Dental services fees and policy

  • Dental services fees

    Dental Services fees effective from 1 July 2017

    Effective as at 1 July 2017, WorkSafe Victoria (WorkSafe) will pay up to a maximum amount for the following categories of the service:

    Service description

     

    General Dentist

    Maximum payment rate

    Dental Specialist

    Maximum Payment Rate

    Diagnostic Services
    Periodical Oral ExaminationDT012G$48.27 DT012S$69.66
    Initial Examination And Report DT011/018G $95.13 DT011/018S $119.28
    Consultation And Report, when arranged by WorkSafe for a second opinion DT014/018G $154.11DT014/018S $220.96
    Single Intral Oral Radiograph DT022G $40.19 DT022S $40.19
    Cephalometric Radiograph DT036G$104.54 DT036S $104.54
    Panoramic Radiograph (e.g. OPG) DT037G $113.90 DT037S$113.90
    Pulp Vitality Testing - Per Visit - Maximum 3 Visits Per Year DT061G $18.81 DT061S $18.81
    Diagnostic Model - Per Model DT071G $75.11 DT071S$75.11
    Photographic Records (for WorkSafe) DT072G $26.81 DT072S $26.81
    Preventative Services
    Scaling And Cleaning DT114G$87.07 DT114S $87.07
    Non-Vital Bleaching - Per Tooth (if separate appointments are made) DT117G $167.49 DT117S $208.98
    Topical Fluoride Treatment DT121G $47.05 DT121S$47.05
    Oral Hygiene Instruction Where Appropriate Time Is Allocated DT141G $17.45 DT141S $17.45
    Adjunctive Services
    Desensitising Procedure - Per Visit DT165G $33.64 DT165S $33.64
    Odontoplasty For Fractured Tooth - Per Tooth DT171G $33.64 DT171S $33.64
    Periodontics
    Root Planing And Subgingival Curettage (Per Segment)

    DT222S$266.28
    Periodontal Flap Surgery (Per Tooth or Implant)

    DT232S $725.76
    Osseous Surgery (Per Tooth or Implant)

    DT233S $326.70
    Osseous Graft (Per Tooth or Implant)

    DT234S $725.76
    Gingival Connective Tissue Graft

    DT235S $725.76
    Guided Tissue Regeneration (Per Tooth Or Implant)

    DT236/237S $725.76
    Expendable GTR Material

    DT236A$737.85
    Crown Lengthening - Including Alveolar Bone Removal (Per Tooth)

