Common use of Schedule of Prices for Special Dental Services Not Requiring Prior Approval Clause in Contracts

Schedule of Prices for Special Dental Services Not Requiring Prior Approval. The payments you will receive, per service provided, for the Services described in clause E5.6 are as follows. Item Code Price (GST excl.) 2023/24 Initial oral consultation for school dental clinic patients referred for Special Dental Services or for school dental clinic patients or adolescents who are not able to access their regular health provider in an emergency during normal practice hours. CON3 $84.12 Emergency consultation outside normal practice hours CON4 $124.22 Bitewing radiograph PBW1 $12.08 Periapical radiograph RAD1 $12.08 Panoramic radiograph RAD2 $46.97 Occlusal radiograph RAD3 $ 31.61 One surface restoration in posterior teeth (including the anterior and posterior pit and all buccal, palatal and lingual fissure extensions of molars) FIL1 $77.19 Two surface (approximo-occlusal) restorations in posterior teeth FIL2 $101.21 Three surface (mesio-occlusal) restorations in posterior teeth FIL3 $124.56 Complex coronal reconstructions (including restoration of one or more cusps) FIL4 $139.81 Simple restoration in anterior teeth FIL5 $91.74 More than one surface restoration in anterior teeth FIL6 $ 123.36 Preformed metal crowns CRN1 $79.32 Extraction of a single permanent tooth or deciduous quadrant (excluding extractions for orthodontic purposes) with local anaesthetics EXT1 $150.00 Extraction of a single permanent tooth or deciduous quadrant Excluding extraction or orthodontic purposes with general anaesthetic EXT3 $102.68 Root canal treatment and root filling in permanent anterior or premolar teeth (per canal) including all necessary radiographs performed during treatment and mandatory post-operative radiology for patient's record RCT1 $313.35 Pulp removal and root filling in a deciduous tooth (maximum fee per deciduous tooth treated) RCT2 $171.91 Pulpotomy in deciduous tooth RCT3 $ 110.25 Pulpotomy in permanent tooth RCT4 $110.25 Emergency dressing EMD1 $32.49 Re-cement inlay crown RCM1 $ 28.40 Payment for these Services will be based on the information reported by you as required by clause E10.

Schedule of Prices for Special Dental Services Not Requiring Prior Approval. The payments you will receive, per service provided, for the Services described in clause E5.6 are as follows. follows Item Code Price (GST excl.) 2023/24 2022/23 Initial oral consultation for school dental clinic patients referred for Special Dental Services or for school dental clinic patients or adolescents who are not able to access their regular health provider in an emergency during normal practice hours. CON3 $84.12 $ 80.54 Emergency consultation outside normal practice hours CON4 $124.22 $ 118.93 Bitewing radiograph PBW1 $12.08 $ 11.57 Periapical radiograph RAD1 $12.08 $ 11.57 Panoramic radiograph RAD2 $46.97 $ 44.97 Occlusal radiograph RAD3 $ 31.61 30.26 One surface restoration in posterior teeth (including the anterior and posterior pit and all buccal, palatal and lingual fissure extensions of molars) FIL1 $77.19 $ 73.90 Two surface (approximo-occlusal) restorations in posterior teeth FIL2 $101.21 $ 96.90 Three surface (mesio-occlusal) restorations in posterior teeth FIL3 $124.56 $ 119.25 Complex coronal reconstructions (including restoration of one or more cusps) FIL4 $139.81 $ 133.85 Simple restoration in anterior teeth FIL5 $91.74 $ 87.83 More than one surface restoration in anterior teeth FIL6 $ 123.36 118.10 Preformed metal crowns CRN1 $79.32 $ 75.94 Extraction of a single permanent tooth or deciduous quadrant (excluding extractions for orthodontic purposes) with local anaesthetics EXT1 $150.00 $ 90.00 Extraction of a single permanent tooth or deciduous quadrant Excluding extraction or orthodontic purposes with general anaesthetic EXT3 $102.68 $ 98.31 Subsequent extraction of a permanent tooth (maximum 4 teeth) or deciduous quadrant (excluding extractions for orthodontic purposes) EXT2 $ 51.44 Root canal Canal treatment and root filling fillings in a permanent anterior or premolar teeth tooth (per canalcanal treated) including all necessary radiographs performed during treatment and a mandatory post-operative radiology radiograph for the patient's record records RCT1 $313.35 $ 300.00 Pulp removal and root filling in a deciduous tooth (maximum fee per deciduous tooth treated) RCT2 $171.91 $ 164.59 Pulpotomy in deciduous tooth RCT3 $ 110.25 105.55 Pulpotomy in permanent tooth RCT4 $110.25 $ 105.55 Emergency dressing EMD1 $32.49 $ 31.11 Re-cement inlay crown RCM1 $ 28.40 27.19 Payment for these Services will be based on the information reported by you as required by clause E10.

