of bone | 323 | $427.26 | $456.92 |
| Splinting of displaced tooth/teeth - per tooth | 386 | $235.29 | $294.56 |
| Replantation and splinting of a tooth - per tooth | 387 | $473.02 | $543.97 |
| Endodontics | |||
| (These fees include the cost of x-rays where required) | |||
| Direct Pulp Capping | 411 | $63.72 | $66.87 |
| Pulpotomy | 414 | $157.20 | $214.80 |
| Complete chemo-mechanical preparation of root canal - one canal | 415 | $367.58 | $422.70 |
| Complete chemo-mechanical preparation of root canal - each additional canal | 416 | $180.93 | $209.65 |
| Root canal obturation - one canal | 417 | $360.76 | $414.87 |
| Root canal obturation - each additional canal | 418 | $177.96 | $204.65 |
| Extirpation of pulp or debridement of root canal(s) - emergency or palliative | 419 | $252.43 | $252.43 |
| Removal Of Root Filling - Per Canal | 451 | $172.08 | $197.91 |
| Additional Visit For Irrigation And/Or Dressing Of The Root Canal System - per tooth | 455 | $190.54 | $219.12 |
| Restorative Services | |||
| Metallic Restoration - One Surface - direct | 511 | $187.99 | $216.18 |
| Metallic Restoration - Two Surfaces - direct | 512 | $224.67 | $258.36 |
| Metallic Restoration - Three Surfaces - direct | 513 | $263.05 | $302.52 |
| Metallic Restoration - Four Surfaces - direct | 514 | $301.75 | $347.02 |
| Metallic Restoration - Five Surfaces - direct | 515 | $342.67 | $394.06 |
| Adhesive Restoration - One Surface - Anterior Tooth - direct | 521 | $202.13 | $232.44 |
| Adhesive Restoration - Two Surfaces - Anterior tooth - direct | 522 | $237.71 | $273.40 |
| Adhesive Restoration - Three Surfaces - Anterior tooth - direct | 523 | $278.97 | $320.82 |
| Adhesive Restoration - Four Surfaces - Anterior tooth - direct | 524 | $313.87 | $360.97 |
| Adhesive Restoration - Five Surfaces - Anterior tooth - direct | 525 | $369.19 | $424.56 |
| Adhesive Restoration - Veneer - Anterior tooth- direct | 526 | $416.01 | $456.87 |
| Adhesive restoration - one surface - posterior tooth - direct | 531 | $213.10 | $245.06 |
| Adhesive restoration - two surfaces - posterior tooth - direct | 532 | $253.85 | $291.93 |
| Adhesive restoration - three surfaces - posterior tooth - direct | 533 | $296.91 | $341.45 |
| Adhesive restoration - four surfaces - posterior tooth - direct | 534 | $334.48 | $384.66 |
| Adhesive restoration - five surfaces - posterior tooth - direct | 535 | $398.56 | $458.34 |
| Adhesive Restoration - Veneer - Posterior tooth - direct | 536 | $408.40 | $456.87 |
| Tooth coloured restoration - one surface - indirect | 551 | $1,028.86 | $1,183.21 |
| Tooth coloured restoration - two surfaces - indirect | 552 | $1,140.36 | $1,311.42 |
| Tooth coloured restoration - three surfaces - indirect | 553 | $1,317.30 | $1,514.89 |
| Tooth coloured restoration - four surfaces - indirect | 554 | $1,429.99 | $1,644.50 |
| Tooth coloured restoration - five surfaces - indirect | 555 | $1,568.15 | $1,803.37 |
| Tooth - coloured restoration - Veneer - indirect | 556 | $1,505.14 | $1,730.91 |
| Provisional (intermediate/temporary) restoration - per tooth | 572 | $110.29 | $110.29 |
| Pin retention - per pin | 575 | $49.84 | $49.84 |
| Post - Direct | 597 | $204.33 | $229.77 |
| Crown and Bridgework | |||
| (If these procedures are to be carried out in a hospital under general anaesthesia, prior approval must be obtained from the TAC) | |||
