Dental services
We can help pay for this treatment in the first 90 days after your accident. You do not need to contact us for approval first if:
- you have a TAC claim number
- your doctor or other health professional recommends it, and
- it is for your accident injuries.
We may contact you or your provider to check your progress and see if you are getting the support you need. This will help us make sure your treatment is helping your recovery. It will allow us to make decisions about what treatment we can pay for and how long we can pay for it.
How to get dental treatment
- Choose a dentist. Your doctor can recommend one in your local area or you can search for a dentist online.
- Call and make an appointment. Tell them you are a TAC client. Ask if they charge at TAC rates. If the provider charges more, they may ask you for a 'gap payment' to make up the difference
- Go to your appointment and give the provider your TAC claim number.
When you need to ask for TAC approval:
Please contact us for approval if it is:
- close to or more than 90 days since your accident and we haven’t already approved more treatment, or
- more than 6 months since you’ve had any treatment or service paid for by the TAC.
How we pay for treatment
There are two ways we can pay for your approved treatments and services:
- we pay your provider at the TAC rate
- you pay your provider, and we repay you at the TAC rate.
To ask for a reimbursement, scan or take a photo of your receipt. Send it to us with the ‘Claim reimbursement’ button on myTAC, or by email to info@tac.vic.gov.au and we will repay you.
We will pay for your treatment at the TAC rate . If your provider charges more than the TAC rate, you may need to pay the difference. This is known as a 'gap payment'.
If your provider charges you a gap payment, you may be able to seek reimbursement for some of this through:
- Medicare or your private health insurance
- The TAC.
Please note, in most cases, we are unable to reimburse you for a gap payment. This is because we have paid for your treatment or service at a rate we have determined is reasonable. You may still ask for a reimbursement from the TAC and we will let you know our decision.
What does a dentist do?
A dentist is a medical professional trained to treat injuries, diseases and conditions that affect the teeth, gums, jaw and mouth.
Information for health and service providers
If you are a dental services provider, please refer to our TAC Provider Guidelines.
Effective 1 July 2023
Dental services can be invoiced online via HICAPS Digital Claims for next business day payments.
| General | Specialist | ||
|---|---|---|---|
| Service Description | ADA Number | Maximum Payment Rate | Maximum Payment Rate |
| Diagnostic services | |||
| Comprehensive Oral Examination | 011 | $111.37 | $111.37 |
| Periodic Oral Examination | 012 | $70.40 | $70.40 |
| Consultation | 014 | $111.37 | $111.37 |
| Written report (not elsewhere included) | 018 | $154.95 | $203.97 |
| Intraoral periapical or bitewing radiograph - per exposure | 022 | $54.86 | $54.86 |
| Cone Beam Volumetric Tomography - scan acquisition - per appointment | 026 | $175.12 | $175.12 |
| Cephalometric Radiograph - per exposure | 036 | $123.80 | $123.80 |
| Panoramic radiograph - per exposure | 037 | $123.80 | $123.80 |
| Pulp Testing - per appointment | 061 | $39.82 | $39.82 |
| Diagnostic model - per model | 071 | $77.04 | $77.04 |
| Photographic records - intraoral - per appointment | 072 | $44.00 | $44.00 |
| Cone Beam Volumetric Tomography analysis and/or interpretation - maxillary or mandibular dentition (both arches) | 089 | $81.73 | $81.73 |
| Preventive Services | |||
| (Prior approval from TAC required for these services) | |||
| Removal Of Calculus - first appointment | 114 | $ 138.37 | $138.37 |
| Bleaching, Internal - per tooth | 117 | $245.52 | $245.52 |
| Topical application of remineralisation and/or cariostatic agents - one treatment | 121 | $50.49 | $50.49 |
| Oral hygiene instruction | 141 | $55.18 | $55.18 |
| Desensitising Procedure - per appointment | 165 | $51.98 | $51.98 |
| Odontoplasty - per tooth | 171 | $55.60 | $55.60 |
| Periodontal Debridement - per tooth | 222 | $63.04 | $72.49 |
| Periodontal Flap Surgery - per tooth - Limit of 10 per visit, 20 per 12 month period | 232 | $311.32 | $311.32 |
| Surgical treatment of Peri-implant Disease - per implant | 233 | $375.62 | $375.62 |
| Gingival Graft - per tooth, implant or extraction | 235 | $542.08 | $637.75 |
| Guided Tissue Regeneration - per tooth or implant | 236 | $542.08 | $637.75 |
| Guided Tissue Regeneration - membrane removal | 237 | $629.72 | $740.87 |
| Periodontal Surgery for Crown Lengthening - per tooth | 238 | $544.63 | $640.74 |
| Osseous Graft- per tooth or implant | 243 | $542.08 | $637.75 |
| Oral Surgery | |||
| Removal of a tooth or part(s) thereof | 311 | $230.55 | $249.32 |
| Sectional removal of tooth or part(s) thereof | 314 | $303.83 | $310.15 |
| Surgical removal of a tooth or tooth fragment not requiring removal of bone or tooth division | 322 | $341.81 | $357.85 |
| Surgical removal of a tooth or tooth fragment requiring removal of bone | 323 | $411.58 | $440.15 |
| Splinting of displaced tooth/teeth - per tooth | 386 | $226.65 | $283.75 |
| Replantation and splinting of a tooth - per tooth | 387 | $455.66 | $524.01 |
| Endodontics | |||
| (These fees include the cost of x-rays where required) | |||
| Direct Pulp Capping | 411 | $61.38 | $64.42 |
| Pulpotomy | 414 | $151.43 | $206.92 |
| Complete chemo-mechanical preparation of root canal - one canal | 415 | $354.09 | $407.19 |
| Complete chemo-mechanical preparation of root canal - each additional canal | 416 | $174.29 | $201.96 |
| Root canal obturation - one canal | 417 | $347.52 | $399.64 |
| Root canal obturation - each additional canal | 418 | $171.43 | $197.14 |
| Extirpation of pulp or debridement of root canal(s) - emergency or palliative | 419 | $243.17 | $243.17 |
| Removal Of Root Filling - Per Canal | 451 | $165.76 | $190.65 |
| Additional Visit For Irrigation And/Or Dressing Of The Root Canal System - per tooth | 455 | $183.55 | $211.08 |
| Restorative Services | |||
| Metallic Restoration - One Surface - direct | 511 | $181.09 | $208.25 |
| Metallic Restoration - Two Surfaces - direct | 512 | $216.42 | $248.88 |
| Metallic Restoration - Three Surfaces - direct | 513 | $253.40 | $291.42 |
| Metallic Restoration - Four Surfaces - direct | 514 | $290.68 | $334.28 |
| Metallic Restoration - Five Surfaces - direct | 515 | $330.09 | $379.60 |
| Adhesive Restoration - One Surface - Anterior Tooth - direct | 521 | $194.71 | $223.91 |
| Adhesive Restoration - Two Surfaces - Anterior tooth - direct | 522 | $228.99 | $263.37 |
| Adhesive Restoration - Three Surfaces - Anterior tooth - direct | 523 | $268.73 | $309.05 |
| Adhesive Restoration - Four Surfaces - Anterior tooth - direct | 524 | $302.35 | $347.72 |
| Adhesive Restoration - Five Surfaces - Anterior tooth - direct | 525 | $355.64 | $408.98 |
| Adhesive Restoration - Veneer - Anterior tooth- direct | 526 | $400.74 | $440.10 |
| Adhesive restoration - one surface - posterior tooth - direct | 531 | $205.28 | $236.07 |
| Adhesive restoration - two surfaces - posterior tooth - direct | 532 | $244.53 | $281.22 |
| Adhesive restoration - three surfaces - posterior tooth - direct | 533 | $286.01 | $328.92 |
| Adhesive restoration - four surfaces - posterior tooth - direct | 534 | $322.20 | $370.54 |
| Adhesive restoration - five surfaces - posterior tooth - direct | 535 | $383.93 | $441.52 |
| Adhesive Restoration - Veneer - Posterior tooth - direct | 536 | $393.41 | $440.10 |
| Tooth coloured restoration - one surface - indirect | 551 | $991.10 | $1,139.78 |
| Tooth coloured restoration - two surfaces - indirect | 552 | $1,098.51 | $1,263.29 |
| Tooth coloured restoration - three surfaces - indirect | 553 | $1,268.95 | $1,459.29 |
| Tooth coloured restoration - four surfaces - indirect | 554 | $1,377.51 | $1,584.14 |
| Tooth coloured restoration - five surfaces - indirect | 555 | $1,510.60 | $1,737.18 |
| Tooth - coloured restoration - Veneer - indirect | 556 | $1,449.90 | $1,667.38 |
| Provisional (intermediate/temporary) restoration - per tooth | 572 | $106.24 | $106.24 |
| Pin retention - per pin | 575 | $48.01 | $48.01 |
| Post - Direct | 597 | $196.83 | $221.34 |
| 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 | $1,706.25 | $1,962.20 |
| Full crown - veneered - indirect | 615 | $1,683.13 | $1,935.60 |
| Full crown - metallic indirect | 618 | $1,693.64 | $1,947.68 |
| Post and core for crown - indirect | 625 | $532.83 | $640.74 |
| Preliminary restoration for crown - direct | 627 | $297.85 | $316.49 |
| Provisional bridge pontic - per pontic | 632 | $337.57 | $337.57 |
| Bridge pontic - direct - per pontic | 642 | $439.50 | $505.43 |
| Bridge pontic - indirect - per pontic | 643 | $1,269.26 | $1,713.50 |
| Retainer for bonded fixture - indirect - per tooth | 649 | $754.02 | $867.12 |
| Implant Procedures | |||
| Fitting of an implant abutment - per abutment | 661 | $1,088.55 | $1,088.55 |
| Prosthesis with metal frame attached to implants - fixed - per arch | 666 | $3,922.41 | $5,747.07 |
| Removal and reattachment of prosthesis fixed to implant(s) – per implant | 669 | $188.99 | $188.99 |
| Full crown attached to osseointegrated implant - veneered indirect | 672 | $2,170.17 | $2,848.86 |
| Surgical implant guide | 679 | $257.80 | $257.80 |
| Insertion of first stage of two-stage endosseous implant - per implant | 684 | $2,334.77 | $2,334.77 |
|
Insertion of one stage endosseous implant - per implant Includes the cost of hardware | 688 | $2,817.48 | $2,817.48 |
|
Second stage surgery of two stage endosseous implant - per implant Includes the cost of hardware | 691 | $482.59 | $482.59 |
| Prosthodontics | |||
| Complete Maxillary Denture | 711 | $1,564.46 | $1,799.12 |
| Complete Mandibular Denture | 712 | $1,564.46 | $1,799.12 |
| Complete Maxillary and Mandibular Denture | 719 | $2,836.93 | $3,262.46 |
| Partial maxillary denture - resin base | 721 | $1,004.53 | $1,004.53 |
| Partial mandibular denture - resin base | 722 | $1,004.53 | $1,004.53 |
| Partial maxillary denture - cast metal framework including rests and retainers | 727 | $1,742.90 | $2,004.35 |
| Partial mandibular denture - cast metal framework including rests and retainers | 728 | $1,742.90 | $2,004.35 |
| Additional items for Acrylic Dentures only | |||
| Retainer - Per Tooth | 731 | $62.95 | $62.95 |
| Occlusal Rest - per rest | 732 | $18.25 | $18.25 |
| Tooth/teeth partial denture | 733 | $61.88 | $61.88 |
| Immediate tooth replacement - per tooth | 736 | $12.28 | $12.28 |
| Relining - complete denture - processed | 743 | $492.64 | $492.64 |
| Relining - partial denture - processed | 744 | $479.52 | $479.52 |
| Adding tooth to partial denture to replace an extracted or decoronated tooth - per tooth | 768 | $213.52 | $248.11 |
| Splint - Resin - Indirect | 772 | $321.95 | $455.66 |