Schedule of Prices for Special Dental Services Not Requiring Prior Approval. The payments you will receive, per service provided, for the Services described in clause E5.6 are as follows. follows Item Code Price (GST excl.) 2023/24 2021/21 Initial oral consultation for school dental clinic patients referred for Special Dental Services or for school dental clinic patients or adolescents who are not able to access their regular health provider in an emergency during normal practice hours. CON3 $84.12 $ 78.67 Emergency consultation outside normal practice hours CON4 $124.22 $ 116.17 Bitewing radiograph PBW1 $12.08 $ 11.30 Periapical radiograph RAD1 $12.08 $ 11.30 Panoramic radiograph RAD2 $46.97 $ 43.92 Occlusal radiograph RAD3 $ 31.61 29.56 One surface restoration in posterior teeth (including the anterior and posterior pit and all buccal, palatal and lingual fissure extensions of molars) FIL1 $77.19 $ 72.18 Two surface (approximo-occlusal) restorations in posterior teeth FIL2 $101.21 $ 94.65 Three surface (mesio-occlusal) restorations in posterior teeth FIL3 $124.56 $ 116.48 Complex coronal reconstructions (including restoration of one or more cusps) FIL4 $139.81 $ 130.74 Simple restoration in anterior teeth FIL5 $91.74 $ 85.79 More than one surface restoration in anterior teeth FIL6 $ 123.36 115.35 Preformed metal crowns CRN1 $79.32 $ 74.17 Extraction of a single permanent tooth or deciduous quadrant (excluding extractions for orthodontic purposes) with local anaesthetics EXT1 $150.00 $ 66.94 Extraction of a single permanent tooth or deciduous quadrant Excluding extraction or orthodontic purposes with general anaesthetic EXT3 $102.68 $ 96.02 Subsequent extraction of a permanent tooth (maximum 4 teeth) or deciduous quadrant (excluding extractions for orthodontic purposes) EXT2 $ 50.24 Root canal Canal treatment and root filling fillings in a permanent anterior or premolar teeth tooth (per canalcanal treated) including all necessary radiographs performed during treatment and a mandatory post-operative radiology radiograph for the patient's record records RCT1 $313.35 $ 199.48 Pulp removal and root filling in a deciduous tooth (maximum fee per deciduous tooth treated) RCT2 $171.91 $ 160.76 Pulpotomy in deciduous tooth RCT3 $ 110.25 103.10 Pulpotomy in permanent tooth RCT4 $110.25 $ 103.10 Emergency dressing EMD1 $32.49 $ 30.39 Re-cement inlay crown RCM1 $ 28.40 26.56 Payment for these Services will be based on the information reported by you as required by clause E10.

Schedule of Prices for Special Dental Services Not Requiring Prior Approval. The payments you will receive, per service provided, for the Services described in clause E5.6 are as follows. follows Item Code Price (GST excl.) 2023/24 2020/21 Initial oral consultation for school dental clinic patients referred for Special Dental Services or for school dental clinic patients or adolescents who are not able to access their regular health provider in an emergency during normal practice hours. CON3 $84.12 $ 77.13 Emergency consultation outside normal practice hours CON4 $124.22 $ 113.87 Bitewing radiograph PBW1 $12.08 $ 11.08 Periapical radiograph RAD1 $12.08 $ 11.08 Panoramic radiograph RAD2 $46.97 $ 43.06 Occlusal radiograph RAD3 $ 31.61 28.98 One surface restoration in posterior teeth (including the anterior and posterior pit and all buccal, palatal and lingual fissure extensions of molars) FIL1 $77.19 $ 70.76 Two surface (approximo-occlusal) restorations in posterior teeth FIL2 $101.21 $ 92.79 Three surface (mesio-occlusal) restorations in posterior teeth FIL3 $124.56 $ 114.20 Complex coronal reconstructions (including restoration of one or more cusps) FIL4 $139.81 $ 128.18 Simple restoration in anterior teeth FIL5 $91.74 $ 84.11 More than one surface restoration in anterior teeth FIL6 $ 123.36 113.07 Preformed metal crowns CRN1 $79.32 $ 72.72 Extraction of a single permanent tooth or deciduous quadrant (excluding extractions for orthodontic purposes) with local anaesthetics EXT1 $150.00 $ 65.63 Extraction of a single permanent tooth or deciduous quadrant Excluding extraction or orthodontic purposes with general anaesthetic EXT3 $102.68 $ 94.14 Subsequent extraction of a permanent tooth (maximum 4 teeth) or deciduous quadrant (excluding extractions for orthodontic purposes) EXT2 $ 49.25 Root canal Canal treatment and root filling fillings in a permanent anterior or premolar teeth (per canalcanal treated) including all necessary radiographs performed during treatment and a mandatory post-operative radiology radiograph for the patient's record records RCT1 $313.35 $ 195.57 Root Canal treatment and root fillings in permanent posterior teeth (per canal treated) including all necessary radiographs performed during treatment and a mandatory post-operative radiograph for the patient's record. RCT5 $ 195.57 Pulp removal and root filling in a deciduous tooth (maximum fee per deciduous tooth treated) RCT2 $171.91 $ 157.61 Pulpotomy in deciduous tooth RCT3 $ 110.25 101.08 Pulpotomy in permanent tooth RCT4 $110.25 $ 101.08 Emergency dressing EMD1 $32.49 $ 29.79 Re-cement inlay crown RCM1 $ 28.40 26.04 Payment for these Services will be based on the information reported by you as required by clause E10.