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Commonwealth Coat of Arms of Australia
Dental Benefits Rules 2026
I, Mark Roddam, as delegate of the Minister for Health and Ageing, make the following rules.
Dated 16 February 2026
Mark Roddam
First Assistant Secretary, Department of Health, Disability and Ageing
Contents
Part 1—Preliminary
1 Name
2 Commencement
3 Authority
4 Schedules
5 Definitions
6 Meaning of eligible dental patient
7 Meaning of dental provider
8 Meaning of rendered on behalf of a dental provider
Part 2—When dental benefit is not payable
Division 1—Dental benefit not payable unless certain conditions satisfied
9 Particulars that must be recorded on accounts etc.
10 Conditions that must be satisfied—certain dental services rendered by kinds of dental providers
11 Condition that must be satisfied—consent to be provided and recorded
12 Condition that must be satisfied—dental services rendered by States and Territories
Division 2—Dental benefit not payable in certain circumstances
13 Dental benefit not payable if no medicare number
14 Dental benefit not payable if certain personal information not provided
15 Dental benefit not payable if cap reached
16 Dental benefit not payable for certain additional dental services
17 Dental benefit not payable for certain additional dental services rendered by same dental practitioner
18 Dental benefit not payable for certain diagnostic services
19 Dental benefit not payable for certain preventive services
20 Dental benefit not payable for certain periodontic services
21 Dental benefit not payable for certain oral surgery
22 Dental benefit not payable for certain endodontic services
23 Dental benefit not payable for certain restorative services
24 Dental benefit not payable for certain prosthodontic services
25 Dental benefit not payable for certain other prosthodontic services
26 Dental benefit not payable for a certain general service
Part 3—Dental Benefits Schedule
27 Dental Benefits Schedule
Part 4—Application, saving and transitional provisions
Division 1—Dental Benefits Rules 2026
28 Definitions
29 Application—dental service provided on or after commencement
30 Transitional—dental benefit 2 year cap
31 Something done under the old rules
Schedule 1—Dental Benefits Schedule
Division 1—Group U0: Diagnostic services
1 Items in Subgroup 1 of Group U0
2 Items in Subgroup 2 of Group U0
Division 2—Group U1: Preventive services
3 Items in Subgroup 1 of Group U1
4 Item in Subgroup 2 of Group U1
5 Items in Subgroup 3 of Group U1
Division 3—Group U2: Periodontic services
6 Items in Group U2
Division 4—Group U3: Oral surgery
7 Items in Subgroup 1 of Group U3
8 Items in Subgroup 2 of Group U3
9 Item in Subgroup 5 of Group U3
10 Items in Subgroup 8 of Group U3
Division 5—Group U4: Endodontic services
11 Items in Subgroup 1 of Group U4
12 Items in Subgroup 4 of Group U4
Division 6—Group U5: Restorative Services
13 Items in Subgroup 1 of Group U5
14 Items in Subgroup 2 of Group U5
15 Items in Subgroup 3 of Group U5
16 Items in Subgroup 7 of Group U5
Division 7—Group U7: Prosthodontics
17 Items in Subgroup 1 of Group U7
18 Item in Subgroup 4 of Group U7
19 Items in Subgroup 6 of Group U7
20 Item in Subgroup 7 of Group U7
Division 8—Group U9: General services
21 Item in Subgroup 1 of Group U9
22 Items in Subgroup 4 of Group U9
Schedule 2—Dental cap
1 Dental cap
Schedule 3—Repeals
Dental Benefits Rules 2014
Part 1—Preliminary
1 Name
This instrument is the Dental Benefits Rules 2026.
2 Commencement
(1) Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.
- Commencement information
- Column 1 Column 2 Column 3
- Provisions Commencement Date/Details
-
- The whole of this instrument The day after this instrument is registered. 19 February 2026
Note: This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.
(2) Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.
3 Authority
This instrument is made under the Dental Benefits Act 2008.
4 Schedules
Each instrument that is specified in Schedule 3 to this instrument is amended or repealed as set out in the applicable items in that Schedule, and any other item in that Schedule has effect according to its terms.
5 Definitions
Note: A number of expressions used in this instrument are defined in the Act, including the following:
(a) ABSTUDY scheme;
(b) dental practitioner;
(c) dental provider;
(d) FTB(A) person;
(e) Human Services Department;
(f) item;
(g) medicare number;
(h) youth allowance.
In this instrument:
Act means the Dental Benefits Act 2008.
carer payment has the same meaning as in the Social Security Act 1991.
dental cap: see Schedule 2.
dental hygienist means a person who has general registration in the dental hygienists division of the dental profession under a law of a State or Territory.
dental prosthetist means a person who has general registration in the dental prosthetists division of the dental profession under a law of a State or Territory.
dental therapist means a person who has general registration in the dental therapists division of the dental profession under a law of a State or Territory.
Department of Veterans’ Affairs means the Department of State that is administered by the Minister administering the Military Rehabilitation and Compensation Act 2004.
disability support pension has the same meaning as in the Social Security Act 1991.
double orphan pension has the same meaning as in the Social Security Act 1991.
member of a couple has the same meaning as in the Social Security Act 1991.
MRCAETS (short for Military Rehabilitation and Compensation Act Education and Training Scheme) means the scheme determined under section 258 of the Military Rehabilitation and Compensation Act 2004 and approved by the Minister administering that Act, as in force from time to time.
oral health therapist means a person who has general registration in the oral health therapists division of the dental profession under a law of a State or Territory.
parenting payment has the same meaning as in the Social Security Act 1991.
partner, in relation to a person who is a member of a couple, means the other member of the couple.
provider number has the same meaning as in the Health Insurance Regulations 2018.
public sector dental provider means:
(a) a dental provider employed by, contracted to, or providing dental services under an arrangement with:
(i) the Commonwealth; or
(ii) a State; or
(iii) a Territory; or
(iv) a local governing body; or
(v) an authority established by a law of the Commonwealth, a law of a State or a law of a Territory; or
(b) a dental provider on whose behalf another dental provider provides dental services under an arrangement with a person or body covered by subparagraph (a)(i), (ii), (iii), (iv) or (v).
receive:
(a) in relation to a payment under the ABSTUDY scheme—has the same meaning as in subsection 24(4) of the Act; and
(b) in relation to the following payments—has the same meaning as in section 23 of the Social Security Act 1991:
(a) carer payment;
(b) disability support pension;
(c) double orphan pension;
(d) parenting payment;
(e) special benefit;
(f) youth allowance; and
(c) in relation to VCES and MRCAETS—has its ordinary meaning.
registered dentist means a dental practitioner who has general registration, or specialist registration, in the dentists division of the dental profession under a law of a State or Territory.
special benefit has the same meaning as in the Social Security Act 1991.