| Orthodontics | |||
| Active removable appliance therapy - per arch | 821 | $1,126.63 | $1,291.85 |
| Full arch banding - per arch | 831 | $3,106.41 | $4,440.20 |
| Minor tooth guidance - fixed | 846 | $1,007.40 | $1,007.40 |
| Complete course of orthodontic treatment | 881 | $6,417.11 | $8,309.29 |
| General | |||
| Travel to provide services | 916 | FBN* | FBN* |
| Clinical occlusal analysis, including muscle and joint palpation - limit one per three year period | 963 | $106.24 | $148.67 |
| Occlusal splint | 965 | $707.08 | $724.76 |
| Adjustment of pre-existing occlusal splint - per appointment | 966 | $100.71 | $128.82 |
| General | Specialist | ||
|---|---|---|---|
| Service Description | ADA Number | Maximum Payment Rate | Maximum Payment Rate |
| Diagnostic services | |||
| Comprehensive Oral Examination | 011 | $103.13 | $103.13 |
| Periodic Oral Examination | 012 | $65.19 | $65.19 |
| Consultation | 014 | $103.13 | $103.13 |
| Written report (not elsewhere included) | 018 | $143.49 | $188.88 |
| Intraoral periapical or bitewing radiograph - per exposure | 022 | $50.80 | $50.80 |
| Cone Beam Volumetric Tomography - scan acquisition - per appointment | 026 | $162.16 | $162.16 |
| Cephalometric Radiograph - per exposure | 036 | $114.64 | $114.64 |
| Panoramic radiograph - per exposure | 037 | $114.64 | $114.64 |
| Pulp Testing - per appointment | 061 | $36.87 | $36.87 |
| Diagnostic model - per model | 071 | $71.34 | $71.34 |
| Photographic records - intraoral - per appointment | 072 | $40.74 | $40.74 |
| Cone Beam Volumetric Tomography analysis and/or interpretation - maxillary or mandibular dentition (both arches) | 089 | $75.68 | $75.68 |
| Preventive Services | |||
| (Prior approval from TAC required for these services) | |||
| Removal Of Calculus - first appointment | 114 | $128.13 | $128.13 |
| Bleaching, Internal - per tooth | 117 | $227.35 | $227.35 |
| Topical application of remineralisation and/or cariostatic agents - one treatment | 121 | $46.75 | $46.75 |
| Oral hygiene instruction | 141 | $51.10 | $51.10 |
| Desensitising Procedure - per appointment | 165 | $48.13 | $48.13 |
| Odontoplasty - per tooth | 171 | $51.49 | $51.49 |
| Periodontal Debridement - per tooth | 222 | $58.38 | $67.13 |
| Periodontal Flap Surgery - per tooth - Limit of 10 per visit, 20 per 12 month period | 232 | $288.29 | $288.29 |
| Surgical treatment of Peri-implant Disease - per implant | 233 | $347.83 | $347.83 |
| Gingival Graft - per tooth, implant or extraction | 235 | $501.97 | $590.56 |
| Guided Tissue Regeneration - per tooth or implant | 236 | $501.97 | $590.56 |
| Guided Tissue Regeneration - membrane removal | 237 | $583.13 | $686.05 |
| Periodontal Surgery for Crown Lengthening - per tooth | 238 | $504.33 | $593.33 |
| Osseous Graft- per tooth or implant | 243 | $501.97 | $590.56 |
| Oral Surgery | |||
| Removal of a tooth or part(s) thereof | 311 | $213.49 | $230.87 |
| Sectional removal of tooth or part(s) thereof | 314 | $281.35 | $287.20 |
| Surgical removal of a tooth or tooth fragment not requiring removal of bone or tooth division | 322 | $316.52 | $331.37 |
| Surgical removal of a tooth or tooth fragment requiring removal of bone | 323 | $381.13 | $407.58 |
| Splinting of displaced tooth/teeth - per tooth | 386 | $209.88 | $262.76 |
| Replantation and splinting of a tooth - per tooth | 387 | $421.95 | $485.24 |
| Endodontics | |||
| (These fees include the cost of x-rays where required) | |||
| Direct Pulp Capping | 411 | $56.84 | $59.65 |
| Pulpotomy | 414 | $140.23 | $191.61 |
| Complete chemo-mechanical preparation of root canal - one canal | 415 | $327.89 | $377.06 |
| Complete chemo-mechanical preparation of root canal - each additional canal | 416 | $161.39 | $187.02 |
| Root canal obturation - one canal | 417 | $321.81 | $370.07 |
| Root canal obturation - each additional canal | 418 | $158.75 | $182.55 |
| Extirpation of pulp or debridement of root canal(s) - emergency or palliative | 419 | $225.18 | $225.18 |
| Removal Of Root Filling - Per Canal | 451 | $153.50 | $176.54 |
| Additional Visit For Irrigation And/Or Dressing Of The Root Canal System - per tooth | 455 | $169.97 | $195.46 |
| Restorative Services | |||
| Metallic Restoration - One Surface - direct | 511 | $167.69 | $192.84 |
| Metallic Restoration - Two Surfaces - direct | 512 | $200.41 | $230.47 |
| Metallic Restoration - Three Surfaces - direct | 513 | $234.65 | $269.86 |
| Metallic Restoration - Four Surfaces - direct | 514 | $269.17 | $309.55 |
| Metallic Restoration - Five Surfaces - direct | 515 | $305.67 | $351.51 |
| Adhesive Restoration - One Surface - Anterior Tooth - direct | 521 | $180.30 | $207.34 |
| Adhesive Restoration - Two Surfaces - Anterior tooth - direct | 522 | $212.05 | $243.88 |
| Adhesive Restoration - Three Surfaces - Anterior tooth - direct | 523 | $248.85 | $286.18 |
| Adhesive Restoration - Four Surfaces - Anterior tooth - direct | 524 | $279.98 | $321.99 |
| Adhesive Restoration - Five Surfaces - Anterior tooth - direct | 525 | $329.33 | $378.72 |
| Adhesive Restoration - Veneer - Anterior tooth- direct | 526 | $371.09 | $407.54 |
| Adhesive restoration - one surface - posterior tooth - direct | 531 | $190.09 | $218.60 |
| Adhesive restoration - two surfaces - posterior tooth - direct | 532 | $226.44 | $260.41 |
| Adhesive restoration - three surfaces - posterior tooth - direct | 533 | $264.85 | $304.58 |
| Adhesive restoration - four surfaces - posterior tooth - direct | 534 | $298.36 | $343.12 |
| Adhesive restoration - five surfaces - posterior tooth - direct | 535 | $355.52 | $408.85 |
| Adhesive Restoration - Veneer - Posterior tooth - direct | 536 | $364.30 | $407.54 |
| Tooth coloured restoration - one surface - indirect | 551 | $917.77 | $1,055.45 |
| Tooth coloured restoration - two surfaces - indirect | 552 | $1,017.23 | $1,169.82 |
| Tooth coloured restoration - three surfaces - indirect | 553 | $1,175.06 | $1,351.32 |
| Tooth coloured restoration - four surfaces - indirect | 554 | $1,275.59 | $1,466.93 |
| Tooth coloured restoration - five surfaces - indirect | 555 | $1,398.83 | $1,608.65 |
| Tooth - coloured restoration - Veneer - indirect | 556 | $1,342.62 | $1,544.01 |
| Provisional (intermediate/temporary) restoration - per tooth | 572 | $98.38 | $98.38 |
| Pin retention - per pin | 575 | $44.46 | $44.46 |
| Post - Direct | 597 | $182.27 | $204.96 |
| 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 | $1,580.01 | $1,817.02 |
| Full crown - veneered - indirect | 615 | $1,558.60 | $1,792.39 |
| Full crown - metallic indirect | 618 | $1,568.33 | $1,803.57 |
| Post and core for crown - indirect | 625 | $493.41 | $593.33 |
| Preliminary restoration for crown - direct | 627 | $275.81 | $293.07 |
| Provisional bridge pontic - per pontic | 632 | $312.59 | $312.59 |
| Bridge pontic - direct - per pontic | 642 | $406.98 | $468.03 |
| Bridge pontic - indirect - per pontic | 643 | $1,175.35 | $1,586.72 |
| Retainer for bonded fixture - indirect - per tooth | 649 | $698.23 | $802.96 |
| Implant Procedures | |||
| Fitting of an implant abutment - per abutment | 661 | $1,008.01 | $1,008.01 |
| Prosthesis with metal frame attached to implants - fixed - per arch | 666 | $3,632.20 | $5,321.85 |
| Removal and reattachment of prosthesis fixed to implant(s) – per implant | 669 | $175.01 | $175.01 |
| Full crown attached to osseointegrated implant - veneered indirect | 672 | $2,009.60 | $2,638.08 |
| Surgical implant guide | 679 | $238.83 | $238.73 |
| Insertion of first stage of two-stage endosseous implant - per implant | 684 | $2,162.02 | $2,162.02 |
|
Insertion of one stage endosseous implant - per implant Includes the cost of hardware | 688 | $2,609.02 | $2,609.02 |
|
Second stage surgery of two stage endosseous implant - per implant Includes the cost of hardware | 691 | $446.88 | $446.88 |
| Prosthodontics | |||
| Complete Maxillary Denture | 711 | $1,448.71 | $1,666.01 |
| Complete Mandibular Denture | 712 | $1,448.71 | $1,666.01 |
| Complete Maxillary and Mandibular Denture | 719 | $2,627.03 | $3,021.08 |
| Partial maxillary denture - resin base | 721 | $930.21 | $930.21 |
| Partial mandibular denture - resin base | 722 | $930.21 | $930.21 |
| Partial maxillary denture - cast metal framework including rests and retainers | 727 | $1,613.95 | $1,856.05 |
| Partial mandibular denture - cast metal framework including rests and retainers | 728 | $1,613.95 | $1,856.05 |
| Additional items for Acrylic Dentures only | |||
| Retainer - Per Tooth | 731 | $58.29 | $58.29 |
| Occlusal Rest - per rest | 732 | $16.90 | $16.90 |
| Tooth/teeth partial denture | 733 | $57.30 | $57.30 |
| Immediate tooth replacement - per tooth | 736 | $11.37 | $11.37 |
| Relining - complete denture - processed | 743 | $456.19 | $456.19 |
| Relining - partial denture - processed | 744 | $444.04 | $444.04 |
| Adding tooth to partial denture to replace an extracted or decoronated tooth - per tooth | 768 | $197.72 | $229.75 |
| Splint - Resin - Indirect | 772 | $298.13 | $421.95 |
| Orthodontics | |||
| Active removable appliance therapy - per arch | 821 | $1,043.27 | $1,196.27 |
| Full arch banding - per arch | 831 | $2,876.57 | $4,111.68 |
| Minor tooth guidance - fixed | 846 | $932.86 | $932.86 |
| Complete course of orthodontic treatment | 881 | $5,942.32 | $7,694.50 |
| General | |||
| Travel to provide services | 916 | FBN* | FBN* |
| Clinical occlusal analysis, including muscle and joint palpation - limit one per three year period | 963 | $98.38 | $137.67 |
| Occlusal splint | 965 | $654.76 | $671.14 |
| Adjustment of pre-existing occlusal splint - per appointment | 966 | $93.26 | $119.29 |
| General | Specialist | ||
|---|---|---|---|
| Service Description | ADA Number | Maximum Payment Rate | Maximum Payment Rate |
| Diagnostic services | |||
| Comprehensive Oral Examination | 011 | $111.37 | $111.37 |
| Periodic Oral Examination | 012 | $70.40 | $70.40 |
| Consultation | 014 | $111.37 | $111.37 |
| Written report (not elsewhere included) | 018 | $154.95 | $203.97 |
| Intraoral periapical or bitewing radiograph - per exposure | 022 | $54.86 | $54.86 |
| Cone Beam Volumetric Tomography - scan acquisition - per appointment | 026 | $175.12 | $175.12 |
| Cephalometric Radiograph - per exposure | 036 | $123.80 | $123.80 |
| Panoramic radiograph - per exposure | 037 | $123.80 | $123.80 |
| Pulp Testing - per appointment | 061 | $39.82 | $39.82 |
| Diagnostic model - per model | 071 | $77.04 | $77.04 |
| Photographic records - intraoral - per appointment | 072 | $44.00 | $44.00 |
| Cone Beam Volumetric Tomography analysis and/or interpretation - maxillary or mandibular dentition (both arches) | 089 | $81.73 | $81.73 |
| Preventive Services | |||
| (Prior approval from TAC required for these services) | |||
| Removal Of Calculus - first appointment | 114 | $ 138.37 | $138.37 |
| Bleaching, Internal - per tooth | 117 | $245.52 | $245.52 |
| Topical application of remineralisation and/or cariostatic agents - one treatment | 121 | $50.49 | $50.49 |
