Dental service fees effective from 1 July 2019
WorkSafe will pay up to a maximum amount for the following categories of the service.
General Dentist
Diagnostic services
| Item number |
Service description |
Maximum payment rate |
|---|
| DT011G |
Initial examination and report |
$99.20 |
| DT012G |
Periodical oral examination |
$50.33 |
| DT014G |
Consultation and report for a second opinion |
$160.70 |
| DT022G |
Single Intral oral radiograph |
$41.91 |
| DT036G |
Cephalometric radiograph |
$109.01 |
| DT037G |
Panoramic radiograph (e.g. OPG) |
$118.77 |
| DT061G |
Pulp vitality testing - Per visit (Maximum 3 visits per year) |
$19.61 |
| DT071G |
Diagnostic model - Per model |
$78.32 |
| DT072G |
Photographic records (for WorkSafe) |
$27.92 |
Preventative services
| Item number |
Service description |
Maximum payment rate |
|---|
| DT114G |
Scaling and cleaning |
$90.79 |
| DT117G |
Non-vital bleaching - Per tooth (if separate appointments are made) |
$174.65 |
| DT121G |
Topical fluoride treatment |
$49.06 |
| DT141G |
Oral hygiene instruction where appropriate time is allocated |
$18.20 |
Adjunctive services
| Item number |
Service description |
Maximum payment rate |
|---|
| DT165G |
Desensitising procedure - Per visit |
$35.08 |
| DT171G |
Odontoplasty for fractured tooth - Per tooth |
$35.08 |
Oral surgery
| Item number |
Service description |
Maximum payment rate |
|---|
| DT311G |
Extraction of tooth - Per tooth
- Multiple operation rule applies |
$125.66 |
| DT323G |
Surgical extraction requiring bone removal - Per tooth
- Multiple operation rule applies |
$242.97 |
| DT377G |
Removal of soft tissue |
$49.06 |
| DT387G |
Replanting avulsed tooth and splinting |
$283.50 |
NB: Multiple operation rule applies to items DT311 and DT323.
Endodontics
| Item number |
Service description |
Maximum payment rate |
|---|
| DT411G |
Pulp capping |
$15.47 |
| DT414G |
Cvek pulpotomy |
$124.38 |
| DT415G |
Extirpation of pulp or debridement of root canal 1 canal |
$234.62 |
| DT416G |
Extirpation of pulp or debridement of root canal each additional canal |
$99.20 |
| DT417G |
Root canal obturation 1 canal |
$244.39 |
| DT418G |
Root canal obturation each additional canal |
$99.20 |
| DT419G |
Emergency endodontic procedure not exceeding 15 minutes |
$55.94 |
| DT432G |
Apicectomy and apical seal |
$247.19 |
| DT451G |
Removal of root filling per canal |
$95.10 |
| DT455G |
Additional visit for irrigation and/or dressing of the root canal system |
$90.79 |
| DT458G |
Apexification - Fee additional to routine endodontic treatment |
$141.14 |
NB: Items for endodontic treatment are inclusive of radiographs taken in the course of treatment.
