I

GENERAL DENTAL PRACTITIONERS

Code

Procedure description

Rc

MP

Fee

Amalgam restorations (including polishing)

All adhesives, liners and bases are included as part of the restoration. If pins are used, they should be reported separately

See Codes 8345, 8347 and 8348 for post and/or pin retention

8346

Restorative material factor

M/W8003

+10%

Note: Restorative material factor - an additional 10% can be added to codes 8341,  8342, 8343, 8344, 8351, 8352, 8353, 8354, 8355, 8367, 8368, 8369 and 8370 by general dental practitioners only

8341

Amalgam - one surface

310.34

T

8342

Amalgam - two surfaces

338.48

T

8343

Amalgam - three surfaces

466.79

T

8344

Amalgam - four or more surfaces

465.50

T

Resin restorations

Resin refers to a broad category of materials including but not limited to composites and may include bonded composite, light-cured composite, etc. Light-curing, acid etching and adhesives (including resin bonding agents) are included as part of the restoration. Glass ionomers/compomers, when used as restorations should be reported with these codes. If pins are used, they should be reported separately.

See codes 8345, 8347 and 8348 for post and/or pin retention

The fees are inclusive of direct pulp capping (code 8301) and rubber dam application (code 8304)

8351

Resin - one surface, anterior

303.53

T

8352

Resin - two surfaces, anterior

387.74

T

8353

Resin - three surfaces, anterior

512.75

T

8354

Resin - four or more surfaces, anterior

569.37

T

8367

Resin - one surface, posterior

366.97

T

8368

Resin - two surfaces, posterior

502.82

T

8369

Resin - three surfaces, posterior

548.42

T

8370

Resin - four or more surfaces, posterior

581.69

T

Inlay/Onlay restorations

METAL INLAYS

The fee for metal inlays on anterior teeth (incisors and canines) are determined 'by arrangement' with the Compensation Commissioner

8358

Inlay, metallic - one surface, anterior

na/nvt

+L

T

8359

Inlay, metallic - two surfaces, anterior

na/nvt

+L

T

8360

Inlay, metallic - three surfaces, anterior

na/nvt

+L

T

8365

Inlay, metallic - four or more surfaces, anterior

na/nvt

+L

T

8361

Inlay, metallic - one surface, posterior

622.32

+L

T

8362

Inlay, metallic - two surfaces, posterior

805.07

+L

T

8363

Inlay, metallic - three surfaces, posterior

1660.30

+L

T

8364

Inlay, metallic - four or more surfaces, posterior

1660.49

+L

T

CERAMIC AND/OR RESIN INLAYS

Porcelain/ceramic inlays include either all ceramic or porcelain inlays. Composite/resin inlays must be laboratory processed.

NOTE: The fees exclude the application of a rubber dam (code 8304)

8371

Inlay, ceramic/resin - one surface

563.49

+L

T

8372

Inlay, ceramic/resin - two surfaces

823.26

+L

T

8373

Inlay, ceramic/resin - three surfaces

1373.88

+L

T

8374

Inlay, ceramic/resin - four or more surfaces

1660.49

+L

T

NOTES

(M/W)

Crowns - single restorations

The fees include the cost of temporary and/or intermediate crowns. See code 8193 (osseo-integrated abutment restoration) in the 'fixed prosthodontic' category for crowns on osseo-integrated implants

8401

Cast full crown

1972.10

+L

T

8403

Cast three-quarter crown

1972.10

+L

T

8405

Acrylic jacket crown

Com Fee

+L

T

8407

Acrylic veneered crown

2105.21

+L

T

8409

Porcelain jacket crown

2105.21

+L

T

8411

Porcelain veneered crown

2105.21

+L

T

Other restorative services

8133

Re-cementing of inlays, crowns or bridges - per abutment

180.73

+L

T

In some cases where item code 8133 is used +L may not apply

8135

Removal of inlays and crowns (per unit) and bridges (per abutment) or sectioning of a bridge, part of which is to be retained as a crown following the failure of a bridge

355.01

+L

T

8137

Temporary crown placed as an emergency procedure

Not applicable to temporary crowns placed during routine crown and bridge preparations i.e. where the impression for the final crown is taken at the same visit

607.25

+L

T

8330

Removal of fractured post or instrument and/or bypassing fractured endodontic instrument

237.73

T

NOTE: The fee excludes the application of a rubber dam (code 8304)

8345

Preformed post retention, per post

262.54

T

8347

Pin retention for restoration, first pin

180.73

T

8348

Pin retention for restoration, each additional pin

A maximum of two additional pins may be charged

156.10

T

8355

Composite veneers (direct)

575.62

T

8357

Preformed metal crown

382.22

T

8366

Pin retention as part of cast restoration, irrespective of number of pins

279.08

T

8376

Prefabricated post and core in addition to crown

The core is built around a prefabricated post(s)

931.54

T

8391

Cast post and core - single

423.03

+L

T

8393

Cast post and core - double

677.11

+L

T

8395

Cast post and core - triple

976.04

+L

T

8396

Cast coping

275.90

+L

T

8397

Cast core with pins

This service is usually provided on grossly broken down vital teeth, and may not be charged when a post has been inserted in the tooth in question

677.11

+L

T

8398

Core build-up, including any pins

Refers to the building up of an anatomical crown when a restorative crown will be placed, irrespective of the number of pins used

677.11

T

8413

Facing replacement

413.41

+L

T

8414

Additional fee for provision of a crown within an existing clasp or rest

129.64

+L

T