| Oral hygiene instruction | 141 | $55.18 | $55.18 |
| Desensitising Procedure - per appointment | 165 | $51.98 | $51.98 |
| Odontoplasty - per tooth | 171 | $55.60 | $55.60 |
| Periodontal Debridement - per tooth | 222 | $63.04 | $72.49 |
| Periodontal Flap Surgery - per tooth - Limit of 10 per visit, 20 per 12 month period | 232 | $311.32 | $311.32 |
| Surgical treatment of Peri-implant Disease - per implant | 233 | $375.62 | $375.62 |
| Gingival Graft - per tooth, implant or extraction | 235 | $542.08 | $637.75 |
| Guided Tissue Regeneration - per tooth or implant | 236 | $542.08 | $637.75 |
| Guided Tissue Regeneration - membrane removal | 237 | $629.72 | $740.87 |
| Periodontal Surgery for Crown Lengthening - per tooth | 238 | $544.63 | $640.74 |
| Osseous Graft- per tooth or implant | 243 | $542.08 | $637.75 |
| Oral Surgery | |||
| Removal of a tooth or part(s) thereof | 311 | $230.55 | $249.32 |
| Sectional removal of tooth or part(s) thereof | 314 | $303.83 | $310.15 |
| Surgical removal of a tooth or tooth fragment not requiring removal of bone or tooth division | 322 | $341.81 | $357.85 |
| Surgical removal of a tooth or tooth fragment requiring removal of bone | 323 | $411.58 | $440.15 |
| Splinting of displaced tooth/teeth - per tooth | 386 | $226.65 | $283.75 |
| Replantation and splinting of a tooth - per tooth | 387 | $455.66 | $524.01 |
| Endodontics | |||
| (These fees include the cost of x-rays where required) | |||
| Direct Pulp Capping | 411 | $61.38 | $64.42 |
| Pulpotomy | 414 | $151.43 | $206.92 |
| Complete chemo-mechanical preparation of root canal - one canal | 415 | $354.09 | $407.19 |
| Complete chemo-mechanical preparation of root canal - each additional canal | 416 | $174.29 | $201.96 |
| Root canal obturation - one canal | 417 | $347.52 | $399.64 |
| Root canal obturation - each additional canal | 418 | $171.43 | $197.14 |
| Extirpation of pulp or debridement of root canal(s) - emergency or palliative | 419 | $243.17 | $243.17 |
| Removal Of Root Filling - Per Canal | 451 | $165.76 | $190.65 |
| Additional Visit For Irrigation And/Or Dressing Of The Root Canal System - per tooth | 455 | $183.55 | $211.08 |
| Restorative Services | |||
| Metallic Restoration - One Surface - direct | 511 | $181.09 | $208.25 |
| Metallic Restoration - Two Surfaces - direct | 512 | $216.42 | $248.88 |
| Metallic Restoration - Three Surfaces - direct | 513 | $253.40 | $291.42 |
| Metallic Restoration - Four Surfaces - direct | 514 | $290.68 | $334.28 |
| Metallic Restoration - Five Surfaces - direct | 515 | $330.09 | $379.60 |
| Adhesive Restoration - One Surface - Anterior Tooth - direct | 521 | $194.71 | $223.91 |
| Adhesive Restoration - Two Surfaces - Anterior tooth - direct | 522 | $228.99 | $263.37 |
| Adhesive Restoration - Three Surfaces - Anterior tooth - direct | 523 | $268.73 | $309.05 |
| Adhesive Restoration - Four Surfaces - Anterior tooth - direct | 524 | $302.35 | $347.72 |
| Adhesive Restoration - Five Surfaces - Anterior tooth - direct | 525 | $355.64 | $408.98 |
| Adhesive Restoration - Veneer - Anterior tooth- direct | 526 | $400.74 | $440.10 |
| Adhesive restoration - one surface - posterior tooth - direct | 531 | $205.28 | $236.07 |
| Adhesive restoration - two surfaces - posterior tooth - direct | 532 | $244.53 | $281.22 |
| Adhesive restoration - three surfaces - posterior tooth - direct | 533 | $286.01 | $328.92 |
| Adhesive restoration - four surfaces - posterior tooth - direct | 534 | $322.20 | $370.54 |
| Adhesive restoration - five surfaces - posterior tooth - direct | 535 | $383.93 | $441.52 |
| Adhesive Restoration - Veneer - Posterior tooth - direct | 536 | $393.41 | $440.10 |
| Tooth coloured restoration - one surface - indirect | 551 | $991.10 | $1,139.78 |
| Tooth coloured restoration - two surfaces - indirect | 552 | $1,098.51 | $1,263.29 |
| Tooth coloured restoration - three surfaces - indirect | 553 | $1,268.95 | $1,459.29 |
| Tooth coloured restoration - four surfaces - indirect | 554 | $1,377.51 | $1,584.14 |
| Tooth coloured restoration - five surfaces - indirect | 555 | $1,510.60 | $1,737.18 |
| Tooth - coloured restoration - Veneer - indirect | 556 | $1,449.90 | $1,667.38 |
| Provisional (intermediate/temporary) restoration - per tooth | 572 | $106.24 | $106.24 |
| Pin retention - per pin | 575 | $48.01 | $48.01 |
| Post - Direct | 597 | $196.83 | $221.34 |
| 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 | $1,706.25 | $1,962.20 |
| Full crown - veneered - indirect | 615 | $1,683.13 | $1,935.60 |
| Full crown - metallic indirect | 618 | $1,693.64 | $1,947.68 |
| Post and core for crown - indirect | 625 | $532.83 | $640.74 |
| Preliminary restoration for crown - direct | 627 | $297.85 | $316.49 |
| Provisional bridge pontic - per pontic | 632 | $337.57 | $337.57 |
| Bridge pontic - direct - per pontic | 642 | $439.50 | $505.43 |
| Bridge pontic - indirect - per pontic | 643 | $1,269.26 | $1,713.50 |
| Retainer for bonded fixture - indirect - per tooth | 649 | $754.02 | $867.12 |
| Implant Procedures | |||
| Fitting of an implant abutment - per abutment | 661 | $1,088.55 | $1,088.55 |
| Prosthesis with metal frame attached to implants - fixed - per arch | 666 | $3,922.41 | $5,747.07 |
| Removal and reattachment of prosthesis fixed to implant(s) – per implant | 669 | $188.99 | $188.99 |
| Full crown attached to osseointegrated implant - veneered indirect | 672 | $2,170.17 | $2,848.86 |
| Surgical implant guide | 679 | $257.80 | $257.80 |
| Insertion of first stage of two-stage endosseous implant - per implant | 684 | $2,334.77 | $2,334.77 |
|
Insertion of one stage endosseous implant - per implant Includes the cost of hardware | 688 | $2,817.48 | $2,817.48 |
|
Second stage surgery of two stage endosseous implant - per implant Includes the cost of hardware | 691 | $482.59 | $482.59 |
| Prosthodontics | |||
| Complete Maxillary Denture | 711 | $1,564.46 | $1,799.12 |
| Complete Mandibular Denture | 712 | $1,564.46 | $1,799.12 |
| Complete Maxillary and Mandibular Denture | 719 | $2,836.93 | $3,262.46 |
| Partial maxillary denture - resin base | 721 | $1,004.53 | $1,004.53 |
| Partial mandibular denture - resin base | 722 | $1,004.53 | $1,004.53 |
| Partial maxillary denture - cast metal framework including rests and retainers | 727 | $1,742.90 | $2,004.35 |
| Partial mandibular denture - cast metal framework including rests and retainers | 728 | $1,742.90 | $2,004.35 |
| Additional items for Acrylic Dentures only | |||
| Retainer - Per Tooth | 731 | $62.95 | $62.95 |
| Occlusal Rest - per rest | 732 | $18.25 | $18.25 |
| Tooth/teeth partial denture | 733 | $61.88 | $61.88 |
| Immediate tooth replacement - per tooth | 736 | $12.28 | $12.28 |
| Relining - complete denture - processed | 743 | $492.64 | $492.64 |
| Relining - partial denture - processed | 744 | $479.52 | $479.52 |
| Adding tooth to partial denture to replace an extracted or decoronated tooth - per tooth | 768 | $213.52 | $248.11 |
| Splint - Resin - Indirect | 772 | $321.95 | $455.66 |
| Orthodontics | |||
| Active removable appliance therapy - per arch | 821 | $1,126.63 | $1,291.85 |
| Full arch banding - per arch | 831 | $3,106.41 | $4,440.20 |
| Minor tooth guidance - fixed | 846 | $1,007.40 | $1,007.40 |
| Complete course of orthodontic treatment | 881 | $6,417.11 | $8,309.29 |
| General | |||
| Travel to provide services | 916 | FBN* | FBN* |
| Clinical occlusal analysis, including muscle and joint palpation - limit one per three year period | 963 | $106.24 | $148.67 |
| Occlusal splint | 965 | $707.08 | $724.76 |
| Adjustment of pre-existing occlusal splint - per appointment | 966 | $100.71 | $128.82 |
| General | Specialist | ||
|---|---|---|---|
| Service Description | ADA Number | Maximum Payment Rate | Maximum Payment Rate |
| Diagnostic services | |||
| Comprehensive Oral Examination | 011 | $103.13 | $103.13 |
| Periodic Oral Examination | 012 | $65.19 | $65.19 |
| Consultation | 014 | $103.13 | $103.13 |
| Written report (not elsewhere included) | 018 | $143.49 | $188.88 |
| Intraoral periapical or bitewing radiograph - per exposure | 022 | $50.80 | $50.80 |
| Cone Beam Volumetric Tomography - scan acquisition - per appointment | 026 | $162.16 | $162.16 |
| Cephalometric Radiograph - per exposure | 036 | $114.64 | $114.64 |
| Panoramic radiograph - per exposure | 037 | $114.64 | $114.64 |
| Pulp Testing - per appointment | 061 | $36.87 | $36.87 |
| Diagnostic model - per model | 071 | $71.34 | $71.34 |
| Photographic records - intraoral - per appointment | 072 | $40.74 | $40.74 |
| Cone Beam Volumetric Tomography analysis and/or interpretation - maxillary or mandibular dentition (both arches) | 089 | $75.68 | $75.68 |
| Preventive Services | |||
| (Prior approval from TAC required for these services) | |||
| Removal Of Calculus - first appointment | 114 | $128.13 | $128.13 |
| Bleaching, Internal - per tooth | 117 | $227.35 | $227.35 |
| Topical application of remineralisation and/or cariostatic agents - one treatment | 121 | $46.75 | $46.75 |
| Oral hygiene instruction | 141 | $51.10 | $51.10 |
| Desensitising Procedure - per appointment | 165 | $48.13 | $48.13 |
| Odontoplasty - per tooth | 171 | $51.49 | $51.49 |
| Periodontal Debridement - per tooth | 222 | $58.38 | $67.13 |
| Periodontal Flap Surgery - per tooth - Limit of 10 per visit, 20 per 12 month period | 232 | $288.29 | $288.29 |
| Surgical treatment of Peri-implant Disease - per implant | 233 | $347.83 | $347.83 |
| Gingival Graft - per tooth, implant or extraction | 235 | $501.97 | $590.56 |
| Guided Tissue Regeneration - per tooth or implant | 236 | $501.97 | $590.56 |
| Guided Tissue Regeneration - membrane removal | 237 | $583.13 | $686.05 |
| Periodontal Surgery for Crown Lengthening - per tooth | 238 | $504.33 | $593.33 |
| Osseous Graft- per tooth or implant | 243 | $501.97 | $590.56 |
| Oral Surgery | |||
| Removal of a tooth or part(s) thereof | 311 | $213.49 | $230.87 |
| Sectional removal of tooth or part(s) thereof | 314 | $281.35 | $287.20 |
| Surgical removal of a tooth or tooth fragment not requiring removal of bone or tooth division | 322 | $316.52 | $331.37 |
| Surgical removal of a tooth or tooth fragment requiring removal of bone | 323 | $381.13 | $407.58 |
| Splinting of displaced tooth/teeth - per tooth | 386 | $209.88 | $262.76 |
| Replantation and splinting of a tooth - per tooth | 387 | $421.95 | $485.24 |
| Endodontics | |||
| (These fees include the cost of x-rays where required) | |||
| Direct Pulp Capping | 411 | $56.84 | $59.65 |
| Pulpotomy | 414 | $140.23 | $191.61 |
| Complete chemo-mechanical preparation of root canal - one canal | 415 | $327.89 | $377.06 |
| Complete chemo-mechanical preparation of root canal - each additional canal | 416 | $161.39 | $187.02 |
| Root canal obturation - one canal | 417 | $321.81 | $370.07 |
| Root canal obturation - each additional canal | 418 | $158.75 | $182.55 |
| Extirpation of pulp or debridement of root canal(s) - emergency or palliative | 419 | $225.18 | $225.18 |