    DT238S $535.58
    NB: Multiple Operation Rule Applies
    Oral Surgery
    Extraction Of Tooth (Per Tooth) DT311G$120.51 DT311S $154.11
    Surgical Extraction Requiring Bone Removal (Per Tooth) DT323G$233.01DT323S $283.86
    Removal Of Soft Tissue DT377G$47.05 DT377S $47.05
    Replanting Avulsed Tooth And Splinting DT387G $271.88DT387SDT323G
    NB: Multiple Operation Rule Applies To Items DT311 and DT323
    Endodontics
    Pulp Capping DT411G$14.84 DT411S $18.81
    Cvek Pulpotomy DT414G $119.28DT414S$178.18
    Extirpation Of Pulp Or Debridement Of Root Canal 1 Canal DT415G $225.00 DT415S $328.11
    Extirpation Of Pulp Or Debridement Of Root Canal Each Additional Canal DT416G $95.13 DT416S$135.35
    Root Canal Obturation 1 Canal DT417G $234.37 DT417S $336.09
    Root Canal Obturation Each Additional Canal DT418G $95.13 DT418S $135.35
    Emergency Endodontic Procedure Not Exceeding 15 Minutes DT419G $53.65 DT419S$67.04
    Apicectomy And Apical Seal DT432G $237.06 DT432S$328.11
    Removal Of Root Filling Per Canal DT451G$91.11 DT451S $129.91
    Additional Visit For Irrigation And/Or Dressing Of The Root Canal System DT455G$87.07 DT455S$104.54
    Apexification - Fee Additional To Routine Endodontic Treatment DT458G $135.35 DT458S $216.99
    NB: Items For Endodontic Treatment Are Inclusive Of Radiographs Taken In The Course Of Treatment
    Restorative Services
    Metallic Restoration 1 Surface DT511G $93.85 DT511S $132.72
    Metallic Restoration 2 Surface DT512G $119.28DT512S $171.53
    Metallic Restoration 3 Surface DT513G $146.10 DT513S $216.99
    Metallic Restoration 4 Surface DT514G $174.12 DT514S $241.03
    Metallic Restoration 5 Surface DT515G $194.19 DT515S $261.18
    Adhesive Resin Restoration Anterior Tooth - 1 Surfaces - Direct DT521G $107.23 DT521S $140.68
    Adhesive Resin Restoration Anterior Tooth - 2 Surfaces - Direct DT522G$127.28DT522S $180.77
    Adhesive Resin Restoration Anterior Tooth - 3 Surfaces - Direct DT523G $154.11 DT523S $220.96
    Adhesive Resin Restoration Anterior Tooth - 4 Surfaces - Direct DT524G $180.77 DT524S $247.81
    Adhesive Resin Restoration Anterior Tooth - 5 Surfaces - Direct DT525G $261.18DT525S $308.01
    Adhesive Resin Restoration Posterior Tooth 1 Surfaces - Direct DT531G $120.51 DT531S $147.34
    Adhesive Resin Restoration Posterior Tooth 2 Surfaces - Direct DT532G $141.95 DT532S $174.12
    Adhesive Resin Restoration Posterior Tooth 3 Surfaces - Direct DT533G $174.12DT533S $227.75
    Adhesive Resin Restoration Posterior Tooth 4 Surfaces - Direct DT534G $200.91 DT534S $254.40
    Adhesive Resin Restoration Posterior Tooth 5 Surfaces - Direct DT535G $261.18 DT535S $308.01
    Metallic Inlay Or Onlay Two Surface Cavity DT542G $618.69 DT542S $747.16
    Metallic Inlay Or Onlay Three Surface Cavity DT543G $727.00DT543S $915.77
    Temporary Restoration Emergency Or Interim Treatment Only DT572G$96.48 DT572S $119.28
    Pin Retention (Per Unit - Pin) DT575G $29.63 DT575S $29.63
    Bonded Veneer - Direct DT526/582G $238.45 DT526/582S$317.24
    Bonded Veneer - IndirectDT556/583G$803.28 DT556/583S$1,097.89
    Post - Direct Preformed DT597G $96.48 DT597S $119.28
    Crown & Bridgework
    Full Crown - Indirect - Non Metallic DT613G $1,237.05 DT613S $1,648.16
    Full Crown - Indirect - Metal Base Veneered DT615G $1,326.82 DT615S $1,735.20
    Full Crown - Indirect - Metallic DT618G $1,237.05 DT618S $1,648.16
    Cast Core For Crown Including Post DT625G $308.01 DT625S$495.44
    Preliminary Restoration For Crown DT627G$191.56 DT627S $273.22
    Provisional Bridge Pontic - Per Pontic DT632G $199.58 DT632S $250.44
    Bridge Pontic - Indirect - Per Pontic DT643G $1,326.88 DT643S $1,606.54
    Bridge - Indirect - Bonded To Abutment - Per Pontic DT643/649G $1,326.88 DT643/649S $1,606.54
    Implant Procedures
    Implant Based Crown - Veneered - Includes Abutment DT661/672G$1,981.40 DT661/672S $2,423.20
    Expendable Implant Hardware DT661AG At retail cost DT661AS At retail cost
    Prosthesis With Metal Frame Attached To Implants - Per Implant DT666G $1,436.57 DT666S $1,686.96
    Removal And Reattachment Of Prosthesis Fixed To Implants - Per Implant DT669G$159.37 DT669S $159.37
    Surgical Implant Guide DT679G $220.96 DT679S $220.96
    Osseo-Integration Procedure - Intraoral Implantation Of Titanium Fixture

    DT684S$964.00
    Osseo-Integration Procedure - One Stage

    DT688S $1,075.10
    Osseo-Integration Procedure - Fixation Of Transcutaneous Abutment