VCES (short for Veterans’ Children Education Scheme) means the scheme determined under subsection 117(1) of the Veterans’ Entitlements Act 1986 and approved by the Minister administering that Act, as in force from time to time.
6 Meaning of eligible dental patient
For the purposes of paragraph 5(1)(b) of the Act, the following classes of eligible persons are eligible dental patients in relation to a dental service:
(a) eligible persons who, at any time in the calendar year in which the dental service is rendered, are aged under 18 years and receive any of the following payments:
(i) carer payment;
(ii) disability support pension;
(iii) parenting payment;
(iv) special benefit;
(v) youth allowance;
(b) eligible persons who, at any time in the calendar year in which the dental service is rendered, are aged under 18 years and either:
(i) who receive a payment under the ABSTUDY scheme; or
(ii) in respect of whom another person receives a payment under the ABSTUDY scheme;
(c) eligible persons who, at any time in the calendar year in which the dental service is rendered, are aged under 18 years and are an FTB(A) person;
(d) eligible persons who, at any time in the calendar year in which the dental service is rendered, are aged 16 or 17 years and either:
(i) who receive a payment under VCES or MRCAETS; or
(ii) in respect of whom another person receives a payment under VCES or MRCAETS;
(e) eligible persons who, at any time in the calendar year in which the dental service is rendered, are aged under 18 years and whose parent, guardian or carer receive either of the following payments in respect of the person:
(i) double orphan pension;
(ii) parenting payment;
(f) eligible persons who, at any time in the calendar year in which the dental service is rendered, are aged under 18 years and whose partner receives parenting payment.
7 Meaning of dental provider
(1) For the purposes of paragraph 6(1)(b) of the Act, the following classes of persons are dental providers in relation to a dental service:
(a) dental hygienists;
(b) dental therapists;
(c) oral health therapists.
(2) For the purposes of paragraph 6(2)(a) of the Act, the class of dental practitioners that are not dental providers in relation to a dental service are dental practitioners who have not been allocated a provider number in respect of the place of practice at which the service is rendered.
8 Meaning of rendered on behalf of a dental provider
Dental services rendered on behalf of registered dentists
(1) For the purposes of paragraph 7(a) of the Act, a dental service may be rendered on behalf of a registered dentist who is not a public sector dental provider by a person who is included in one or more of the following classes of persons:
(a) dental hygienists;
(b) dental therapists;
(c) dental prosthetists;
(d) oral health therapists.
Dental services rendered on behalf of public sector dental providers
(2) For the purposes of paragraph 7(a) of the Act, a dental service may be rendered on behalf of a public sector dental provider who is a registered dentist by another public sector dental provider.
Part 2—When dental benefit is not payable
Division 1—Dental benefit not payable unless certain conditions satisfied
9 Particulars that must be recorded on accounts etc.
(1) For the purposes of subsection 17(2) of the Act, the particulars that must be recorded on an account or receipt for fees, or on a form of an assignment, in respect of a dental service, are the following:
(a) the name of the eligible dental patient in respect of whom the dental service was rendered;
(b) the date on which the dental service was rendered;
(c) the item that corresponds to the dental service;
(d) the name of the dental provider by whom, or on whose behalf, the dental service is rendered;
(e) the dental provider’s provider number in respect of the place of practice at which the dental service was rendered;
(f) for:
(i) an account or receipt for fees—the amount charged by the dental provider for the dental service, and the amount paid or outstanding (if any); or
(ii) a form of an assignment—the amount of dental benefit assigned to the dental provider.
(2) The particulars in subsection (1) are specified in relation to dental services generally.
10 Conditions that must be satisfied—certain dental services rendered by kinds of dental providers
For the purposes of subsection 18(1) of the Act, dental benefit is not payable in respect of a dental service specified in an item listed column 1 in an item in the following table unless the dental service is rendered by or on behalf of a dental provider specified in column 2 of the item.
| Item | Column 1<br>A dental service specified in one of the following items… | Column 2<br>must be rendered by or on behalf of… |
|---|
| 1 | 88314<br>88322<br>88323<br>88324<br>88326<br>88351<br>88392<br>88412<br>88415<br>88416<br>88417<br>88418<br>88419<br>88421<br>88455<br>88458<br>88597<br>88721<br>88722<br>88723<br>88724<br>88731<br>88733<br>88736<br>88741<br>88761<br>88762<br>88764<br>88765<br>88766<br>88768<br>88942<br>88943 | a registered dentist. |
| 2 | 88311<br>88316<br>88384<br>88386<br>88387<br>88411<br>88414<br>88511<br>88512<br>88513<br>88514<br>88515<br>88521<br>88522<br>88523<br>88524<br>88525<br>88531<br>88532<br>88533<br>88534<br>88535<br>88574<br>88575<br>88579<br>88586<br>88587 | (a) a registered dentist; or<br>(b) a dental therapist; or<br>(c) an oral health therapist. |
11 Condition that must be satisfied—consent to be provided and recorded
(1) For the purposes of subsection 18(1) of the Act, dental benefit is not payable in respect of a dental service unless:
(a) the person incurring the dental expenses in respect of the service:
(i) makes an assignment of the dental benefit in accordance with section 12 of the Act; and
(ii) has signed an approved form known as the Child Dental Benefits Schedule Bulk Billing Patient Consent Form in the calendar year in which the service is rendered; or
(b) the person incurring the dental expenses in respect of the service signs an approved form known as the Child Dental Benefits Schedule Non‑Bulk Billing Patient Consent Form on the day the service is rendered; or
(c) the dental provider by whom, or on whose behalf, the service is rendered:
(i) obtains and records consent to render the service from the eligible dental patient or the patient’s parent or guardian before the service is rendered; and
(ii) informs the person incurring the dental expenses in respect of the service of the amount of dental benefit likely payable for the service and any likely out‑of‑pocket costs before rendering the service; and
(iii) obtains and records the consent of the person mentioned in paragraph (ii) to render the service; and
(iv) obtains a signature from the person or persons providing the consents specified in subparagraph (i) and (iii) on the day the service is rendered.
Note: The approved forms known as the Child Dental Benefits Schedule Bulk Billing Patient Consent Form and the Child Dental Benefits Schedule Non‑Bulk Billing Patient Consent Form could, on 1 April 2025, be viewed on the Department’s website (www.health.gov.au).