| Removal Of Root Filling - Per Canal | 451 | $153.50 | $176.54 |
| Additional Visit For Irrigation And/Or Dressing Of The Root Canal System - per tooth | 455 | $169.97 | $195.46 |
| Restorative Services | |||
| Metallic Restoration - One Surface - direct | 511 | $167.69 | $192.84 |
| Metallic Restoration - Two Surfaces - direct | 512 | $200.41 | $230.47 |
| Metallic Restoration - Three Surfaces - direct | 513 | $234.65 | $269.86 |
| Metallic Restoration - Four Surfaces - direct | 514 | $269.17 | $309.55 |
| Metallic Restoration - Five Surfaces - direct | 515 | $305.67 | $351.51 |
| Adhesive Restoration - One Surface - Anterior Tooth - direct | 521 | $180.30 | $207.34 |
| Adhesive Restoration - Two Surfaces - Anterior tooth - direct | 522 | $212.05 | $243.88 |
| Adhesive Restoration - Three Surfaces - Anterior tooth - direct | 523 | $248.85 | $286.18 |
| Adhesive Restoration - Four Surfaces - Anterior tooth - direct | 524 | $279.98 | $321.99 |
| Adhesive Restoration - Five Surfaces - Anterior tooth - direct | 525 | $329.33 | $378.72 |
| Adhesive Restoration - Veneer - Anterior tooth- direct | 526 | $371.09 | $407.54 |
| Adhesive restoration - one surface - posterior tooth - direct | 531 | $190.09 | $218.60 |
| Adhesive restoration - two surfaces - posterior tooth - direct | 532 | $226.44 | $260.41 |
| Adhesive restoration - three surfaces - posterior tooth - direct | 533 | $264.85 | $304.58 |
| Adhesive restoration - four surfaces - posterior tooth - direct | 534 | $298.36 | $343.12 |
| Adhesive restoration - five surfaces - posterior tooth - direct | 535 | $355.52 | $408.85 |
| Adhesive Restoration - Veneer - Posterior tooth - direct | 536 | $364.30 | $407.54 |
| Tooth coloured restoration - one surface - indirect | 551 | $917.77 | $1,055.45 |
| Tooth coloured restoration - two surfaces - indirect | 552 | $1,017.23 | $1,169.82 |
| Tooth coloured restoration - three surfaces - indirect | 553 | $1,175.06 | $1,351.32 |
| Tooth coloured restoration - four surfaces - indirect | 554 | $1,275.59 | $1,466.93 |
| Tooth coloured restoration - five surfaces - indirect | 555 | $1,398.83 | $1,608.65 |
| Tooth - coloured restoration - Veneer - indirect | 556 | $1,342.62 | $1,544.01 |
| Provisional (intermediate/temporary) restoration - per tooth | 572 | $98.38 | $98.38 |
| Pin retention - per pin | 575 | $44.46 | $44.46 |
| Post - Direct | 597 | $182.27 | $204.96 |
| 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 | $1,580.01 | $1,817.02 |
| Full crown - veneered - indirect | 615 | $1,558.60 | $1,792.39 |
| Full crown - metallic indirect | 618 | $1,568.33 | $1,803.57 |
| Post and core for crown - indirect | 625 | $493.41 | $593.33 |
| Preliminary restoration for crown - direct | 627 | $275.81 | $293.07 |
| Provisional bridge pontic - per pontic | 632 | $312.59 | $312.59 |
| Bridge pontic - direct - per pontic | 642 | $406.98 | $468.03 |
| Bridge pontic - indirect - per pontic | 643 | $1,175.35 | $1,586.72 |
| Retainer for bonded fixture - indirect - per tooth | 649 | $698.23 | $802.96 |
| Implant Procedures | |||
| Fitting of an implant abutment - per abutment | 661 | $1,008.01 | $1,008.01 |
| Prosthesis with metal frame attached to implants - fixed - per arch | 666 | $3,632.20 | $5,321.85 |
| Removal and reattachment of prosthesis fixed to implant(s) – per implant | 669 | $175.01 | $175.01 |
| Full crown attached to osseointegrated implant - veneered indirect | 672 | $2,009.60 | $2,638.08 |
| Surgical implant guide | 679 | $238.83 | $238.73 |
| Insertion of first stage of two-stage endosseous implant - per implant | 684 | $2,162.02 | $2,162.02 |
|
Insertion of one stage endosseous implant - per implant Includes the cost of hardware | 688 | $2,609.02 | $2,609.02 |
|
Second stage surgery of two stage endosseous implant - per implant Includes the cost of hardware | 691 | $446.88 | $446.88 |
| Prosthodontics | |||
| Complete Maxillary Denture | 711 | $1,448.71 | $1,666.01 |
| Complete Mandibular Denture | 712 | $1,448.71 | $1,666.01 |
| Complete Maxillary and Mandibular Denture | 719 | $2,627.03 | $3,021.08 |
| Partial maxillary denture - resin base | 721 | $930.21 | $930.21 |
| Partial mandibular denture - resin base | 722 | $930.21 | $930.21 |
| Partial maxillary denture - cast metal framework including rests and retainers | 727 | $1,613.95 | $1,856.05 |
| Partial mandibular denture - cast metal framework including rests and retainers | 728 | $1,613.95 | $1,856.05 |
| Additional items for Acrylic Dentures only | |||
| Retainer - Per Tooth | 731 | $58.29 | $58.29 |
| Occlusal Rest - per rest | 732 | $16.90 | $16.90 |
| Tooth/teeth partial denture | 733 | $57.30 | $57.30 |
| Immediate tooth replacement - per tooth | 736 | $11.37 | $11.37 |
| Relining - complete denture - processed | 743 | $456.19 | $456.19 |
| Relining - partial denture - processed | 744 | $444.04 | $444.04 |
| Adding tooth to partial denture to replace an extracted or decoronated tooth - per tooth | 768 | $197.72 | $229.75 |
| Splint - Resin - Indirect | 772 | $298.13 | $421.95 |
| Orthodontics | |||
| Active removable appliance therapy - per arch | 821 | $1,043.27 | $1,196.27 |
| Full arch banding - per arch | 831 | $2,876.57 | $4,111.68 |
| Minor tooth guidance - fixed | 846 | $932.86 | $932.86 |
| Complete course of orthodontic treatment | 881 | $5,942.32 | $7,694.50 |
| General | |||
| Travel to provide services | 916 | FBN* | FBN* |
| Clinical occlusal analysis, including muscle and joint palpation - limit one per three year period | 963 | $98.38 | $137.67 |
| Occlusal splint | 965 | $654.76 | $671.14 |
| Adjustment of pre-existing occlusal splint - per appointment | 966 | $93.26 | $119.29 |
* Note: Where the terminology FBN appears in this schedule, the fee must be negotiated with the TAC before any dental treatment is commenced.
The TAC has adopted the Medicare Benefits Schedule (MBS) items, explanations, definitions, rules and conditions for services provided by medical practitioners. When invoicing for medical services, medical practitioners are expected to adhere to the MBS rules unless otherwise specified by the TAC on the Reimbursement Rates for Medical Services information page or its medical policies.
The Reimbursement Rates for Medical Services must be read in conjunction with:
- Medicare Benefits Schedule (MBS)
- Clarification of Medicare Benefits Schedule (MBS) rules
- Other policies outlined within the Medical Practitioners section of our website
Current rates
Important: The Excel spreadsheet includes all the temporary MBS COVID19 telehealth items payable by the TAC. It was last updated on 29 February 2024. For further information about TAC funded telehealth, please refer to our telehealth information page. |
Current rates
Important: The Excel spreadsheet includes all the temporary MBS COVID19 telehealth items payable by the TAC. It was last updated on 29 February 2024. For further information about TAC funded telehealth, please refer to our telehealth information page. |
At the time of production this publication contained up to date information as released by Medicare Australia (Medicare). The relevant publication will be updated to reflect any further changes that are implemented by Medicare each year. Please check our website for the latest version.
If you have any questions about these publications or the reimbursement rates, please contact the TAC on 1300 654 329. Alternatively, e-mail info@tac.vic.gov.au.
We’re here to help you get your life back on track after your transport accident. We will pay for dental services, provided in Australia, that you need as a result of a transport accident. This includes surgery by an oral or maxillofacial surgeon.
In the first 90 days after your accident, the TAC can help pay for this treatment without the need for you to contact us for approval first.
When you need to contact us for approval
You or your provider need to contact the TAC for approval of this treatment if:
- It is approaching or more than 90 days since your accident and we have not approved further treatment or services, or
- It has been more than 6 months since you’ve had any treatment or service paid for by the TAC.
When can we pay for dental services
As dental services are a TAC approved treatment we will pay for you to visit a dentist, dental prosthetist, or an oral or maxillofacial surgeon for treatment, assessment and care planning immediately after your accident. You can also immediately access any radiology or diagnostic procedures required as part of this treatment.
If your dentures were damaged or lost in the accident, we can also pay for their repair or replacement.
To help you with your injuries, your dentist may also recommend treatments such as:
- Partial or full dentures.
- Dental implants and associated procedures, such as bone and soft tissue grafts.
- Prosthodontics including the construction and insertion of an implant-supported prosthesis.
For more information on oral or maxillofacial surgery, see: Surgery and medical specialists.
We will, where appropriate, work with your treating team to make sure that you receive the dental services you need.
We may contact your dental services provider to discuss your progress or request an assessment to make sure that:
- You have access to the most appropriate treatment and support.
- You are getting proven, evidence-based treatment and not receiving treatment that isn't helping you recover.
- You are moving towards getting your life back on track or being able to live independently.
What we can pay for
Treatments and services that we can't pay for
We can’t pay for services that:
- Do not treat your transport accident injuries.
- Are not reasonable, necessary or appropriate.
- Are not clinically justified, safe and effective.
What does my dentist do?
A dentist is trained to treat injuries, diseases and conditions that affect the teeth, gums, jaw and mouth.
Your dentist may be helped by a qualified dental technician, who assists with the design, manufacture, modification and repair of dentures, mouthguards, bridges and crowns.
For more information, see:
How treatments and services are paid for
We pay for your treatment:
- Directly to your dentist, when you have provided them with your TAC claim number, or
- If you have to pay, use myTAC to send a copy of your receipt to us and we will repay you.
We pay for your services in line with our responsibilities under the Transport Accident Act 1986.
How much we will pay
We will pay for your dental services, including consultations, implants, prosthodontics and implant based bridge maintenance according to our fee schedule. If your provider charges more than the TAC rate, you may need to pay the difference.
For a list of TAC rates, see:
For accidents that happened before 14 February 2018, we can only pay for these services once any required medical excess has been reached. Find out if the medical excess applies to you.
For providers
If you are a dental services provider, please refer to our TAC Provider Guidelines.