Restorative services
| Item number |
Service description |
Maximum payment rate |
|---|
| DT511G |
Metallic restoration 1 surface |
$97.86 |
| DT512G |
Metallic restoration 2 surface |
$124.38 |
| DT513G |
Metallic restoration 3 surface |
$152.35 |
| DT514G |
Metallic restoration 4 surface |
$181.56 |
| DT515G |
Metallic restoration 5 surface |
$202.49 |
| DT521G |
Adhesive resin restoration anterior tooth - 1 surfaces - direct |
$111.81 |
| DT522G |
Adhesive resin restoration anterior tooth - 2 surfaces - direct |
$132.72 |
| DT523G |
AAdhesive resin restoration anterior tooth - 3 surfaces - direct |
$160.70 |
| DT524G |
Adhesive resin restoration anterior tooth - 4 surfaces - direct |
$188.50 |
| DT525G |
Adhesive resin restoration anterior tooth - 5 surfaces - direct |
$272.34 |
| DT526G |
Bonded veneer - direct |
$248.64 |
| DT531G |
Adhesive resin restoration posterior tooth 1 surfaces - direct |
$125.66 |
| DT532G |
Adhesive resin restoration posterior tooth 2 surfaces - direct |
$148.02 |
| DT533G |
Adhesive resin restoration posterior tooth 3 surfaces - direct |
$181.56 |
| DT534G |
Adhesive resin restoration posterior tooth 4 surfaces - direct |
$209.50 |
| DT535G |
Adhesive resin restoration posterior tooth 5 surfaces - direct |
$272.34 |
| DT542G |
Metallic inlay or onlay two surface cavity |
$645.14 |
| DT543G |
Metallic inlay or onlay three surface cavity |
$758.08 |
| DT556G |
Bonded veneer - indirect |
$837.62 |
| DT572G |
Temporary restoration emergency or interim treatment only |
$100.60 |
| DT575G |
Pin retention (per unit - Pin) |
$30.90 |
| DT597G |
Post - Direct preformed |
$100.60 |
Crown and bridgework
| Item number |
Service description |
Maximum payment rate |
|---|
| DT613G |
Full Crown - Indirect - Non Metallic |
$1,289.93 |
| DT615G |
Full Crown - Indirect - Metal Base Veneered |
$1,383.54 |
| DT618G |
Full Crown - Indirect - Metallic |
$1,289.93 |
| DT625G |
Cast Core For Crown Including Post |
$321.18 |
| DT627G |
Preliminary Restoration For Crown |
$199.75 |
| DT632G |
Provisional Bridge Pontic - Per Pontic |
$208.11 |
| DT643G |
Bridge Pontic - Indirect - Per Pontic |
$1,342.33 |
| DT649G |
Bridge - Indirect - Bonded To Abutment - Per Pontic |
$1,383.60 |
Implant procedures
| Item number |
Service description |
Maximum payment rate |
|---|
| DT661G |
Implant based crown - Veneered - Includes abutment |
$2,066.10 |
| DT661AG |
Expendable implant hardware |
As at retail |
| DT666G |
Prosthesis with metal frame attached to implants - Per implant |
$1,497.98 |
| DT669G |
Removal and reattachment of prosthesis fixed to implants - Per implant |
$166.18 |
| DT672G |
Implant based crown - Veneered - Includes abutment |
$2,066.10 |
| DT679G |
Surgical implant guide |
$230.41 |
NB: Multiple operation rule applies to items DT684, DT688 and DT691.
Prosthodontics
| Item number |
Service description |
Maximum payment rate |
|---|
| DT711G |
Full upper denture |
$986.29 |
| DT712G |
Full lower denture |
$986.29 |
| DT719G |
Full upper and lower denture |
$1,745.12 |
| DT721AG |
One tooth - Partial denture - Acrylic base - upper |
$328.11 |
| DT721BG |
Two teeth |
$379.83 |
| DT721CG |
Three teeth |
$450.97 |
| DT721DG |
Four teeth |
$515.34 |
| DT721EG |
Five to nine teeth |
$635.34 |
| DT721FG |
Ten or more teeth |
$731.62 |
| DT722AG |
One tooth - Partial denture - Acrylic base - lower |
$328.11 |
| DT722BG |
Two teeth |
$379.83 |
| DT722CG |
Three teeth |
$450.97 |
| DT722DG |
Four teeth |
$515.34 |
| DT722EG |
Five to nine teeth |
$635.34 |
| DT722FG |
Ten or more teeth |
$731.62 |
| DT727AG |
One tooth or two teeth - Partial denture - chrome cobalt including rests and retainers - upper |
$1,228.55 |
| DT727BG |