Exception—dental services provided in an emergency
(2) Subsection (1) does not apply if:
(a) the dental provider, or person on behalf of the dental provider, renders the dental service on an emergency basis outside the provider’s usual hours of practice or in a different location to the provider’s usual location of practice; and
(b) either:
(i) the person incurring the dental expenses in respect of the service did not sign a form mentioned in paragraph (1)(a) or (b) on the day the service is rendered; or
(ii) the dental provider is unable to record the consents or obtain the signature or signatures mentioned in paragraph (1)(c) on the day the service is rendered; and
(c) the person signs one of the forms, or the dental provider records the consents or obtains the signature or signatures (as the case requires), as soon as is reasonably practicable after the day the service is rendered.
Exception—other exceptional circumstances
(3) Subsection (1) does not apply if:
(a) the dental provider is unaware that the eligible dental patient is an eligible dental patient at the time the dental service is rendered; or
(b) the dental provider obtains and records the consents mentioned in subparagraph (1)(c)(i) and (iii) but a person providing a consent:
(i) refuses to provide the provider with the person’s signature; or
(ii) is incapacitated or dies before the person is able to provide the provider with their signature; or
(c) for the purposes of paragraph (1)(a), (b) or (c), a person purports to be a person incurring dental expenses or to be a parent or guardian of an eligible dental patient, but the person is not such a person and the provider is unaware of this fact; or
(d) a requirement set out in subparagraph (1)(c)(i), (iii) or (iv) is not met due to an administrative error by the dental provider or a person working with the provider, where the error occurs outside the provider or person’s (as the case requires) standard operating procedures.
12 Condition that must be satisfied—dental services rendered by States and Territories
For the purposes of subsection 18(1) of the Act, dental benefit is not payable in respect of a dental service rendered to an eligible dental patient by, on behalf of or under an arrangement with a State or Territory unless:
(a) the service is rendered before 1 January 2027; or
(b) the Minister directs that this section does not apply to the arrangement.
Division 2—Dental benefit not payable in certain circumstances
13 Dental benefit not payable if no medicare number
For the purposes of subsection 21(1) of the Act, dental benefit is not payable in respect of a dental service rendered to an eligible dental patient if, at the time the service is rendered, the patient has not been assigned a medicare number.
14 Dental benefit not payable if certain personal information not provided
For the purposes of subsection 21(1) of the Act, dental benefit is not payable in respect of a dental service rendered to an eligible dental patient if:
(a) the patient is an eligible dental patient because they are covered by paragraph 6(d) of this instrument; and
(b) the patient, or the person who receives a payment under VCES or MRCAETS in respect of the patient (as the case requires), has not consented to the Department of Veterans’ Affairs providing personal information (within the meaning of the Privacy Act 1988) about the patient to the Human Services Department.
15 Dental benefit not payable if cap reached
(1) For the purposes of subsection 21(1) of the Act, dental benefit, or an amount of dental benefit, is not payable in respect of a dental service if the payment of the benefit or amount would result in the total amount of dental benefit paid:
(a) in respect of the eligible dental patient to whom the service is rendered; and
(b) in a 2 year period specified in subsection (2);
exceeding the dental cap specified in Schedule 2 to this instrument for the 2 year period.
(2) The 2 year periods specified in this subsection are the following periods:
(a) a 2 year period beginning on 1 January of the year in which dental benefit is first payable in respect of the patient;
(b) any 2 year period beginning on 1 January of the year in which dental benefit is first payable in respect of the patient after the expiry of a previous 2 year period (including a 2 year period under this paragraph).
16 Dental benefit not payable for certain additional dental services
(1) For the purposes of subsection 21(1) of the Act, dental benefit is not payable in respect of a dental service:
(a) specified in an item listed in column 1 of an item in the following table; and
(b) rendered to an eligible dental patient on a day;
if dental benefit is or was payable in respect of the same service previously rendered to the patient on the number of occasions specified in column 2 of the item, at any time in the period specified in column 3 of the item.
| Item | Column 1<br>Dental service specified in the following items | Column 2<br>Number of occasions dental service previously rendered | Column 3<br>Period |
|---|
| 1 | 88311<br>88314<br>88322<br>88323<br>88324 | 1 | The day the service is rendered |
| 2 | 88111<br>88114<br>88121 | 1 | 5 months ending on the day the service is rendered |
| 3 | 88942 | 1 | 12 months ending on the day the service is rendered |
| 4 | 88221<br>88721<br>88722 | 1 | 24 months ending on the day the service is rendered |
| 5 | 88115<br>88213 | 2 | 12 months ending on the day the service is rendered |
| 6 | 88013<br>88572 | 3 | 3 months ending on the day the service is rendered |
| 7 | 88458 | 3 | 12 months ending on the day the service is rendered |
| 8 | 88022<br>88161<br>88575 | 4 | The day the service is rendered |
| 9 | 88768 | 8 | 24 months ending on the day the service is rendered |
(2) Further, dental benefit is not payable in respect of a dental service specified in item 88111, 88114 or 88121 and rendered to an eligible dental patient on a day if dental benefit is or was payable in respect of the same service previously rendered to the patient twice in the same calendar year in which the day falls.
17 Dental benefit not payable for certain additional dental services rendered by same dental practitioner
(1) For the purposes of subsection 21(1) of the Act, dental benefit is not payable in respect of a dental service:
(a) specified in an item listed in column 1 of an item in the following table; and
(b) rendered to an eligible dental patient by, or on behalf of, a dental provider on a day;
if dental benefit is or was payable in respect of the same service previously rendered to the patient by, or on behalf of, the same provider at any time in the period listed in column 2 of the item.
| Item | Column 1<br>Dental service specified in the following items | Column 2<br>Period |
|---|
| 1 | 88012 | 5 months ending on the day the service is rendered |
| 2 | 88011 | 24 months ending on the day the service is rendered |
(2) Further, dental benefit is not payable in respect of a dental service specified in item 88012 and rendered to an eligible dental patient by, or on behalf of, a dental provider on a day if dental benefit is or was payable in respect of the same service previously rendered to the patient by, or on behalf of, the same provider twice in the same calendar year in which the day falls.
18 Dental benefit not payable for certain diagnostic services
(1) For the purposes of subsection 21(1) of the Act, dental benefit is not payable in respect of a dental service specified in an item in Subgroup 1 of Group U0 of the Dental Benefits Schedule and rendered to an eligible dental patient on a day if:
(a) dental benefit is payable in respect of the same service rendered to the patient on the same day; or
(b) dental benefit is payable in respect of a different dental service specified in another item in Subgroup 1 of Group U0 and rendered to the patient on the same day.