We can help pay for this treatment in the first 90 days after your accident. You do not need to contact us for approval first if:
- you have a TAC claim number
- your doctor or other health professional recommends it, and
- it is for your accident injuries.
We may contact you or your provider to check your progress and see if you are getting the support you need. This will help us make sure your treatment is helping your recovery. It will allow us to make decisions about what treatment we can pay for and how long we can pay for it.
How to get dental treatment
- Choose a dentist. Your doctor can recommend one in your local area or you can search for a dentist online.
- Call and make an appointment. Tell them you are a TAC client. Ask if they charge at TAC rates. If the provider charges more, they may ask you for a 'gap payment' to make up the difference
- Go to your appointment and give the provider your TAC claim number.
When you need to ask for TAC approval:
Please contact us for approval if it is:
- close to or more than 90 days since your accident and we haven’t already approved more treatment, or
- more than 6 months since you’ve had any treatment or service paid for by the TAC.
How we pay for treatment
There are two ways we can pay for your approved treatments and services:
- we pay your provider at the TAC rate
- you pay your provider, and we repay you at the TAC rate.
To ask for a reimbursement, scan or take a photo of your receipt. Send it to us with the ‘Claim reimbursement’ button on myTAC, or by email to info@tac.vic.gov.au and we will repay you.
We will pay for your treatment at the TAC rate . If your provider charges more than the TAC rate, you may need to pay the difference. This is known as a 'gap payment'.
If your provider charges you a gap payment, you may be able to seek reimbursement for some of this through:
- Medicare or your private health insurance
- The TAC.
Please note, in most cases, we are unable to reimburse you for a gap payment. This is because we have paid for your treatment or service at a rate we have determined is reasonable. You may still ask for a reimbursement from the TAC and we will let you know our decision.
What does a dentist do?
A dentist is a medical professional trained to treat injuries, diseases and conditions that affect the teeth, gums, jaw and mouth.
Information for health and service providers
If you are a dental services provider, please refer to our TAC Provider Guidelines.
Effective 1 July 2023
Dental services can be invoiced online via HICAPS Digital Claims for next business day payments.
| General | Specialist | ||
|---|---|---|---|
| Service Description | ADA Number | Maximum Payment Rate | Maximum Payment Rate |
| Diagnostic services | |||
| Comprehensive Oral Examination | 011 | $111.37 | $111.37 |
| Periodic Oral Examination | 012 | $70.40 | $70.40 |
| Consultation | 014 | $111.37 | $111.37 |
| Written report (not elsewhere included) | 018 | $154.95 | $203.97 |
| Intraoral periapical or bitewing radiograph - per exposure | 022 | $54.86 | $54.86 |
| Cone Beam Volumetric Tomography - scan acquisition - per appointment | 026 | $175.12 | $175.12 |
| Cephalometric Radiograph - per exposure | 036 | $123.80 | $123.80 |
| Panoramic radiograph - per exposure | 037 | $123.80 | $123.80 |
| Pulp Testing - per appointment | 061 | $39.82 | $39.82 |
| Diagnostic model - per model | 071 | $77.04 | $77.04 |
| Photographic records - intraoral - per appointment | 072 | $44.00 | $44.00 |
| Cone Beam Volumetric Tomography analysis and/or interpretation - maxillary or mandibular dentition (both arches) | 089 | $81.73 | $81.73 |
| Preventive Services | |||
| (Prior approval from TAC required for these services) | |||
| Removal Of Calculus - first appointment | 114 | $ 138.37 | $138.37 |
| Bleaching, Internal - per tooth | 117 | $245.52 | $245.52 |
| Topical application of remineralisation and/or cariostatic agents - one treatment | 121 | $50.49 | $50.49 |
| Oral hygiene instruction | 141 | $55.18 | $55.18 |
| Desensitising Procedure - per appointment | 165 | $51.98 | $51.98 |
| Odontoplasty - per tooth | 171 | $55.60 | $55.60 |
| Periodontal Debridement - per tooth | 222 | $63.04 | $72.49 |
| Periodontal Flap Surgery - per tooth - Limit of 10 per visit, 20 per 12 month period | 232 | $311.32 | $311.32 |
| Surgical treatment of Peri-implant Disease - per implant | 233 | $375.62 | $375.62 |
| Gingival Graft - per tooth, implant or extraction | 235 | $542.08 | $637.75 |
| Guided Tissue Regeneration - per tooth or implant | 236 | $542.08 | $637.75 |
| Guided Tissue Regeneration - membrane removal | 237 | $629.72 | $740.87 |
| Periodontal Surgery for Crown Lengthening - per tooth | 238 | $544.63 | $640.74 |
| Osseous Graft- per tooth or implant | 243 | $542.08 | $637.75 |
| Oral Surgery | |||
| Removal of a tooth or part(s) thereof | 311 | $230.55 | $249.32 |
| Sectional removal of tooth or part(s) thereof | 314 | $303.83 | $310.15 |
| Surgical removal of a tooth or tooth fragment not requiring removal of bone or tooth division | 322 | $341.81 | $357.85 |
| Surgical removal of a tooth or tooth fragment requiring removal of bone | 323 | $411.58 | $440.15 |
| Splinting of displaced tooth/teeth - per tooth | 386 | $226.65 | $283.75 |
| Replantation and splinting of a tooth - per tooth | 387 | $455.66 | $524.01 |
| Endodontics | |||
| (These fees include the cost of x-rays where required) | |||
| Direct Pulp Capping | 411 | $61.38 | $64.42 |
| Pulpotomy | 414 | $151.43 | $206.92 |
| Complete chemo-mechanical preparation of root canal - one canal | 415 | $354.09 | $407.19 |
| Complete chemo-mechanical preparation of root canal - each additional canal | 416 | $174.29 | $201.96 |
| Root canal obturation - one canal | 417 | $347.52 | $399.64 |
| Root canal obturation - each additional canal | 418 | $171.43 | $197.14 |
| Extirpation of pulp or debridement of root canal(s) - emergency or palliative | 419 | $243.17 | $243.17 |
| Removal Of Root Filling - Per Canal | 451 | $165.76 | $190.65 |
| Additional Visit For Irrigation And/Or Dressing Of The Root Canal System - per tooth | 455 | $183.55 | $211.08 |
| Restorative Services | |||
| Metallic Restoration - One Surface - direct | 511 | $181.09 | $208.25 |
| Metallic Restoration - Two Surfaces - direct | 512 | $216.42 | $248.88 |
| Metallic Restoration - Three Surfaces - direct | 513 | $253.40 | $291.42 |
| Metallic Restoration - Four Surfaces - direct | 514 | $290.68 | $334.28 |
| Metallic Restoration - Five Surfaces - direct | 515 | $330.09 | $379.60 |
| Adhesive Restoration - One Surface - Anterior Tooth - direct | 521 | $194.71 | $223.91 |
| Adhesive Restoration - Two Surfaces - Anterior tooth - direct | 522 | $228.99 | $263.37 |
| Adhesive Restoration - Three Surfaces - Anterior tooth - direct | 523 | $268.73 | $309.05 |
| Adhesive Restoration - Four Surfaces - Anterior tooth - direct | 524 | $302.35 | $347.72 |
| Adhesive Restoration - Five Surfaces - Anterior tooth - direct | 525 | $355.64 | $408.98 |
| Adhesive Restoration - Veneer - Anterior tooth- direct | 526 | $400.74 | $440.10 |
| Adhesive restoration - one surface - posterior tooth - direct | 531 | $205.28 | $236.07 |
| Adhesive restoration - two surfaces - posterior tooth - direct | 532 | $244.53 | $281.22 |
| Adhesive restoration - three surfaces - posterior tooth - direct | 533 | $286.01 | $328.92 |
| Adhesive restoration - four surfaces - posterior tooth - direct | 534 | $322.20 | $370.54 |
| Adhesive restoration - five surfaces - posterior tooth - direct | 535 | $383.93 | $441.52 |
| Adhesive Restoration - Veneer - Posterior tooth - direct | 536 | $393.41 | $440.10 |
| Tooth coloured restoration - one surface - indirect | 551 | $991.10 | $1,139.78 |
| Tooth coloured restoration - two surfaces - indirect | 552 | $1,098.51 | $1,263.29 |
| Tooth coloured restoration - three surfaces - indirect | 553 | $1,268.95 | $1,459.29 |
| Tooth coloured restoration - four surfaces - indirect | 554 | $1,377.51 | $1,584.14 |
| Tooth coloured restoration - five surfaces - indirect | 555 | $1,510.60 | $1,737.18 |
| Tooth - coloured restoration - Veneer - indirect | 556 | $1,449.90 | $1,667.38 |
| Provisional (intermediate/temporary) restoration - per tooth | 572 | $106.24 | $106.24 |
| Pin retention - per pin | 575 | $48.01 | $48.01 |
| Post - Direct | 597 | $196.83 | $221.34 |
| 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 | $1,706.25 | $1,962.20 |
| Full crown - veneered - indirect | 615 | $1,683.13 | $1,935.60 |
| Full crown - metallic indirect | 618 | $1,693.64 | $1,947.68 |
| Post and core for crown - indirect | 625 | $532.83 | $640.74 |
| Preliminary restoration for crown - direct | 627 | $297.85 | $316.49 |
| Provisional bridge pontic - per pontic | 632 | $337.57 | $337.57 |
| Bridge pontic - direct - per pontic | 642 | $439.50 | $505.43 |
| Bridge pontic - indirect - per pontic | 643 | $1,269.26 | $1,713.50 |
| Retainer for bonded fixture - indirect - per tooth | 649 | $754.02 | $867.12 |
| Implant Procedures | |||
| Fitting of an implant abutment - per abutment | 661 | $1,088.55 | $1,088.55 |
| Prosthesis with metal frame attached to implants - fixed - per arch | 666 | $3,922.41 | $5,747.07 |
| Removal and reattachment of prosthesis fixed to implant(s) – per implant | 669 | $188.99 | $188.99 |
| Full crown attached to osseointegrated implant - veneered indirect | 672 | $2,170.17 | $2,848.86 |
| Surgical implant guide | 679 | $257.80 | $257.80 |
| Insertion of first stage of two-stage endosseous implant - per implant | 684 | $2,334.77 | $2,334.77 |
|
Insertion of one stage endosseous implant - per implant Includes the cost of hardware | 688 | $2,817.48 | $2,817.48 |
|
Second stage surgery of two stage endosseous implant - per implant Includes the cost of hardware | 691 | $482.59 | $482.59 |
| Prosthodontics | |||
| Complete Maxillary Denture | 711 | $1,564.46 | $1,799.12 |
| Complete Mandibular Denture | 712 | $1,564.46 | $1,799.12 |
| Complete Maxillary and Mandibular Denture | 719 | $2,836.93 | $3,262.46 |
| Partial maxillary denture - resin base | 721 | $1,004.53 | $1,004.53 |
| Partial mandibular denture - resin base | 722 | $1,004.53 | $1,004.53 |
| Partial maxillary denture - cast metal framework including rests and retainers | 727 | $1,742.90 | $2,004.35 |
| Partial mandibular denture - cast metal framework including rests and retainers | 728 | $1,742.90 | $2,004.35 |
| Additional items for Acrylic Dentures only | |||
| Retainer - Per Tooth | 731 | $62.95 | $62.95 |
| Occlusal Rest - per rest | 732 | $18.25 | $18.25 |
| Tooth/teeth partial denture | 733 | $61.88 | $61.88 |
| Immediate tooth replacement - per tooth | 736 | $12.28 | $12.28 |
| Relining - complete denture - processed | 743 | $492.64 | $492.64 |
| Relining - partial denture - processed | 744 | $479.52 | $479.52 |
| Adding tooth to partial denture to replace an extracted or decoronated tooth - per tooth | 768 | $213.52 | $248.11 |
| Splint - Resin - Indirect | 772 | $321.95 | $455.66 |
| Orthodontics | |||