Three or four teeth |
$1,256.46 |
| DT727CG |
Five to nine teeth |
$1,298.39 |
| DT727DG |
Ten or more teeth |
$1,340.21 |
| DT728AG |
One tooth or two teeth - Partial denture - chrome cobalt including rests and retainers - lower |
$1,228.55 |
| DT728BG |
Three or four teeth |
$1,256.46 |
| DT728CG |
Five to nine teeth |
$1,298.39 |
| DT728DG |
Ten or more teeth |
$1,340.21 |
| DT731G |
Each retainer |
$41.91 |
| DT732G |
Occlusal rest (not part of retainer) |
$16.87 |
| DT736G |
Immediate tooth replacement |
$8.53 |
| DT743G |
Relining - Full denture - Processed |
$315.61 |
| DT744G |
Relining - Partial denture - Processed |
$231.88 |
| DT768G |
Adding tooth to partial denture to replace extracted tooth |
$160.70 |
Orthodontics
| Item number |
Service description |
Maximum payment rate |
|---|
| DT821G |
Active removable appliance therapy - One arch |
$753.94 |
Temporomandibular joint therapy
| Item number |
Service description |
Maximum payment rate |
|---|
| DT963G |
Full clinical assessment of case including joint and muscle palpation, occlusal analysis with study models and report. |
$240.24 |
| DT964G |
Full clinical assessment of case including joint and muscle palpation, occlusal analysis with study models and report. |
$240.24 |
| DT965G |
Occlusal splint including initial programming |
$541.78 |
| DT966G |
Routine adjustment of splint - Per visit (maximum of six visits) |
$90.79 |
Dentist Specialist
Diagnostic services
| Item number |
Service description |
Maximum payment rate |
|---|
| DT011S |
Initial examination and report |
$124.38 |
| DT012S |
Periodical oral examination |
$72.64 |
| DT014S |
Consultation and report for a second opinion |
$230.41 |
| DT022S |
Single intral oral radiograph |
$41.91 |
| DT036S |
Cephalometric radiograph |
$109.01 |
| DT037S |
Panoramic radiograph (e.g. OPG) |
$118.77 |
| DT061S |
Pulp vitality testing - Per visit - Maximum 3 visits per year |
$19.61 |
| DT071S |
Diagnostic model - Per model |
$78.32 |
| DT072S |
Photographic Records (for WorkSafe) |
$27.96 |
Preventative services
| Item number |
Service description |
Maximum payment rate |
|---|
| DT114S |
Scaling and cleaning |
$90.79 |
| DT117S |
Non-vital bleaching - Per tooth (if separate appointments are made) |
$217.91 |
| DT121S |
Topical fluoride treatment |
$49.06 |
| DT141S |
Oral hygiene instruction where appropriate time is allocated |
$18.20 |
Adjunctive services
| Item number |
Service description |
Maximum payment rate |
|---|
| DT165S |
Desensitising procedure - Per visit |
$35.08 |
| DT171S |
Odontoplasty for fractured tooth - Per tooth |
$35.08 |
Periodontics
| Item number |
Service description |
Maximum payment rate |
|---|
| DT222S |
Root planing and subgingival curettage (Per segment) |
$277.66 |
| DT232S |
Periodontal flap surgery (Per tooth or implant) |
$340.67 |
| DT235S |
Gingival connective tissue graft |
$756.78 |
| DT236S |
Guided tissue regeneration (Per tooth or implant) |
$756.78 |
| DT237S |
Guided tissue regeneration (Per tooth or implant) |
$756.78 |
| DT236A |
Expendable GTR material |
$769.39 |
| DT238S |
Crown lengthening - Including alveolar bone removal (Per tooth) |
$558.47 |
| DT242S |
Osseous surgery (Per tooth or implant) |
$340.67 |
| DT243S |
Osseous graft (Per tooth or implant) |
$756.78 |
NB: Multiple operation rule applies.
Oral surgery
| Item number |
Service description |
Maximum payment rate |
|---|
| DT311S |
Extraction of tooth (Per tooth) |
$160.70 |
| DT323S |
Surgical extraction requiring bone removal (Per tooth) |
$295.99 |
| DT377S |
Removal of soft tissue |
$49.06 |
| DT387S |
Replanting avulsed tooth and splinting |
$409.11 |
NB: Multiple operation rule applies to items DT311S and DT323S.