(2) For the purposes of subsection 21(1) of the Act, dental benefit is not payable in respect of a dental service specified in item 88012 and rendered to an eligible dental patient by, or on behalf of, a dental provider on a day if dental benefit is or was payable in respect of a dental service specified in item 88011 and previously rendered to the patient by, or on behalf of, the same provider less than 5 months before the day.
19 Dental benefit not payable for certain preventive services
(1) For the purposes of subsection 21(1) of the Act, dental benefit is not payable in respect of a dental service specified in an item in Subgroup 1 of Group U1 of the Dental Benefits Schedule and rendered to an eligible dental patient on a day if dental benefit is payable in respect of a different dental service specified in another item in Subgroup 1 of Group U1 and rendered to the patient on the same day.
(2) For the purposes of subsection 21(1) of the Act, dental benefit is not payable in respect of a dental service specified in an item in Subgroup 3 of Group U1 of the Dental Benefits Schedule and rendered on a tooth on a day if dental benefit is payable in respect of another dental service specified in an item in Subgroup 1, 2 or 3 of Group U5 and rendered on the same tooth on the same day.
20 Dental benefit not payable for certain periodontic services
For the purposes of subsection 21(1) of the Act, dental benefit is not payable in respect of a dental service specified in item 88213 and rendered on a tooth on a day if dental benefit is payable in respect of a dental service specified in item 88415 and rendered on the same tooth on the same day.
21 Dental benefit not payable for certain oral surgery
For the purposes of subsection 21(1) of the Act, dental benefit is not payable in respect of the following dental services:
(a) a service specified in item 88311 and rendered to an eligible dental patient on a day if dental benefit is payable in respect of a dental service specified in item 88314 and rendered to the patient on the same day;
(b) a service specified in item 88322 and rendered to an eligible dental patient on a day if dental benefit is payable in respect of a dental service specified in item 88323 or 88324 and rendered to the patient on the same day;
(c) a service specified in item 88323 and rendered to an eligible dental patient on a day if dental benefit is payable in respect of a dental service specified in item 88324 and rendered to the patient on the same day;
(d) a service specified in item 88324 if the service is rendered on a tooth that is not a multi‑rooted tooth;
(e) a service specified in an item in Subgroup 1 or 2 of Group U3 and rendered on a tooth on a day if dental benefit is payable in respect of another dental service also specified in an item in Subgroup 1 or 2 of Group U3 and rendered on the same tooth on the same day;
(f) a service specified in an item in Subgroup 8 of Group U3 and rendered on a tooth if dental benefit is or was payable in respect of a dental service specified in an item in Subgroup 1 or 2 of Group U3 and previously rendered on the same tooth at any time before the service specified in an item in Subgroup 8 of Group U3 was rendered;
(g) a service specified in item 88351 and rendered to an eligible dental patient on a day if the service is not rendered on the same day as a dental service specified in item 88384, 88386 or 88387.
22 Dental benefit not payable for certain endodontic services
(1) For the purposes of subsection 21(1) of the Act, dental benefit is not payable in respect of the following dental services:
(a) a service specified in item 88412 and rendered on a tooth on a day if dental benefit is or was payable in respect of the same service previously rendered on the same tooth at any time;
(b) a service specified in any item in Group U4 of the Dental Benefits Schedule and rendered on a tooth if dental benefit is or was payable in respect of a service specified in item 88412 and previously rendered on the same tooth at any time;
(c) a service specified in item 88415 and rendered on a tooth on a day if dental benefit is payable in respect of the same service rendered on the same tooth on the same day;
(d) a service specified in item 88416 and rendered on a tooth on a day if dental benefit is payable in respect of the same service rendered on the same tooth twice on the same day;
(e) a service specified in item 88417 and rendered on a tooth on a day if dental benefit is payable in respect of the same service rendered on the same tooth on the same day;
(f) a service specified in item 88418 and rendered on a tooth on a day if dental benefit is payable in respect of the same service rendered on the same tooth twice on the same day;
(g) a service specified in item 88414 and rendered on a tooth on a day if dental benefit is payable in respect of a dental service specified in item 88421 and rendered on the same tooth on the same day;
(h) a service specified in item 88418 and rendered on a tooth on a day if dental benefit is payable in respect of a dental service specified in item 88419 and rendered on the same tooth on the same day;
(i) a service specified in item 88419 and rendered to a tooth on a day if dental benefit is payable in respect of a dental service specified in item 88311 to 88326, 88411 to 88417, 88421, 88455, 88458 or 88511 to 88535 and rendered on the same tooth on the same day;
(j) a service specified in item 88421 and rendered on a primary tooth on a day if dental benefit is or was payable in respect of:
(i) the same service previously rendered on the same tooth at any time; or
(ii) a dental service specified in item 88414 and rendered on the same tooth on the same day;
(k) a service specified in item 88455 and rendered to a tooth on a day if:
(i) dental benefit is payable in respect of a dental service specified in item 88414, 88415, 88416, 88417, 88418, or 88421 and rendered on the same tooth on the same day; or
(ii) dental benefit is not, or was not, payable in respect of a dental service specified in item 88415 or 88416 and rendered on the same tooth in the 3 month period ending on the day.
Dental service specified in item 88458
(2) For the purposes of subsection 21(1) of the Act, dental benefit is not payable in respect of a dental service specified in an item in Group U4 of the Dental Benefits Schedule and rendered to an eligible dental patient on a day if dental benefit is or was payable in respect of a dental service specified in item 88458 and previously rendered to the patient in the 3 month period ending on the day.
(3) Subsection (2) does not apply if the dental service:
(a) is a service specified in item 88415 or 88416 and rendered to the patient on the same day as a dental service specified in item 88458; or
(b) is a service specified in item 88455.