| Active removable appliance therapy - per arch | 821 | $1,126.63 | $1,291.85 |
| Full arch banding - per arch | 831 | $3,106.41 | $4,440.20 |
| Minor tooth guidance - fixed | 846 | $1,007.40 | $1,007.40 |
| Complete course of orthodontic treatment | 881 | $6,417.11 | $8,309.29 |
| General | |||
| Travel to provide services | 916 | FBN* | FBN* |
| Clinical occlusal analysis, including muscle and joint palpation - limit one per three year period | 963 | $106.24 | $148.67 |
| Occlusal splint | 965 | $707.08 | $724.76 |
| Adjustment of pre-existing occlusal splint - per appointment | 966 | $100.71 | $128.82 |
| General | Specialist | ||
|---|---|---|---|
| Service Description | ADA Number | Maximum Payment Rate | Maximum Payment Rate |
| Diagnostic services | |||
| Comprehensive Oral Examination | 011 | $103.13 | $103.13 |
| Periodic Oral Examination | 012 | $65.19 | $65.19 |
| Consultation | 014 | $103.13 | $103.13 |
| Written report (not elsewhere included) | 018 | $143.49 | $188.88 |
| Intraoral periapical or bitewing radiograph - per exposure | 022 | $50.80 | $50.80 |
| Cone Beam Volumetric Tomography - scan acquisition - per appointment | 026 | $162.16 | $162.16 |
| Cephalometric Radiograph - per exposure | 036 | $114.64 | $114.64 |
| Panoramic radiograph - per exposure | 037 | $114.64 | $114.64 |
| Pulp Testing - per appointment | 061 | $36.87 | $36.87 |
| Diagnostic model - per model | 071 | $71.34 | $71.34 |
| Photographic records - intraoral - per appointment | 072 | $40.74 | $40.74 |
| Cone Beam Volumetric Tomography analysis and/or interpretation - maxillary or mandibular dentition (both arches) | 089 | $75.68 | $75.68 |
| Preventive Services | |||
| (Prior approval from TAC required for these services) | |||
| Removal Of Calculus - first appointment | 114 | $128.13 | $128.13 |
| Bleaching, Internal - per tooth | 117 | $227.35 | $227.35 |
| Topical application of remineralisation and/or cariostatic agents - one treatment | 121 | $46.75 | $46.75 |
| Oral hygiene instruction | 141 | $51.10 | $51.10 |
| Desensitising Procedure - per appointment | 165 | $48.13 | $48.13 |
| Odontoplasty - per tooth | 171 | $51.49 | $51.49 |
| Periodontal Debridement - per tooth | 222 | $58.38 | $67.13 |
| Periodontal Flap Surgery - per tooth - Limit of 10 per visit, 20 per 12 month period | 232 | $288.29 | $288.29 |
| Surgical treatment of Peri-implant Disease - per implant | 233 | $347.83 | $347.83 |
| Gingival Graft - per tooth, implant or extraction | 235 | $501.97 | $590.56 |
| Guided Tissue Regeneration - per tooth or implant | 236 | $501.97 | $590.56 |
| Guided Tissue Regeneration - membrane removal | 237 | $583.13 | $686.05 |
| Periodontal Surgery for Crown Lengthening - per tooth | 238 | $504.33 | $593.33 |
| Osseous Graft- per tooth or implant | 243 | $501.97 | $590.56 |
| Oral Surgery | |||
| Removal of a tooth or part(s) thereof | 311 | $213.49 | $230.87 |
| Sectional removal of tooth or part(s) thereof | 314 | $281.35 | $287.20 |
| Surgical removal of a tooth or tooth fragment not requiring removal of bone or tooth division | 322 | $316.52 | $331.37 |
| Surgical removal of a tooth or tooth fragment requiring removal of bone | 323 | $381.13 | $407.58 |
| Splinting of displaced tooth/teeth - per tooth | 386 | $209.88 | $262.76 |
| Replantation and splinting of a tooth - per tooth | 387 | $421.95 | $485.24 |
| Endodontics | |||
| (These fees include the cost of x-rays where required) | |||
| Direct Pulp Capping | 411 | $56.84 | $59.65 |
| Pulpotomy | 414 | $140.23 | $191.61 |
| Complete chemo-mechanical preparation of root canal - one canal | 415 | $327.89 | $377.06 |
| Complete chemo-mechanical preparation of root canal - each additional canal | 416 | $161.39 | $187.02 |
| Root canal obturation - one canal | 417 | $321.81 | $370.07 |
| Root canal obturation - each additional canal | 418 | $158.75 | $182.55 |
| Extirpation of pulp or debridement of root canal(s) - emergency or palliative | 419 | $225.18 | $225.18 |
| Removal Of Root Filling - Per Canal | 451 | $153.50 | $176.54 |
| Additional Visit For Irrigation And/Or Dressing Of The Root Canal System - per tooth | 455 | $169.97 | $195.46 |
| Restorative Services | |||
| Metallic Restoration - One Surface - direct | 511 | $167.69 | $192.84 |
| Metallic Restoration - Two Surfaces - direct | 512 | $200.41 | $230.47 |
| Metallic Restoration - Three Surfaces - direct | 513 | $234.65 | $269.86 |
| Metallic Restoration - Four Surfaces - direct | 514 | $269.17 | $309.55 |
| Metallic Restoration - Five Surfaces - direct | 515 | $305.67 | $351.51 |
| Adhesive Restoration - One Surface - Anterior Tooth - direct | 521 | $180.30 | $207.34 |
| Adhesive Restoration - Two Surfaces - Anterior tooth - direct | 522 | $212.05 | $243.88 |
| Adhesive Restoration - Three Surfaces - Anterior tooth - direct | 523 | $248.85 | $286.18 |
| Adhesive Restoration - Four Surfaces - Anterior tooth - direct | 524 | $279.98 | $321.99 |
| Adhesive Restoration - Five Surfaces - Anterior tooth - direct | 525 | $329.33 | $378.72 |
| Adhesive Restoration - Veneer - Anterior tooth- direct | 526 | $371.09 | $407.54 |
| Adhesive restoration - one surface - posterior tooth - direct | 531 | $190.09 | $218.60 |
| Adhesive restoration - two surfaces - posterior tooth - direct | 532 | $226.44 | $260.41 |
| Adhesive restoration - three surfaces - posterior tooth - direct | 533 | $264.85 | $304.58 |
| Adhesive restoration - four surfaces - posterior tooth - direct | 534 | $298.36 | $343.12 |
| Adhesive restoration - five surfaces - posterior tooth - direct | 535 | $355.52 | $408.85 |
| Adhesive Restoration - Veneer - Posterior tooth - direct | 536 | $364.30 | $407.54 |
| Tooth coloured restoration - one surface - indirect | 551 | $917.77 | $1,055.45 |
| Tooth coloured restoration - two surfaces - indirect | 552 | $1,017.23 | $1,169.82 |
| Tooth coloured restoration - three surfaces - indirect | 553 | $1,175.06 | $1,351.32 |
| Tooth coloured restoration - four surfaces - indirect | 554 | $1,275.59 | $1,466.93 |
| Tooth coloured restoration - five surfaces - indirect | 555 | $1,398.83 | $1,608.65 |
| Tooth - coloured restoration - Veneer - indirect | 556 | $1,342.62 | $1,544.01 |
| Provisional (intermediate/temporary) restoration - per tooth | 572 | $98.38 | $98.38 |
| Pin retention - per pin | 575 | $44.46 | $44.46 |
| Post - Direct | 597 | $182.27 | $204.96 |
| 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 | $1,580.01 | $1,817.02 |
| Full crown - veneered - indirect | 615 | $1,558.60 | $1,792.39 |
| Full crown - metallic indirect | 618 | $1,568.33 | $1,803.57 |
| Post and core for crown - indirect | 625 | $493.41 | $593.33 |
| Preliminary restoration for crown - direct | 627 | $275.81 | $293.07 |
| Provisional bridge pontic - per pontic | 632 | $312.59 | $312.59 |
| Bridge pontic - direct - per pontic | 642 | $406.98 | $468.03 |
| Bridge pontic - indirect - per pontic | 643 | $1,175.35 | $1,586.72 |
| Retainer for bonded fixture - indirect - per tooth | 649 | $698.23 | $802.96 |
| Implant Procedures | |||
| Fitting of an implant abutment - per abutment | 661 | $1,008.01 | $1,008.01 |
| Prosthesis with metal frame attached to implants - fixed - per arch | 666 | $3,632.20 | $5,321.85 |
| Removal and reattachment of prosthesis fixed to implant(s) – per implant | 669 | $175.01 | $175.01 |
| Full crown attached to osseointegrated implant - veneered indirect | 672 | $2,009.60 | $2,638.08 |
| Surgical implant guide | 679 | $238.83 | $238.73 |
| Insertion of first stage of two-stage endosseous implant - per implant | 684 | $2,162.02 | $2,162.02 |
|
Insertion of one stage endosseous implant - per implant Includes the cost of hardware | 688 | $2,609.02 | $2,609.02 |
|
Second stage surgery of two stage endosseous implant - per implant Includes the cost of hardware | 691 | $446.88 | $446.88 |
| Prosthodontics | |||
| Complete Maxillary Denture | 711 | $1,448.71 | $1,666.01 |
| Complete Mandibular Denture | 712 | $1,448.71 | $1,666.01 |
| Complete Maxillary and Mandibular Denture | 719 | $2,627.03 | $3,021.08 |
| Partial maxillary denture - resin base | 721 | $930.21 | $930.21 |
| Partial mandibular denture - resin base | 722 | $930.21 | $930.21 |
| Partial maxillary denture - cast metal framework including rests and retainers | 727 | $1,613.95 | $1,856.05 |
| Partial mandibular denture - cast metal framework including rests and retainers | 728 | $1,613.95 | $1,856.05 |
| Additional items for Acrylic Dentures only | |||
| Retainer - Per Tooth | 731 | $58.29 | $58.29 |
| Occlusal Rest - per rest | 732 | $16.90 | $16.90 |
| Tooth/teeth partial denture | 733 | $57.30 | $57.30 |
| Immediate tooth replacement - per tooth | 736 | $11.37 | $11.37 |
| Relining - complete denture - processed | 743 | $456.19 | $456.19 |
| Relining - partial denture - processed | 744 | $444.04 | $444.04 |
| Adding tooth to partial denture to replace an extracted or decoronated tooth - per tooth | 768 | $197.72 | $229.75 |
| Splint - Resin - Indirect | 772 | $298.13 | $421.95 |
| Orthodontics | |||
| Active removable appliance therapy - per arch | 821 | $1,043.27 | $1,196.27 |
| Full arch banding - per arch | 831 | $2,876.57 | $4,111.68 |
| Minor tooth guidance - fixed | 846 | $932.86 | $932.86 |
| Complete course of orthodontic treatment | 881 | $5,942.32 | $7,694.50 |
| General | |||
| Travel to provide services | 916 | FBN* | FBN* |
| Clinical occlusal analysis, including muscle and joint palpation - limit one per three year period | 963 | $98.38 | $137.67 |
| Occlusal splint | 965 | $654.76 | $671.14 |
| Adjustment of pre-existing occlusal splint - per appointment | 966 | $93.26 | $119.29 |
| General | Specialist | ||
|---|---|---|---|
| Service Description | ADA Number | Maximum Payment Rate | Maximum Payment Rate |
| Diagnostic services | |||
| Comprehensive Oral Examination | 011 | $111.37 | $111.37 |
| Periodic Oral Examination | 012 | $70.40 | $70.40 |
| Consultation | 014 | $111.37 | $111.37 |
| Written report (not elsewhere included) | 018 | $154.95 | $203.97 |
| Intraoral periapical or bitewing radiograph - per exposure | 022 | $54.86 | $54.86 |
| Cone Beam Volumetric Tomography - scan acquisition - per appointment | 026 | $175.12 | $175.12 |
| Cephalometric Radiograph - per exposure | 036 | $123.80 | $123.80 |
| Panoramic radiograph - per exposure | 037 | $123.80 | $123.80 |
| Pulp Testing - per appointment | 061 | $39.82 | $39.82 |
| Diagnostic model - per model | 071 | $77.04 | $77.04 |
| Photographic records - intraoral - per appointment | 072 | $44.00 | $44.00 |
| Cone Beam Volumetric Tomography analysis and/or interpretation - maxillary or mandibular dentition (both arches) | 089 | $81.73 | $81.73 |
| Preventive Services | |||
| (Prior approval from TAC required for these services) | |||
| Removal Of Calculus - first appointment | 114 | $ 138.37 | $138.37 |
| Bleaching, Internal - per tooth | 117 | $245.52 | $245.52 |
| Topical application of remineralisation and/or cariostatic agents - one treatment | 121 | $50.49 | $50.49 |