Endodontics
| Item number |
Service description |
Maximum payment rate |
|---|
| DT411S |
Pulp capping |
$19.61 |
| DT414S |
Cvek pulpotomy |
$185.80 |
| DT415S |
Extirpation of pulp or debridement of root canal 1 canal |
$342.14 |
| DT416S |
Extirpation of pulp or debridement of root canal each additional canal |
$141.14 |
| DT417S |
Root canal obturation 1 Canal |
$350.46 |
| DT418S |
Root canal obturation each additional canal |
$141.14 |
| DT419S |
Emergency endodontic procedure not exceeding 15 minutes |
$69.91 |
| DT432S |
Apicectomy and apical seal |
$342.14 |
| DT451S |
Removal of root filling per canal |
$135.46 |
| DT455S |
Additional visit for irrigation and/or dressing of the root canal system |
$109.01 |
| DT458S |
Apexification - Fee additional to routine endodontic treatment |
$226.27 |
NB: Items for endodontic treatment are Inclusive of radiographs taken in the course of treatment.
Restorative services
| Item number |
Service description |
Maximum payment rate |
|---|
| DT511S |
Metallic restoration 1 surface |
$138.39 |
| DT512S |
Metallic restoration 2 surface |
$178.86 |
| DT513S |
Metallic restoration 3 surface |
$226.27 |
| DT514S |
Metallic restoration 4 surface |
$251.33 |
| DT515S |
Metallic restoration 5 surface |
$272.34 |
| DT521S |
Adhesive resin restoration anterior tooth - 1 surfaces - Direct |
$146.69 |
| DT522S |
Adhesive resin restoration anterior tooth - 2 surfaces - Direct |
$188.50 |
| DT523S |
Adhesive resin restoration anterior tooth - 3 surfaces - Direct |
$230.41 |
| DT524S |
Adhesive resin restoration anterior tooth - 4 surfaces - Direct |
$258.40 |
| DT525S |
Adhesive resin restoration anterior tooth - 5 surfaces - Direct |
$321.18 |
| DT526S |
Bonded veneer - Direct |
$330.80 |
| DT531S |
Adhesive resin restoration posterior tooth 1 surfaces - Direct |
$153.64 |
| DT532S |
Adhesive resin restoration posterior tooth 2 surfaces - Direct |
$181.56 |
| DT533S |
Adhesive resin restoration posterior tooth 3 surfaces - Direct |
$237.49 |
| DT534S |
Adhesive resin restoration posterior tooth 4 surfaces - Direct |
$265.27 |
| DT535S |
Adhesive resin restoration posterior tooth 5 surfaces - Direct |
$321.18 |
| DT542S |
Metallic inlay or onlay two surface cavity |
$779.10 |
| DT543S |
Metallic inlay or onlay three surface cavity |
$954.92 |
| DT556S |
Bonded veneer - Indirect |
$1,144.19 |
| DT572S |
Temporary restoration emergency or interim treatment only |
$124.38 |
| DT575S |
Pin retention (Per unit - Pin) |
$30.90 |
| DT597S |
Post - direct preformed |
$124.38 |
Crown and bridgework
| Item number |
Service description |
Maximum payment rate |
|---|
| DT613S |
Full crown - Indirect - Non metallic |
$1,718.61 |
| DT615S |
Full crown - Indirect - Metal base veneered |
$1,809.37 |
| DT618S |
Full crown - Indirect - Metallic |
$1,718.61 |
| DT625S |
Cast core for crown including post |
$516.62 |
| DT627S |
Preliminary restoration for crown |
$284.90 |
| DT632S |
Provisional bridge pontic - Per pontic |
$261.15 |
| DT643S |
Bridge pontic - Indirect - Per pontic |
$1,625.25 |
| DT649S |
Bridge - Indirect - Bonded to abutment - Per pontic |
$1,675.21 |
Implant procedures
NB: Multiple operation rule applies to Items DT684S, DT688S and DT691S.
