Dental Fees
Western Australia
Dentacare® fee schedule current to end September 2017
| Item No. | Service | Fee $ |
|---|---|---|
| DIAGNOSTIC SERVICES | ||
| Examinations | ||
| 011 | Oral Examination – Comprehensive | $52.00 |
| 012 | Oral Examination – Periodic | $50.00 |
| 014 | Consultation | $54.00 |
| Radiological Examination and Interpretation | ||
| 022 | X-Ray – Per Film | $40.00 |
| 037 | Panoramic Radiograph – Per Exposure | $89.00 |
| Other Diagnostic Services | ||
| 071 | Diagnostic Model – Per Model | $59.00 |
| PREVENTITIVE, PROPHYLACTIC SERVICES (Cleaning of the Teeth) | ||
| Dental Prophylaxis | ||
| 111 | Plaque/ Stain Removal | $54.00 |
| 114 | Removal of Calculus – First Visit (Heavy Staining) | $97.00 |
| 115 | Removal of Calculus – Subsequent Visit (Heavy Staining) | $90.00 |
| Topical Fluoride | ||
| 121 | Topical Application of Remineralising and/or Cariostatic Agents – One Treatment | $36.00 |
| Other Preventive Services | ||
| 161 | Fissure Sealing – Per Tooth | $47.00 |
| PERIODONTICS (Prevention/ Diagnosis of Gum Disease) | ||
| 213 | Treatment of Acute Periodontal Infection – Per Visit | $88.00 |
| 222 | Root Planing and Subgingival Curettage – Per Tooth | $23.00 |
| ORAL SURGERY | ||
| Extractions | ||
| 311 | Removal of a Tooth or Part(s) Thereof | $125.00 |
| Surgical Extractions | ||
| 322 | Surgical Removal of a Tooth or Tooth Fragment Not Requiring Removal of Bone or Tooth Division | $220.00 |
| 323 | Surgical Removal of a Tooth or Tooth Fragment Requiring Bone Removal | $277.00 |
| 324 | Surgical Removal of a Tooth or Tooth Fragment Requiring Bone Removal and tooth division | $323.00 |
| ENDODONTICS (Treatment of Diseases of the Dental Pulp, Tooth Root and Surrounding Tissue) | ||
| Pulp Treatments | ||
| 411 | Direct Pulp Capping | $37.00 |
| 414 | Pulpotomy | $76.00 |
| 415 | Complete Chemo-Mechanical Preparation of Root Canal – 1 canal | $229.00 |
| 416 | Complete Chemo-Mechanical Preparation of Root Canal – each additional canal | $102.00 |
| 417 | Root Canal Obturation – 1 canal | $250.00 |
| 418 | Root Canal Obturatiol – Each Additional Canal | $102.00 |
| 455 | Additional visit for irrigation and/or dressing of the root canal system per tooth | $102.00 |
| RESTORATIVE SERVICES (Fillings) | ||
| Metallic Restorations – Direct | ||
| 511 | Metallic Restoration – 1 surface | $115.00 |
| 512 | Metallic Restoration – 2 surfaces | $125.00 |
| 513 | Metallic Restoration – 3 surfaces | $150.00 |
| 514 | Metallic Restoration – 4 surfaces | $185.00 |
| 515 | Metallic Restoration – 5 surfaces | $215.00 |
| Tooth Coloured Adhesive Restorations – Direct | ||
| 521 | Adhesive Restoration – 1 Surface – Front Tooth – Direct | $125.00 |
| 522 | Adhesive Restoration – 2 Surfaces – Front Tooth – Direct | $140.00 |
| 523 | Adhesive Restoration – 3 Surfaces – Front Tooth – Direct | $170.00 |
| 524 | Adhesive Restoration – 4 Surfaces – Front Tooth – Direct | $195.00 |
| 525 | Adhesive Restoration – 5 Surfaces – Front Tooth – Direct | $220.00 |
| 531 | Adhesive Restoration – 1 Surface – Back Tooth – Direct | $130.00 |
| 532 | Adhesive Restoration – 2 Surfaces – Back Tooth – Direct | $150.00 |
| 533 | Adhesive Restoration – 3 Surfaces – Back Tooth – Direct | $175.00 |
| 534 | Adhesive Restoration – 4 Surfaces – Back Tooth – Direct | $210.00 |
| 535 | Adhesive Restoration – 5 Surfaces – Back Tooth – Direct | $240.00 |
| Other Restorative Services | ||
| 526 / 536 | Composite Veneer – Direct – Per Tooth | $270.00 |
| 556 | Porcelain Veneer – Indirect | $900.00 |
| 575 | Pin Retention – Per Pin | $32.00 |
| 596 | Recementing of Inlay/Onlay | $95.00 |
| PROSTHODONTIC/ COSMETIC SERVICES | ||
| Crowns (Lab Fees included) | ||
| 613 | Full crown – Non-Metallic – Indirect | $1455.00 |
| 615 | Full crown – Veneered – Indirect | $1428.00 |
| 618 | Full crown – Metallic – indirect | $1270.00 |
| 625 | Post and Core for Crown – Indirect | $350.00 |
| 643 | Bridge Pontic – Indirect – Per Pontic | $1070.00 |
| Crown and Bridge Repairs and Other Services | ||
| 651 | Re-cementing Crown or Veneer | $95.00 |
| 652 | Re-cementing Bridge or Splint – Per Abutment | $100.00 |
| Dentures and Denture Components (*Cost of casting and *Lab fees extra) | ||
| 711 | Upper Denture | $950.00 |
| 712 | Lower Denture | $950.00 |
| 719 | Upper & Lower Denture | $1650.00 |
| 721 | Partial Upper Denture – Resin Base | $515.00* |
| 722 | Partial Lower Denture – Resin Base | $515.00* |
| 727 | Partial Upper Denture – Cast Metal Framework | $560.00* |
| 728 | Partial Lower Denture – Cast Metal Framework | $560.00* |
| 733 | Tooth/Teeth (Partial Denture) | $50.00 |
| Denture Maintenance | ||
| 743 | Relining – Complete Denture – Processed | $350.00 |
| Denture Repairs | ||
| 762 | Replacing/Adding Clasp to Denture – Per Clasp | $115.00 |
| 763 | Repairing Broken Base of a Complete Denture | $120.00 |
| 764 | Repairing Broken Base of a Partial Denture | $120.00 |
| 765 | Replacing Tooth on Denture – Per Tooth | $120.00 |
| 768 | Adding Tooth to Partial Denture to Replace an Extracted or Decoronated Tooth – per tooth | $148.00 |
| Other Prosthodontic Services | ||
| 771 | Tissue Conditioning Preparatory to Impressions – Per Application | $89.00 |
| 776 | Impression – Denture Repair/Modification | $48.00 |
| GENERAL SERVICES | ||
| Emergencies | ||
| 911 | Palliative Care (Interim care to relieve pain, infection, bleeding etc.) | $60.00 |
| Occlusal Therapy | ||
| 961 | Minor Occlusal Adjustment – Per Visit (Bite Adjustment) | $50.00 |
| 965 | Occlusal Splint (Stops grinding) | $505.00 |
GENERAL INFORMATION
- Any items NOT on this fee schedule list and/or special services MUST be charged at 15% less than the usual practice fee.
- If the Dentists fees are lower than the Dentacare fee, the member will get a 15% discount on the private practice fee/s. The amount charged to the member will either be the fee detailed on the Dentacare fee schedule OR 15% off the dentists fee, whichever is the lower figure.
- Specialists working within the Dentacare Plan charge 15% less than their usual fees.
- Some Dental Services may be subject to a GST.