23 Dental benefit not payable for certain restorative services
For the purposes of subsection 21(1) of the Act, dental benefit is not payable in respect of the following dental services:
(a) a service specified in an item in Subgroup 1, 2 or 3 of Group U5 and rendered on a tooth on a day if dental benefit is payable in respect of another dental service also specified in an item in Subgroup 1, 2 or 3 of Group U5 and rendered on the same tooth on the same day;
(b) a service specified in item 88521 or 88531 and rendered to an eligible dental patient on a day if dental benefit is payable in respect of dental services specified in either or both of those items on 5 occasions on the same day;
(c) a service specified in item 88521 and rendered to an eligible dental patient on a day if dental benefit is payable in respect of a dental service specified in item 88531 and rendered to the patient on the same day;
(d) a service specified in item 88572 and rendered to an eligible dental patient on a day if dental benefit is payable in respect of a dental service specified in item 88411 to 88418 or 88421 to 88458 and rendered to the patient on the same day;
(e) a service specified in item 88575 and rendered on a tooth on a day if:
(i) dental benefit is not payable in respect of a dental service specified in Subgroup 1, 2 or 3 of Group U5 and rendered in respect of the same tooth on the same day; or
(ii) dental benefit is payable in respect of the same service rendered to the same tooth twice on the day;
(f) a service specified in item 88586 or 88587 and rendered on a tooth on a day if dental benefit is payable in respect of a dental service specified in either of those items and rendered on the same tooth on the same day;
(g) a service specified in item 88597 and rendered on a tooth on a day if:
(i) dental benefit is not payable in respect of a dental service specified in Subgroup 1, 2 or 3 of Group U5 and rendered in respect of the same tooth on the same day; or
(ii) dental benefit is payable in respect of the same service rendered to the same tooth twice on the same day.
24 Dental benefit not payable for certain prosthodontic services
For the purposes of subsection 21(1) of the Act, dental benefit is not payable in respect of the following dental services:
(a) a service specified in item 88721 and rendered to an eligible dental patient on a day if dental benefit is or was payable in respect of a dental service specified in item 88723 and previously rendered to the patient in the 6 month period ending on the day;
(b) a service specified in item 88722 and rendered to an eligible dental patient on a day if dental benefit is or was payable in respect of a dental service specified in item 88724 and previously rendered to the patient in the 6 month period ending on the day;
(c) a service specified in item 88723 and rendered to an eligible dental patient if dental benefit is or was payable in respect of the same service previously rendered to the patient at any time;
(d) a service specified in item 88724 and rendered to an eligible dental patient if dental benefit is or was payable in respect of the same service previously rendered to the patient at any time.
25 Dental benefit not payable for certain other prosthodontic services
For the purposes of subsection 21(1) of the Act, dental benefit is not payable in respect of the following dental services:
(a) a service specified in item 88731 and rendered to an eligible dental patient if:
(i) the service is rendered in respect of a dental service that is not a service specified in item 88721, 88722, 88723 or 88724; or
(ii) the service is rendered more than 4 times in respect of a dental service specified in each of item 88721, 88722, 88723 or 88724 and dental benefit was payable in respect of the 4 dental services previously rendered;
(b) a service specified in item 88733 and rendered to an eligible dental patient if:
(i) the service is not rendered in respect of a dental service specified in item 88721, 88722, 88723 or 88724; or
(ii) the service is rendered more than 4 times in respect of a dental service specified in each of item 88721, 88722, 88723 or 88724 and dental benefit is or was payable in respect of the 4 dental services previously rendered; or
(iii) the service is rendered to a tooth which is not an anterior tooth;
(c) a service specified in item 88736 and rendered to an eligible dental patient if:
(i) the service is not rendered in respect of a dental service specified in item 88721, 88722, 88723 or 88724; or
(ii) the service is rendered more than 4 times in respect of a dental service specified in each of item 88721, 88722, 88723 or 88724 and dental benefit is or was payable in respect of the 4 dental services previously rendered;
(d) a service specified in item 88741 and rendered by, or on behalf of, a dental provider on a day if dental benefit is or was payable in respect of a dental service specified in item 88721, 88722, 88723 or 88724 and previously rendered by or on behalf of the same dental provider less than 12 months before the day.
26 Dental benefit not payable for a certain general service
For the purposes of subsection 21(1) of the Act, dental benefit is not payable in respect of a dental service specified in item 88911 and rendered to an eligible dental patient by, or on behalf of, a dental provider on a day if any other dental service specified in an item in the Dental Benefits Schedule is rendered to the patient by, or on behalf of, the same provider on the same day and dental benefit is payable in respect of that other dental service.
Part 3—Dental Benefits Schedule
27 Dental Benefits Schedule
For the purposes of subsection 61(1) of the Act, the Dental Benefits Schedule is Schedule 1 to this instrument.
Part 4—Application, saving and transitional provisions
Division 1—Dental Benefits Rules 2026
28 Definitions
In this Part:
commencement time means the time this section commences.
old rules means the Dental Benefits Rules 2014.
29 Application—dental service provided on or after commencement
This instrument applies in relation to dental services rendered to an eligible dental patient on or after the commencement of this section.
30 Transitional—dental benefit 2 year cap
(1) If a relevant 2 year period was in effect in relation to an eligible dental patient under section 14 of the old rules immediately before the commencement of this section, the relevant 2 year period continues in effect:
(a) in relation to the patient; and
(b) after commencement;
as if it were a 2 year period specified in subsection 15(2) of this instrument.
(2) The period remains in force for the balance of the relevant 2 year period.
31 Something done under the old rules
(1) If:
(a) something was done for a particular purpose under the old rules as in force immediately before the commencement time; and
(b) the thing could be done for that purpose under this instrument;
the thing has effect for the purposes of this instrument as if it had been done for that purpose under this instrument.
(2) Without limiting subsection (1), a reference in that subsection to something being done includes a reference to a notice, application or other instrument being given or made.
Schedule 1—Dental Benefits Schedule
Note: See section 27.
Division 1—Group U0: Diagnostic services
1 Items in Subgroup 1 of Group U0
This clause sets out items in Subgroup 1 of Group U0.
- Group U0: Diagnostic services
- Column 1Item Column 2Dental service Column 3Amount of dental benefit ($)
- Subgroup 1—Examinations
- 88011 Comprehensive oral examinationEvaluation of all teeth, their supporting tissues and the oral tissues in order to record the condition of these structures. This evaluation includes recording an appropriate medical history and any other relevant information. 60.95
- 88012 Periodic oral examinationAn evaluation performed on a patient of record to determine any changes in the patient’s dental and medical health status since a previous comprehensive or periodic examination. 50.70
- 88013 Oral examination—limitedA limited oral problem‑focussed evaluation carried out immediately prior to required treatment. This evaluation includes recording an appropriate medical history and any other relevant information. 31.80
2 Items in Subgroup 2 of Group U0
This clause sets out items in Subgroup 2 of Group U0.