| Item number |
Service description |
Maximum payment rate |
|---|
| DT661S |
Implant based crown - Veneered - Includes abutment |
$2,526.78 |
| DT661AS |
Expendable implant hardware |
As at retail |
| DT666S |
Prosthesis with metal frame attached to implants - Per implant |
$1,759.07 |
| DT669S |
Removal and reattachment of prosthesis fixed to implants - Per implant |
$166.18 |
| DT672S |
Implant based crown - Veneered - Includes abutment |
$2,526.78 |
| DT679S |
Surgical implant guide |
$230.41 |
| DT684S |
Osseo-Integration procedure - Intraoral implantation of titanium fixture |
$1,005.21 |
| DT688S |
Osseo-Integration procedure - One stage |
$1,121.06 |
| DT691S |
Osseo-Integration procedure - Fixation of transcutaneous abutment |
$379.83 |
Prosthodontics
| Item number |
Service description |
Maximum payment rate |
|---|
| DT711S |
Full upper denture |
$1,377.99 |
| DT712S |
Full lower denture |
$1,377.99 |
| DT719S |
Full upper and lower denture |
$2,564.51 |
| DT721AS |
One tooth - Partial denture - Acrylic base - upper |
$404.90 |
| DT721BS |
Two teeth |
$526.43 |
| DT721CS |
Three teeth |
$631.12 |
| DT721DS |
Four teeth |
$700.88 |
| DT721ES |
Five to nine teeth |
$841.93 |
| DT721FS |
Ten or more teeth |
$963.24 |
| DT722AS |
One tooth - Partial denture - Acrylic base - lower |
$404.90 |
| DT722BS |
Two teeth |
$526.43 |
| DT722CS |
Three teeth |
$631.12 |
| DT722DS |
Four teeth |
$700.88 |
| DT722ES |
Five to nine teeth |
$841.93 |
| DT722FS |
Ten or more teeth |
$963.24 |
| DT727AS |
One tooth or two teeth - Partial denture - Chrome cobalt including rests and retainers - upper |
$1,417.01 |
| DT727BS |
Three or four teeth |
$1,527.30 |
| DT727CS |
Five to nine teeth |
$1,584.54 |
| DT727DS |
Ten or more teeth |
$1,647.44 |
| DT728AS |
One tooth or two teeth - Partial denture - Chrome cobalt including rests and retainers - lower |
$1,417.01 |
| DT728BS |
Three or four teeth |
$1,527.30 |
| DT728CS |
Five to nine teeth |
$1,584.54 |
| DT728DS |
Ten or more teeth |
$1,647.44 |
| DT731S |
Each retainer |
$41.91 |
| DT732S |
Occlusal rest (Not part of retainer) |
$16.87 |
| DT736S |
Immediate tooth replacement |
$8.53 |
| DT743S |
Relining - Full denture - Processed |
$390.94 |
| DT744S |
Relining - Partial denture - Processed |
$284.90 |
| DT768S |
Adding tooth to partial denture to replace extracted tooth |
$160.70 |
Orthodontics
| Item number |
Service description |
Maximum payment rate |
|---|
| DT821S |
Active removable appliance therapy - One arch |
$1,075.04 |
| DT831S |
Full arch banding - One Arch |
$3,918.55 |
| DT846S |
Orthodontic extrusion of tooth |
$889.35 |
| DT881S |
Full course of fixed appliance orthodontic treatment |
$6,108.78 |
Temporomandibular joint therapy
| Item number |
Service description |
Maximum payment rate |
|---|
| DT963S |
Full clinical assessment of case including joint and muscle palpation, occlusal analysis with study models and report. |
$295.99 |
| DT964S |
Full clinical assessment of case including joint and muscle palpation, occlusal analysis with study models and report. |
$295.99 |
| DT965S |
Occlusal splint including initial programming |
$639.47 |
| DT966S |
Routine adjustment of splint - Per visit (maximum of six visits) |
$116.04 |