| Oral hygiene instruction | 141 | $55.18 | $55.18 |
| Desensitising Procedure - per appointment | 165 | $51.98 | $51.98 |
| Odontoplasty - per tooth | 171 | $55.60 | $55.60 |
| Periodontal Debridement - per tooth | 222 | $63.04 | $72.49 |
| Periodontal Flap Surgery - per tooth - Limit of 10 per visit, 20 per 12 month period | 232 | $311.32 | $311.32 |
| Surgical treatment of Peri-implant Disease - per implant | 233 | $375.62 | $375.62 |
| Gingival Graft - per tooth, implant or extraction | 235 | $542.08 | $637.75 |
| Guided Tissue Regeneration - per tooth or implant | 236 | $542.08 | $637.75 |
| Guided Tissue Regeneration - membrane removal | 237 | $629.72 | $740.87 |
| Periodontal Surgery for Crown Lengthening - per tooth | 238 | $544.63 | $640.74 |
| Osseous Graft- per tooth or implant | 243 | $542.08 | $637.75 |
| Oral Surgery | |||
| Removal of a tooth or part(s) thereof | 311 | $230.55 | $249.32 |
| Sectional removal of tooth or part(s) thereof | 314 | $303.83 | $310.15 |
| Surgical removal of a tooth or tooth fragment not requiring removal of bone or tooth division | 322 | $341.81 | $357.85 |
| Surgical removal of a tooth or tooth fragment requiring removal of bone | 323 | $411.58 | $440.15 |
| Splinting of displaced tooth/teeth - per tooth | 386 | $226.65 | $283.75 |
| Replantation and splinting of a tooth - per tooth | 387 | $455.66 | $524.01 |
| Endodontics | |||
| (These fees include the cost of x-rays where required) | |||
| Direct Pulp Capping | 411 | $61.38 | $64.42 |
| Pulpotomy | 414 | $151.43 | $206.92 |
| Complete chemo-mechanical preparation of root canal - one canal | 415 | $354.09 | $407.19 |
| Complete chemo-mechanical preparation of root canal - each additional canal | 416 | $174.29 | $201.96 |
| Root canal obturation - one canal | 417 | $347.52 | $399.64 |
| Root canal obturation - each additional canal | 418 | $171.43 | $197.14 |
| Extirpation of pulp or debridement of root canal(s) - emergency or palliative | 419 | $243.17 | $243.17 |
| Removal Of Root Filling - Per Canal | 451 | $165.76 | $190.65 |
| Additional Visit For Irrigation And/Or Dressing Of The Root Canal System - per tooth | 455 | $183.55 | $211.08 |
| Restorative Services | |||
| Metallic Restoration - One Surface - direct | 511 | $181.09 | $208.25 |
| Metallic Restoration - Two Surfaces - direct | 512 | $216.42 | $248.88 |
| Metallic Restoration - Three Surfaces - direct | 513 | $253.40 | $291.42 |
| Metallic Restoration - Four Surfaces - direct | 514 | $290.68 | $334.28 |
| Metallic Restoration - Five Surfaces - direct | 515 | $330.09 | $379.60 |
| Adhesive Restoration - One Surface - Anterior Tooth - direct | 521 | $194.71 | $223.91 |
| Adhesive Restoration - Two Surfaces - Anterior tooth - direct | 522 | $228.99 | $263.37 |
| Adhesive Restoration - Three Surfaces - Anterior tooth - direct | 523 | $268.73 | $309.05 |
| Adhesive Restoration - Four Surfaces - Anterior tooth - direct | 524 | $302.35 | $347.72 |
| Adhesive Restoration - Five Surfaces - Anterior tooth - direct | 525 | $355.64 | $408.98 |
| Adhesive Restoration - Veneer - Anterior tooth- direct | 526 | $400.74 | $440.10 |
| Adhesive restoration - one surface - posterior tooth - direct | 531 | $205.28 | $236.07 |
| Adhesive restoration - two surfaces - posterior tooth - direct | 532 | $244.53 | $281.22 |
| Adhesive restoration - three surfaces - posterior tooth - direct | 533 | $286.01 | $328.92 |
| Adhesive restoration - four surfaces - posterior tooth - direct | 534 | $322.20 | $370.54 |
| Adhesive restoration - five surfaces - posterior tooth - direct | 535 | $383.93 | $441.52 |
| Adhesive Restoration - Veneer - Posterior tooth - direct | 536 | $393.41 | $440.10 |
| Tooth coloured restoration - one surface - indirect | 551 | $991.10 | $1,139.78 |
| Tooth coloured restoration - two surfaces - indirect | 552 | $1,098.51 | $1,263.29 |
| Tooth coloured restoration - three surfaces - indirect | 553 | $1,268.95 | $1,459.29 |
| Tooth coloured restoration - four surfaces - indirect | 554 | $1,377.51 | $1,584.14 |
| Tooth coloured restoration - five surfaces - indirect | 555 | $1,510.60 | $1,737.18 |
| Tooth - coloured restoration - Veneer - indirect | 556 | $1,449.90 | $1,667.38 |
| Provisional (intermediate/temporary) restoration - per tooth | 572 | $106.24 | $106.24 |
| Pin retention - per pin | 575 | $48.01 | $48.01 |
| Post - Direct | 597 | $196.83 | $221.34 |
| 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 | $1,706.25 | $1,962.20 |
| Full crown - veneered - indirect | 615 | $1,683.13 | $1,935.60 |
| Full crown - metallic indirect | 618 | $1,693.64 | $1,947.68 |
| Post and core for crown - indirect | 625 | $532.83 | $640.74 |
| Preliminary restoration for crown - direct | 627 | $297.85 | $316.49 |
| Provisional bridge pontic - per pontic | 632 | $337.57 | $337.57 |
| Bridge pontic - direct - per pontic | 642 | $439.50 | $505.43 |
| Bridge pontic - indirect - per pontic | 643 | $1,269.26 | $1,713.50 |
| Retainer for bonded fixture - indirect - per tooth | 649 | $754.02 | $867.12 |
| Implant Procedures | |||
| Fitting of an implant abutment - per abutment | 661 | $1,088.55 | $1,088.55 |
| Prosthesis with metal frame attached to implants - fixed - per arch | 666 | $3,922.41 | $5,747.07 |
| Removal and reattachment of prosthesis fixed to implant(s) – per implant | 669 | $188.99 | $188.99 |
| Full crown attached to osseointegrated implant - veneered indirect | 672 | $2,170.17 | $2,848.86 |
| Surgical implant guide | 679 | $257.80 | $257.80 |
| Insertion of first stage of two-stage endosseous implant - per implant | 684 | $2,334.77 | $2,334.77 |
|
Insertion of one stage endosseous implant - per implant Includes the cost of hardware | 688 | $2,817.48 | $2,817.48 |
|
Second stage surgery of two stage endosseous implant - per implant Includes the cost of hardware | 691 | $482.59 | $482.59 |
| Prosthodontics | |||
| Complete Maxillary Denture | 711 | $1,564.46 | $1,799.12 |
| Complete Mandibular Denture | 712 | $1,564.46 | $1,799.12 |
| Complete Maxillary and Mandibular Denture | 719 | $2,836.93 | $3,262.46 |
| Partial maxillary denture - resin base | 721 | $1,004.53 | $1,004.53 |
| Partial mandibular denture - resin base | 722 | $1,004.53 | $1,004.53 |
| Partial maxillary denture - cast metal framework including rests and retainers | 727 | $1,742.90 | $2,004.35 |
| Partial mandibular denture - cast metal framework including rests and retainers | 728 | $1,742.90 | $2,004.35 |
| Additional items for Acrylic Dentures only | |||
| Retainer - Per Tooth | 731 | $62.95 | $62.95 |
| Occlusal Rest - per rest | 732 | $18.25 | $18.25 |
| Tooth/teeth partial denture | 733 | $61.88 | $61.88 |
| Immediate tooth replacement - per tooth | 736 | $12.28 | $12.28 |
| Relining - complete denture - processed | 743 | $492.64 | $492.64 |
| Relining - partial denture - processed | 744 | $479.52 | $479.52 |
| Adding tooth to partial denture to replace an extracted or decoronated tooth - per tooth | 768 | $213.52 | $248.11 |
| Splint - Resin - Indirect | 772 | $321.95 | $455.66 |
| Orthodontics | |||
| Active removable appliance therapy - per arch | 821 | $1,126.63 | $1,291.85 |
| Full arch banding - per arch | 831 | $3,106.41 | $4,440.20 |
| Minor tooth guidance - fixed | 846 | $1,007.40 | $1,007.40 |
| Complete course of orthodontic treatment | 881 | $6,417.11 | $8,309.29 |
| General | |||
| Travel to provide services | 916 | FBN* | FBN* |
| Clinical occlusal analysis, including muscle and joint palpation - limit one per three year period | 963 | $106.24 | $148.67 |
| Occlusal splint | 965 | $707.08 | $724.76 |
| Adjustment of pre-existing occlusal splint - per appointment | 966 | $100.71 | $128.82 |
| General | Specialist | ||
|---|---|---|---|
| Service Description | ADA Number | Maximum Payment Rate | Maximum Payment Rate |
| Diagnostic services | |||
| Comprehensive Oral Examination | 011 | $103.13 | $103.13 |
| Periodic Oral Examination | 012 | $65.19 | $65.19 |
| Consultation | 014 | $103.13 | $103.13 |
| Written report (not elsewhere included) | 018 | $143.49 | $188.88 |
| Intraoral periapical or bitewing radiograph - per exposure | 022 | $50.80 | $50.80 |
| Cone Beam Volumetric Tomography - scan acquisition - per appointment | 026 | $162.16 | $162.16 |
| Cephalometric Radiograph - per exposure | 036 | $114.64 | $114.64 |
| Panoramic radiograph - per exposure | 037 | $114.64 | $114.64 |
| Pulp Testing - per appointment | 061 | $36.87 | $36.87 |
| Diagnostic model - per model | 071 | $71.34 | $71.34 |
| Photographic records - intraoral - per appointment | 072 | $40.74 | $40.74 |
| Cone Beam Volumetric Tomography analysis and/or interpretation - maxillary or mandibular dentition (both arches) | 089 | $75.68 | $75.68 |
| Preventive Services | |||
| (Prior approval from TAC required for these services) | |||
| Removal Of Calculus - first appointment | 114 | $128.13 | $128.13 |
| Bleaching, Internal - per tooth | 117 | $227.35 | $227.35 |
| Topical application of remineralisation and/or cariostatic agents - one treatment | 121 | $46.75 | $46.75 |
| Oral hygiene instruction | 141 | $51.10 | $51.10 |
| Desensitising Procedure - per appointment | 165 | $48.13 | $48.13 |
| Odontoplasty - per tooth | 171 | $51.49 | $51.49 |
| Periodontal Debridement - per tooth | 222 | $58.38 | $67.13 |
| Periodontal Flap Surgery - per tooth - Limit of 10 per visit, 20 per 12 month period | 232 | $288.29 | $288.29 |
| Surgical treatment of Peri-implant Disease - per implant | 233 | $347.83 | $347.83 |
| Gingival Graft - per tooth, implant or extraction | 235 | $501.97 | $590.56 |
| Guided Tissue Regeneration - per tooth or implant | 236 | $501.97 | $590.56 |
| Guided Tissue Regeneration - membrane removal | 237 | $583.13 | $686.05 |
| Periodontal Surgery for Crown Lengthening - per tooth | 238 | $504.33 | $593.33 |
| Osseous Graft- per tooth or implant | 243 | $501.97 | $590.56 |
| Oral Surgery | |||
| Removal of a tooth or part(s) thereof | 311 | $213.49 | $230.87 |
| Sectional removal of tooth or part(s) thereof | 314 | $281.35 | $287.20 |
| Surgical removal of a tooth or tooth fragment not requiring removal of bone or tooth division | 322 | $316.52 | $331.37 |
| Surgical removal of a tooth or tooth fragment requiring removal of bone | 323 | $381.13 | $407.58 |
| Splinting of displaced tooth/teeth - per tooth | 386 | $209.88 | $262.76 |
| Replantation and splinting of a tooth - per tooth | 387 | $421.95 | $485.24 |
| Endodontics | |||
| (These fees include the cost of x-rays where required) | |||
| Direct Pulp Capping | 411 | $56.84 | $59.65 |
| Pulpotomy | 414 | $140.23 | $191.61 |
| Complete chemo-mechanical preparation of root canal - one canal | 415 | $327.89 | $377.06 |
| Complete chemo-mechanical preparation of root canal - each additional canal | 416 | $161.39 | $187.02 |
| Root canal obturation - one canal | 417 | $321.81 | $370.07 |
| Root canal obturation - each additional canal | 418 | $158.75 | $182.55 |
| Extirpation of pulp or debridement of root canal(s) - emergency or palliative | 419 | $225.18 | $225.18 |