- Group U0: Diagnostic services
- Column 1Item Column 2Dental service Column 3Amount of dental benefit ($)
- Subgroup 2—Radiological examination and interpretation
- 88022 Intraoral periapical or bitewing radiograph—per exposureTaking and interpreting a radiograph made with the film inside the mouth. 35.30
- 88025 Intraoral radiograph—occlusal, maxillary, mandibular—per exposureTaking and interpreting an occlusal, maxillary or mandibular intraoral radiograph. This radiograph shows a more extensive view of teeth and maxillary or mandibular bone. 71.30
Division 2—Group U1: Preventive services
3 Items in Subgroup 1 of Group U1
This clause sets out items in Subgroup 1 of Group U1.
- Group U1: Preventive services
- Column 1Item Column 2Dental service Column 3Amount of dental benefit ($)
- Subgroup 1—Dental prophylaxis
- 88111 Removal of plaque and/or stainRemoval of dental plaque and/or stain from the surfaces of all teeth and/or implants. 62.30
- 88114 Removal of calculus—first visitRemoval of calculus from the surfaces of teeth. 103.90
- 88115 Removal of calculus—subsequent visitProcedures in item 88114 when, because of the extent or degree of calculus, an additional visit(s) is required to remove deposits from the teeth. 67.50
4 Item in Subgroup 2 of Group U1
This clause sets out items in Subgroup 2 of Group U1.
- Group U1: Preventive services
- Column 1Item Column 2Dental service Column 3Amount of dental benefit ($)
- Subgroup 2—Remineralising agents
- 88121 Topical application of remineralisation and/or cariostatic agents, one treatmentApplication of remineralisation and/or cariostatic agents to the surfaces of the teeth. This may include activation of the agent. Not to be used as an intrinsic part of the restoration. 40.05
5 Items in Subgroup 3 of Group U1
This clause sets out items in Subgroup 3 of Group U1.
- Group U1: Preventive services
- Column 1Item Column 2Dental service Column 3Amount of dental benefit ($)
- Subgroup 3—Other preventive services
- 88161 Fissure and/or tooth surface sealing—per tooth (first four services on a day)Sealing of non‑carious pits, fissures, smooth surfaces or cracks in a tooth with an adhesive material. Any preparation prior to application of the sealant is included in this item number. 53.35
- 88162 Fissure and/or tooth surface sealing – per tooth (subsequent services)Sealing of non‑carious pits, fissures, smooth surfaces or cracks in a tooth with an adhesive material. Any preparation prior to application of the sealant is included in this item number. 26.70
Division 3—Group U2: Periodontic services
6 Items in Group U2
This clause sets out items in Group U2.
- Group U2: Periodontic services
- Column 1Item Column 2Dental service Column 3Amount of dental benefit ($)
- 88213 Treatment of acute periodontal infection—per visitTreatment of acute periodontal infection(s). It may include establishing drainage and the removal of calculus from the affected tooth (teeth). Inclusive of the insertion of sutures, normal post‑operative care and suture removal. 80.70
- 88221 Clinical periodontal analysis and recordingA special examination performed as part of the diagnosis and management of periodontal disease. The procedure consists of assessing and recording a patient’s periodontal condition. All teeth and six sites per tooth must be recorded. 61.35
Division 4—Group U3: Oral surgery
7 Items in Subgroup 1 of Group U3
This clause sets out items in Subgroup 1 of Group U3.
- Group U3: Oral surgery
- Column 1Item Column 2Dental service Column 3Amount of dental benefit ($)
- Subgroup 1—Extractions
- 88311 Removal of a tooth or part(s) thereof—first tooth extracted on a dayA procedure consisting of the removal of a tooth or part(s) thereof. Inclusive of the insertion of sutures, normal post‑operative care and suture removal. 152.05
- 88314 Sectional removal of a tooth or part(s) thereof—first tooth extracted on a dayThe removal of a tooth or part(s) thereof in sections. Bone removal may be necessary. Inclusive of the insertion of sutures, normal post‑operative care and suture removal. 194.35
- 88316 Additional extraction requiring removal of a tooth or part(s) thereof, or sectional removal of a toothAdditional extraction rendered on the same day as a service described in item 88311 or 88314 is rendered to the patient. 95.85
8 Items in Subgroup 2 of Group U3
This clause sets out items in Subgroup 2 of Group U3.
- Group U3: Oral surgery
- Column 1Item Column 2Dental service Column 3Amount of dental benefit ($)
- Subgroup 2—Surgical extractions
- 88322 Surgical removal of a tooth or tooth fragment not requiring removal of bone or tooth division—first tooth extracted on a dayRemoval of a tooth or tooth fragment where an incision and the raising of a mucoperiosteal flap is required, but where removal of bone or sectioning of the tooth is not necessary to remove the tooth. Inclusive of the insertion of sutures, normal post‑operative care and suture removal. 246.80
- 88323 Surgical removal of a tooth or tooth fragment requiring removal of bone—first tooth extracted on a dayRemoval of a tooth or tooth fragment where removal of bone is required after an incision and a mucoperiosteal flap raised. Inclusive of the insertion of sutures, normal post‑operative care and suture removal. 281.85
- 88324 Surgical removal of a tooth or tooth fragment requiring both removal of bone and tooth division—first tooth extracted on a dayRemoval of a tooth or tooth fragment where both removal of bone and sectioning of the tooth are required after an incision and a mucoperiosteal flap raised. The tooth will be removed in portions. Inclusive of the insertion of sutures, normal post‑operative care and suture removal. 379.10
- 88326 Additional extraction requiring surgical removal of a tooth or tooth fragmentAdditional surgical extraction rendered on the same day as a service described in item 88322, 88323 or 88324 is rendered to the patient. 201.90
9 Item in Subgroup 5 of Group U3
This clause sets out items in Subgroup 5 of Group U3.
- Group U3: Oral surgery
- Column 1Item Column 2Dental service Column 3Amount of dental benefit ($)
- Subgroup 5—Treatment of maxillo‑facial injuries
- 88351 Repair of skin and subcutaneous tissue or mucous membraneThe surgical cleaning and repair of a facial skin wound in the region of the mouth or jaws, or the repair of oral mucous membrane, where the wounds involve the subcutaneous tissues. Inclusive of the insertion of sutures, normal post‑operative care and suture removal. 185.25
10 Items in Subgroup 8 of Group U3
This clause sets out items in Subgroup 8 of Group U3.