    DT691S $364.26
    NB: Multiple Operation Rule Applies To Items DT684, DT688 and 691
    Prosthodontics
    Full Upper Or Full Lower Denture DT711G $945.86 DT711S $1,321.50
    Full Lower Denture DT712G$945.86 DT712S $1321.50
    Full Upper & Lower Denture DT719G $1,673.58 DT719S $2,459.38
    One Tooth - Partial Denture - Acrylic Base - Upper DT721AG $314.66 DT721AS $388.30
    Two Teeth DT721BG $364.26 DT721BS $504.85
    Three Teeth DT721CG $432.48 DT721CS $605.27
    Four Teeth DT721DG $494.21DT721DS $672.15
    Five To Nine Teeth DT721EG $609.29 DT721ES $807.42
    Ten Or More Teeth DT721FG $701.63 DT721FS$923.78
    One Tooth - Partial Denture - Acrylic Base - Lower DT722AG $314.66DT722AS$388.30
    Two Teeth DT722BG $364.26 DT722BS $504.85
    Three Teeth DT722CG $432.48 DT722CS $605.27
    Four Teeth DT722DG $494.21 DT722DS $672.15
    Five To Nine Teeth DT722EG $609.29 DT722ES $807.42
    Ten Or More Teeth DT722FG $701.63 DT722FS $923.78
    One Tooth Or Two Teeth - Partial Denture - Chrome Cobalt Including Rests & Retainers - Upper DT727AG $1,178.19 DT727AS $1,358.92
    Three Or Four Teeth DT727BG $1,204.95DT727BS$1,464.69
    Five To Nine Teeth DT727CG $1,245.16 DT727CS$1,519.63
    Ten Or More Teeth DT727DG$1,285.27 DT727DS$1,579.90
    One Tooth Or Two Teeth - Partial Denture - Chrome Cobalt Including Rests & Retainers - Lower DT728AG $1,178.19 DT728AS $1,358.92
    Three Or Four Teeth DT728BG $1,204.95 DT728BS $1,464.69
    Five To Nine Teeth DT728CG $1,245.16 DT728CS $1,519.58
    Ten Or More Teeth DT728DG $1,285.27 DT728DS $1,579.90
    Each Retainer DT731G $40.19DT731S $40.19
    Occlusal Rest (Not Part Of Retainer) DT732G $16.18 DT732S $16.18
    Immediate Tooth Replacement DT736G $8.18 DT736S $8.18
    Relining - Full Denture - Processed DT743G $302.67 DT743S $374.91
    Relining - Partial Denture - Processed DT744G $222.37 DT744S $273.22
    Adding Tooth To Partial Denture To Replace Extracted Tooth DT768G $154.11 DT768S $154.11
    Orthodontics
    Active Removable Appliance Therapy - One Arch DT821G $723.03 DT821S $1030.97
    Full Arch Banding - One Arch

    DT831S $3757.91
    Full Course Of Fixed Appliance Orthodontic Treatment

    DT881S $5858.35
    Orthodontic Extrusion Of Tooth

    DT846S $852.89
    Temporomandibular Joint Therapy
    Full Clinical Assessment Of Case Including Joint And Muscle Palpation, Occlusal Analysis With Study Models And Report DT963/964G $230.39 DT963/964S$283.86
    Occlusal Splint Including Initial Programming DT965G $519.57 DT965S $613.26
    Routine Adjustment Of Splint - Per Visit (Maximum Of Six Visits)
    $87.07 DT966S $111.28
    Multiple Operations WorkSafe will apply the multiple-operation rule where two or more procedures are performed on the one occassion. In accordance with this rule WorkSafe will pay100% of the WorkSafe fee for the most expensive item, 50% of the WorkSafe fee for the second most expensive item, and 25% of the WorkSafe fee thereafter
    Multiple Operations

    WorkSafe will apply the multiple-operation rule where two or more procedures are performed on the one occassion. In accordance with this rule WorkSafe will pay100% of the WorkSafe fee for the most expensive item, 50% of the WorkSafe fee for the second most expensive item, and 25% of the WorkSafe fee thereafter.

    Download dental services fees [PDF, 1.79MB]

    Download ddentalservices fees [PDF, 1.79MB]

    View fee schedules from previous years

  • Dental Services policy

    Who can provide dental services to injured workers?

    Guidelines for providing dietetic services to injured workers

    WorkSafe Victoria (WorkSafe), will only pay for dental services by healthcare professionals who are:

    registered by WorkSafe to provide dental services, and

    registered with the Dental Board of Australia

    Referral requirements

    Referral from a medical practitioner is not required for provision of dental services

    WorkSafe considers dentistry to be a primary contact service. A referral from a medical practitioner is therefore not required. A referral is required from a medical practitioner for the provision of any approved health service with the exception of medical, physiotherapy, osteopathic, chiropractic, optometry, dental and podiatry services.

    No referral to other health services

    WorkSafe does not allow dentists to provide referrals to other health services.

    How much will WorkSafe pay?

    WorkSafe will pay the reasonable costs of dental services, as detailed in WorkSafe's Dental Services Fee Schedule, which can be found at worksafe.vic.gov.au/hcp

    What WorkSafe will pay for

    Treatment is for a work-related injury or illness

    The provider is currently registered as a dentist with WorkSafe

    Any medicines, curative apparatus, appliances or materials for a worker are provided by a registered pharmacist

    WorkSafe will pay the reasonable costs of dental services up to the maximum amount as detailed on WorkSafe's Dental Services Fee Schedule, which can be found at worksafe.vic.gov.au/hcp

    What WorkSafe will not pay for

    WorkSafe will not pay the reasonable cost associated with:

    Non-attendance/cancellation

    WorkSafe will not pay for appointments where injured workers cancel or do not attend.

    Telephone conversations

    WorkSafe will not pay for telephone consultations or conversations, either to the injured worker or other related parties (such as the employer, WorkSafe, WorkSafe Agents, self-insurers or other healthcare professionals)

    More than one consultation on the same day WorkSafe will not pay for more than one dental consultation provided on the same day to the same injured worker.

    Download dental services policy [PDF, 313kB]

    Download dental services policy [PDF, 313kB]

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