| Removal Of Root Filling - Per Canal | 451 | $153.50 | $176.54 |
| Additional Visit For Irrigation And/Or Dressing Of The Root Canal System - per tooth | 455 | $169.97 | $195.46 |
| Restorative Services | |||
| Metallic Restoration - One Surface - direct | 511 | $167.69 | $192.84 |
| Metallic Restoration - Two Surfaces - direct | 512 | $200.41 | $230.47 |
| Metallic Restoration - Three Surfaces - direct | 513 | $234.65 | $269.86 |
| Metallic Restoration - Four Surfaces - direct | 514 | $269.17 | $309.55 |
| Metallic Restoration - Five Surfaces - direct | 515 | $305.67 | $351.51 |
| Adhesive Restoration - One Surface - Anterior Tooth - direct | 521 | $180.30 | $207.34 |
| Adhesive Restoration - Two Surfaces - Anterior tooth - direct | 522 | $212.05 | $243.88 |
| Adhesive Restoration - Three Surfaces - Anterior tooth - direct | 523 | $248.85 | $286.18 |
| Adhesive Restoration - Four Surfaces - Anterior tooth - direct | 524 | $279.98 | $321.99 |
| Adhesive Restoration - Five Surfaces - Anterior tooth - direct | 525 | $329.33 | $378.72 |
| Adhesive Restoration - Veneer - Anterior tooth- direct | 526 | $371.09 | $407.54 |
| Adhesive restoration - one surface - posterior tooth - direct | 531 | $190.09 | $218.60 |
| Adhesive restoration - two surfaces - posterior tooth - direct | 532 | $226.44 | $260.41 |
| Adhesive restoration - three surfaces - posterior tooth - direct | 533 | $264.85 | $304.58 |
| Adhesive restoration - four surfaces - posterior tooth - direct | 534 | $298.36 | $343.12 |
| Adhesive restoration - five surfaces - posterior tooth - direct | 535 | $355.52 | $408.85 |
| Adhesive Restoration - Veneer - Posterior tooth - direct | 536 | $364.30 | $407.54 |
| Tooth coloured restoration - one surface - indirect | 551 | $917.77 | $1,055.45 |
| Tooth coloured restoration - two surfaces - indirect | 552 | $1,017.23 | $1,169.82 |
| Tooth coloured restoration - three surfaces - indirect | 553 | $1,175.06 | $1,351.32 |
| Tooth coloured restoration - four surfaces - indirect | 554 | $1,275.59 | $1,466.93 |
| Tooth coloured restoration - five surfaces - indirect | 555 | $1,398.83 | $1,608.65 |
| Tooth - coloured restoration - Veneer - indirect | 556 | $1,342.62 | $1,544.01 |
| Provisional (intermediate/temporary) restoration - per tooth | 572 | $98.38 | $98.38 |
| Pin retention - per pin | 575 | $44.46 | $44.46 |
| Post - Direct | 597 | $182.27 | $204.96 |
| 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 | $1,580.01 | $1,817.02 |
| Full crown - veneered - indirect | 615 | $1,558.60 | $1,792.39 |
| Full crown - metallic indirect | 618 | $1,568.33 | $1,803.57 |
| Post and core for crown - indirect | 625 | $493.41 | $593.33 |
| Preliminary restoration for crown - direct | 627 | $275.81 | $293.07 |
| Provisional bridge pontic - per pontic | 632 | $312.59 | $312.59 |
| Bridge pontic - direct - per pontic | 642 | $406.98 | $468.03 |
| Bridge pontic - indirect - per pontic | 643 | $1,175.35 | $1,586.72 |
| Retainer for bonded fixture - indirect - per tooth | 649 | $698.23 | $802.96 |
| Implant Procedures | |||
| Fitting of an implant abutment - per abutment | 661 | $1,008.01 | $1,008.01 |
| Prosthesis with metal frame attached to implants - fixed - per arch | 666 | $3,632.20 | $5,321.85 |
| Removal and reattachment of prosthesis fixed to implant(s) – per implant | 669 | $175.01 | $175.01 |
| Full crown attached to osseointegrated implant - veneered indirect | 672 | $2,009.60 | $2,638.08 |
| Surgical implant guide | 679 | $238.83 | $238.73 |
| Insertion of first stage of two-stage endosseous implant - per implant | 684 | $2,162.02 | $2,162.02 |
|
Insertion of one stage endosseous implant - per implant Includes the cost of hardware | 688 | $2,609.02 | $2,609.02 |
|
Second stage surgery of two stage endosseous implant - per implant Includes the cost of hardware | 691 | $446.88 | $446.88 |
| Prosthodontics | |||
| Complete Maxillary Denture | 711 | $1,448.71 | $1,666.01 |
| Complete Mandibular Denture | 712 | $1,448.71 | $1,666.01 |
| Complete Maxillary and Mandibular Denture | 719 | $2,627.03 | $3,021.08 |
| Partial maxillary denture - resin base | 721 | $930.21 | $930.21 |
| Partial mandibular denture - resin base | 722 | $930.21 | $930.21 |
| Partial maxillary denture - cast metal framework including rests and retainers | 727 | $1,613.95 | $1,856.05 |
| Partial mandibular denture - cast metal framework including rests and retainers | 728 | $1,613.95 | $1,856.05 |
| Additional items for Acrylic Dentures only | |||
| Retainer - Per Tooth | 731 | $58.29 | $58.29 |
| Occlusal Rest - per rest | 732 | $16.90 | $16.90 |
| Tooth/teeth partial denture | 733 | $57.30 | $57.30 |
| Immediate tooth replacement - per tooth | 736 | $11.37 | $11.37 |
| Relining - complete denture - processed | 743 | $456.19 | $456.19 |
| Relining - partial denture - processed | 744 | $444.04 | $444.04 |
| Adding tooth to partial denture to replace an extracted or decoronated tooth - per tooth | 768 | $197.72 | $229.75 |
| Splint - Resin - Indirect | 772 | $298.13 | $421.95 |
| Orthodontics | |||
| Active removable appliance therapy - per arch | 821 | $1,043.27 | $1,196.27 |
| Full arch banding - per arch | 831 | $2,876.57 | $4,111.68 |
| Minor tooth guidance - fixed | 846 | $932.86 | $932.86 |
| Complete course of orthodontic treatment | 881 | $5,942.32 | $7,694.50 |
| General | |||
| Travel to provide services | 916 | FBN* | FBN* |
| Clinical occlusal analysis, including muscle and joint palpation - limit one per three year period | 963 | $98.38 | $137.67 |
| Occlusal splint | 965 | $654.76 | $671.14 |
| Adjustment of pre-existing occlusal splint - per appointment | 966 | $93.26 | $119.29 |
* Note: Where the terminology FBN appears in this schedule, the fee must be negotiated with the TAC before any dental treatment is commenced.
The TAC has adopted the Medicare Benefits Schedule (MBS) items, explanations, definitions, rules and conditions for services provided by medical practitioners. When invoicing for medical services, medical practitioners are expected to adhere to the MBS rules unless otherwise specified by the TAC on the Reimbursement Rates for Medical Services information page or its medical policies.
The Reimbursement Rates for Medical Services must be read in conjunction with:
- Medicare Benefits Schedule (MBS)
- Clarification of Medicare Benefits Schedule (MBS) rules
- Other policies outlined within the Medical Practitioners section of our website
Current rates
Important: The Excel spreadsheet includes all the temporary MBS COVID19 telehealth items payable by the TAC. It was last updated on 29 February 2024. For further information about TAC funded telehealth, please refer to our telehealth information page. |
Current rates
Important: The Excel spreadsheet includes all the temporary MBS COVID19 telehealth items payable by the TAC. It was last updated on 29 February 2024. For further information about TAC funded telehealth, please refer to our telehealth information page. |
At the time of production this publication contained up to date information as released by Medicare Australia (Medicare). The relevant publication will be updated to reflect any further changes that are implemented by Medicare each year. Please check our website for the latest version.
If you have any questions about these publications or the reimbursement rates, please contact the TAC on 1300 654 329. Alternatively, e-mail info@tac.vic.gov.au.
We’re here to help you get your life back on track after your transport accident. We will pay for dental services, provided in Australia, that you need as a result of a transport accident. This includes surgery by an oral or maxillofacial surgeon.
In the first 90 days after your accident, the TAC can help pay for this treatment without the need for you to contact us for approval first.
When you need to contact us for approval
You or your provider need to contact the TAC for approval of this treatment if:
- It is approaching or more than 90 days since your accident and we have not approved further treatment or services, or
- It has been more than 6 months since you’ve had any treatment or service paid for by the TAC.
When can we pay for dental services
As dental services are a TAC approved treatment we will pay for you to visit a dentist, dental prosthetist, or an oral or maxillofacial surgeon for treatment, assessment and care planning immediately after your accident. You can also immediately access any radiology or diagnostic procedures required as part of this treatment.
If your dentures were damaged or lost in the accident, we can also pay for their repair or replacement.
To help you with your injuries, your dentist may also recommend treatments such as:
- Partial or full dentures.
- Dental implants and associated procedures, such as bone and soft tissue grafts.
- Prosthodontics including the construction and insertion of an implant-supported prosthesis.
For more information on oral or maxillofacial surgery, see: Surgery and medical specialists.
We will, where appropriate, work with your treating team to make sure that you receive the dental services you need.
We may contact your dental services provider to discuss your progress or request an assessment to make sure that:
- You have access to the most appropriate treatment and support.
- You are getting proven, evidence-based treatment and not receiving treatment that isn't helping you recover.
- You are moving towards getting your life back on track or being able to live independently.
What we can pay for
Treatments and services that we can't pay for
We can’t pay for services that:
- Do not treat your transport accident injuries.
- Are not reasonable, necessary or appropriate.
- Are not clinically justified, safe and effective.
What does my dentist do?
A dentist is trained to treat injuries, diseases and conditions that affect the teeth, gums, jaw and mouth.
Your dentist may be helped by a qualified dental technician, who assists with the design, manufacture, modification and repair of dentures, mouthguards, bridges and crowns.
For more information, see:
How treatments and services are paid for
We pay for your treatment:
- Directly to your dentist, when you have provided them with your TAC claim number, or
- If you have to pay, use myTAC to send a copy of your receipt to us and we will repay you.
We pay for your services in line with our responsibilities under the Transport Accident Act 1986.
How much we will pay
We will pay for your dental services, including consultations, implants, prosthodontics and implant based bridge maintenance according to our fee schedule. If your provider charges more than the TAC rate, you may need to pay the difference.
For a list of TAC rates, see:
For accidents that happened before 14 February 2018, we can only pay for these services once any required medical excess has been reached. Find out if the medical excess applies to you.
For providers
If you are a dental services provider, please refer to our TAC Provider Guidelines.