- Group U3: Oral surgery
- Column 1Item Column 2Dental service Column 3Amount of dental benefit ($)
- Subgroup 8—Other surgical procedures
- 88384 Repositioning of displaced tooth/teeth—per toothA procedure following trauma where the position of the displaced tooth/teeth is corrected by manipulation. Stabilising procedures are itemised separately. Inclusive of the insertion of sutures, normal post‑operative care and suture removal. 221.05
- 88386 Splinting of displaced tooth/teeth—per toothA procedure following trauma where the position of the displaced tooth/teeth may be stabilized by splinting. Inclusive of the insertion of sutures, normal post‑operative care and suture removal. 228.10
- 88387 Replantation and splinting of a toothReplantation of a tooth which has been avulsed or intentionally removed. It may be held in the correct position by splinting. Inclusive of the insertion of sutures, normal post‑operative care and suture removal. 446.60
- 88392 Drainage of abscessDrainage and/or irrigation of an abscess other than through a root canal or at the time of extraction. The drainage may be through an incision or inserted tube. Inclusive of the insertion of sutures, normal post‑operative care and suture removal. 112.20
Division 5—Group U4: Endodontic services
11 Items in Subgroup 1 of Group U4
This clause sets out items in Subgroup 1 of Group U4.
- Group U4: Endodontic services
- Column 1Item Column 2Dental service Column 3Amount of dental benefit ($)
- Subgroup 1 of Group U4—Pulp and root canal treatments
- 88411 Direct pulp cappingA procedure where an exposed pulp is directly covered with a protective dressing or cement. 40.35
- 88412 Incomplete endodontic therapy (tooth not suitable for further treatment)A procedure where in assessing the suitability of a tooth for endodontic treatment a decision is made that the tooth is not suitable for restoration. 138.25
- 88414 PulpotomyAmputation within the pulp chamber of part of the vital pulp of a tooth. The pulp remaining in the canal(s) is then covered with a protective dressing or cement. 88.15
- 88415 Complete chemo‑mechanical preparation of root canal—one canalComplete chemo‑mechanical preparation including removal of pulp or necrotic debris from a canal. 248.05
- 88416 Complete chemo‑mechanical preparation of root canal—each additional canalComplete chemo‑mechanical preparation including removal of pulp or necrotic debris from each additional canal of a tooth with multiple canals. 118.15
- 88417 Root canal obturation—one canalThe filling of a root canal, following chemo‑mechanical preparation. 241.60
- 88418 Root canal obturation—each additional canalThe filling, following chemo‑mechanical preparation, of each additional canal in a tooth with multiple canals. 113.00
- 88419 Extirpation of pulp or debridement of root canal(s)—emergency or palliativeThe partial or thorough removal of pulp and/or debris from the root canal system of a tooth. This is an emergency or palliative procedure distinct from visits for scheduled endodontic treatment. 159.75
- 88421 Resorbable root canal filling—primary toothThe placement of resorbable root canal filling material in a primary tooth. 138.25
12 Items in Subgroup 4 of Group U4
This clause sets out items in Subgroup 4 of Group U4.
- Group U4: Endodontic services
- Column 1Item Column 2Dental service Column 3Amount of dental benefit ($)
- Subgroup 4—Other endodontic services
- 88455 Additional visit for irrigation and/or dressing of the root canal system—per toothAdditional debridement irrigation and short‑term dressing required where evidence of infection or inflammation persists following prior opening of the root canal and removal of its contents. 122.40
- 88458 Interim therapeutic root filling—per toothA procedure consisting of the insertion of a long‑term provisional (temporary) root canal filling with therapeutic properties which facilitates healing/development of the root and periradicular tissues over an extended time. 163.25
Division 6—Group U5: Restorative Services
13 Items in Subgroup 1 of Group U5
This clause sets out items in Subgroup 1 of Group U5.
- Group U5: Restorative Services
- Column 1Item Column 2Dental service Column 3Amount of dental benefit ($)
- Subgroup 1 of Group U5—Metallic restorations—direct
- 88511 Metallic restoration—one surface—directDirect metallic restoration involving one surface of a tooth. Inclusive of the preparation of the tooth, placement of a lining, contouring of the adjacent and opposing teeth, placement of the restoration and normal post‑operative care. 120.70
- 88512 Metallic restoration—two surfaces—directDirect metallic restoration involving two surfaces of a tooth. Inclusive of the preparation of the tooth, placement of a lining, contouring of the adjacent and opposing teeth, placement of the restoration and normal post‑operative care. 148.05
- 88513 Metallic restoration—three surfaces—directDirect metallic restoration involving three surfaces of a tooth. Inclusive of the preparation of the tooth, placement of a lining, contouring of the adjacent and opposing teeth, placement of the restoration and normal post‑operative care. 176.65
- 88514 Metallic restoration—four surfaces—directDirect metallic restoration involving four surfaces of a tooth. Inclusive of the preparation of the tooth, placement of a lining, contouring of the adjacent and opposing teeth, placement of the restoration and normal post‑operative care. 201.35
- 88515 Metallic restoration—five surfaces—directDirect metallic restoration involving five surfaces of a tooth. Inclusive of the preparation of the tooth, placement of a lining, contouring of the adjacent and opposing teeth, placement of the restoration and normal post‑operative care. 229.85
14 Items in Subgroup 2 of Group U5
This clause sets out items in Subgroup 2 of Group U5.
- Group U5: Restorative Services
- Column 1Item Column 2Dental service Column 3Amount of dental benefit ($)
- Subgroup 2 of Group U5—Adhesive restorations—anterior teeth—direct
- 88521 Adhesive restoration—one surface—anterior tooth—directDirect restoration, using an adhesive technique and a tooth‑coloured material, involving one surface of an anterior tooth. Inclusive of the preparation of the tooth, placement of a lining, contouring of the adjacent and opposing teeth, placement of the restoration and normal post‑operative care. 133.70
- 88522 Adhesive restoration—two surfaces—anterior tooth—directDirect restoration, using an adhesive technique and a tooth‑coloured material, involving two surfaces of an anterior tooth. Inclusive of the preparation of the tooth, placement of a lining, contouring of the adjacent and opposing teeth, placement of the restoration and normal post‑operative care. 162.30
- 88523 Adhesive restoration—three surfaces—anterior tooth—directDirect restoration, using an adhesive technique and a tooth‑coloured material, involving three surfaces of an anterior tooth. Inclusive of the preparation of the tooth, placement of a lining, contouring of the adjacent and opposing teeth, placement of the restoration and normal post‑operative care. 192.25
- 88524 Adhesive restoration—four surfaces—anterior tooth—directDirect restoration, using an adhesive technique and a tooth‑coloured material, involving four surfaces of an anterior tooth. Inclusive of the preparation of the tooth, placement of a lining, contouring of the adjacent and opposing teeth, placement of the restoration and normal post‑operative care. 222.20
- 88525 Adhesive restoration—five surfaces—anterior tooth—directDirect restoration, using an adhesive technique and a tooth‑coloured material, involving five surfaces of an anterior tooth. Inclusive of the preparation of the tooth, placement of a lining, contouring of the adjacent and opposing teeth, placement of the restoration and normal post‑operative care. 261.10
15 Items in Subgroup 3 of Group U5
This clause sets out items in Subgroup 3 of Group U5.