| Full crown - non metallic - indirect | 613 | $1,771.26 | $2,036.96 |
| Full crown - veneered - indirect | 615 | $1,747.26 | $2,009.35 |
| Full crown - metallic indirect | 618 | $1,758.17 | $2,021.89 |
| Post and core for crown - indirect | 625 | $553.13 | $665.15 |
| Preliminary restoration for crown - direct | 627 | $309.20 | $328.55 |
| Provisional bridge pontic - per pontic | 632 | $350.43 | $350.43 |
| Bridge pontic - direct - per pontic | 642 | $456.24 | $524.69 |
| Bridge pontic - indirect - per pontic | 643 | $1,317.62 | $1,778.78 |
| Retainer for bonded fixture - indirect - per tooth | 649 | $782.75 | $900.16 |
| Implant Procedures | |||
| Fitting of an implant abutment - per abutment | 661 | $1,130.02 | $1,130.02 |
| Prosthesis with metal frame attached to implants - fixed - per arch | 666 | $4,071.85 | $5,966.03 |
| Removal and reattachment of prosthesis fixed to implant(s) – per implant | 669 | $196.19 | $196.19 |
| Full crown attached to osseointegrated implant - veneered indirect | 672 | $2,252.85 | $2,957.40 |
| Surgical implant guide | 679 | $267.62 | $267.62 |
| Insertion of first stage of two-stage endosseous implant - per implant | 684 | $2,423.72 | $2,423.72 |
|
Insertion of one stage endosseous implant - per implant Includes the cost of hardware | 688 | $2,924.83 | $2,924.83 |
|
Second stage surgery of two stage endosseous implant - per implant Includes the cost of hardware | 691 | $500.98 | $500.98 |
| Prosthodontics | |||
| Complete Maxillary Denture | 711 | $1624.07 | $1,867.67 |
| Complete Mandibular Denture | 712 | $1624.07 | $1,867.67 |
| Complete Maxillary and Mandibular Denture | 719 | $2,945.02 | $3,386.76 |
| Partial maxillary denture - resin base | 721 | $1,042.80 | $1,042.80 |
| Partial mandibular denture - resin base | 722 | $1,042.80 | $1,042.80 |
| Partial maxillary denture - cast metal framework including rests and retainers | 727 | $1,809.30 | $2,080.72 |
| Partial mandibular denture - cast metal framework including rests and retainers | 728 | $1,809.30 | $2,080.72 |
| Additional items for Acrylic Dentures only | |||
| Retainer - Per Tooth | 731 | $65.35 | $65.35 |
| Occlusal Rest - per rest | 732 | $18.95 | $18.95 |
| Tooth/teeth partial denture | 733 | $64.24 | $64.24 |
| Immediate tooth replacement - per tooth | 736 | $12.75 | $12.75 |
| Relining - complete denture - processed | 743 | $511.41 | $511.41 |
| Relining - partial denture - processed | 744 | $497.79 | $497.79 |
| Adding tooth to partial denture to replace an extracted or decoronated tooth - per tooth | 768 | $221.66 | $257.56 |
| Splint - Resin - Indirect | 772 | $334.22 | $473.02 |
| Orthodontics | |||
| Active removable appliance therapy - per arch | 821 | $1,169.55 | $1,341.07 |
| Full arch banding - per arch | 831 | $3,224.76 | $4,609.37 |
| Minor tooth guidance - fixed | 846 | $1,045.78 | $1,045.78 |
| Complete course of orthodontic treatment | 881 | $6,661.60 | $8,625.87 |
| General | |||
| Travel to provide services | 916 | FBN* | FBN* |
| Clinical occlusal analysis, including muscle and joint palpation - limit one per three year period | 963 | $110.29 | $154.33 |
| Occlusal splint | 965 | $734.02 | $752.37 |
| Adjustment of pre-existing occlusal splint - per appointment | 966 | $104.55 | $133.73 |
* Note: Where the terminology FBN appears in this schedule, the fee must be negotiated with the TAC before any dental treatment is commenced.