- Group U5: Restorative Services
- Column 1Item Column 2Dental service Column 3Amount of dental benefit ($)
- Subgroup 3 of Group U5—Adhesive restorations—posterior teeth—direct
- 88531 Adhesive restoration—one surface—posterior tooth—directDirect restoration, using an adhesive technique and a tooth‑coloured material, involving one surface of a posterior tooth. Inclusive of the preparation of the tooth, placement of a lining, contouring of the adjacent and opposing teeth, placement of the restoration and normal post‑operative care. 142.75
- 88532 Adhesive restoration—two surfaces—posterior tooth—directDirect restoration, using an adhesive technique and a tooth‑coloured material, involving two surfaces of a posterior tooth. Inclusive of the preparation of the tooth, placement of a lining, contouring of the adjacent and opposing teeth, placement of the restoration and normal post‑operative care. 179.25
- 88533 Adhesive restoration—three surfaces—posterior tooth—directDirect restoration, using an adhesive technique and a tooth‑coloured material, involving three surfaces of a posterior tooth. Inclusive of the preparation of the tooth, placement of a lining, contouring of the adjacent and opposing teeth, placement of the restoration and normal post‑operative care. 215.50
- 88534 Adhesive restoration—four surfaces—posterior tooth—directDirect restoration, using an adhesive technique and a tooth‑coloured material, involving four surfaces of a posterior tooth. Inclusive of the preparation of the tooth, placement of a lining, contouring of the adjacent and opposing teeth, placement of the restoration and normal post‑operative care. 242.90
- 88535 Adhesive restoration—five surfaces—posterior tooth—directDirect restoration, using an adhesive technique and a tooth‑coloured material, involving five surfaces of a posterior tooth. Inclusive of the preparation of the tooth, placement of a lining, contouring of the adjacent and opposing teeth, placement of the restoration and normal post‑operative care. 280.50
16 Items in Subgroup 7 of Group U5
This clause sets out items in Subgroup 7 of Group U5.
- Group U5: Restorative Services
- Column 1Item Column 2Dental service Column 3Amount of dental benefit ($)
- Subgroup 7 of Group U5—Other restorative services
- 88572 Provisional (intermediate/temporary) restoration—per toothThe provisional (intermediate) restoration of a tooth designed to last until the definitive restoration can be constructed or the tooth is removed. This item should only be used where the provisional (intermediate) restoration is not an intrinsic part of treatment. It does not include provisional (temporary) sealing of the access cavity during endodontic treatment or during construction of indirect restorations. 56.45
- 88574 Metal bandThe cementation of a metal band for diagnostic, protective purposes or for the placement of a provisional (intermediate) restoration. 47.55
- 88575 Pin retention—per pinUse of a pin to aid the retention and support of direct or indirect restorations in a tooth. 32.45
- 88579 Bonding of tooth fragmentThe direct bonding of a tooth fragment as an alternative to placing a restoration. 112.20
- 88586 Crown—metallic—with tooth preparation—preformedPlacing a preformed metallic crown as a coronal restoration for a tooth. 297.75
- 88587 Crown—metallic—minimal tooth preparation—preformedPlacing a preformed metallic crown as a coronal restoration for a tooth and where minimal or no restoration of the tooth is required. Commonly referred to as a ‘Hall’ crown. 176.65
- 88597 Post—directInsertion of a post into a prepared root canal to provide an anchor for an artificial crown or other restoration. 102.10
Division 7—Group U7: Prosthodontics
17 Items in Subgroup 1 of Group U7
This clause sets out items in Subgroup 1 of Group U7.
- Group U7: Prosthodontics
- Column 1Item Column 2Dental service Column 3Amount of dental benefit ($)
- Subgroup 1 of Group U7—Dentures and denture components
- 88721 Partial maxillary denture—resin, base onlyProvision of a resin base for a removable dental prosthesis for the maxilla where some natural teeth remain. 505.70
- 88722 Partial mandibular denture—resin, base onlyProvision of a resin base for a removable dental prosthesis for the mandible where some natural teeth remain. 505.70
- 88723 Provisional partial maxillary dentureProvision of a patient removable partial dental prosthesis replacing the natural teeth and adjacent tissues in the maxilla which is designed to last until the definitive prosthesis can be constructed. This item should only be used where a provisional denture is not an intrinsic part of item 88721. 379.25
- 88724 Provisional partial mandibular dentureProvision of a patient removable partial dental prosthesis replacing the natural teeth and adjacent tissues in the mandible which is designed to last until the definitive prosthesis can be constructed. This item should only be used where a provisional denture is not an intrinsic part of item 88722. 379.25
- 88731 Retainer—per toothA retainer or attachment fitted to a tooth to aid retention of a partial denture. The number of retainers should be indicated. 51.05
- 88733 Tooth/teeth (partial denture)An item to describe each tooth added to the base of a new partial denture. The number of teeth should be indicated. 41.90
- 88736 Immediate tooth replacement—per toothProvision within a denture to allow immediate replacement of an extracted tooth. The number of teeth so replaced should be indicated. 10.55
18 Item in Subgroup 4 of Group U7
This clause sets out items in Subgroup 4 of Group U7.
- Group U7: Prosthodontics
- Column 1Item Column 2Dental service Column 3Amount of dental benefit ($)
- Subgroup 4 of Group U7—Denture maintenance
- 88741 Adjustment of a dentureAdjustment of a denture to improve comfort, function or aesthetics. This item does not apply to routine adjustments following the insertion of a new denture or the maintenance or repair of an existing denture. 60.80
19 Items in Subgroup 6 of Group U7
This clause sets out items in Subgroup 6 of Group U7.
- Group U7: Prosthodontics
- Column 1Item Column 2Dental service Column 3Amount of dental benefit ($)
- Subgroup 6 of Group U7—Denture repairs
- 88761 Reattaching pre‑existing clasp to dentureRepair, insertion and adjustment of a denture involving re‑attachment of a pre‑existing clasp. 166.95
- 88762 Replacing/adding clasp to denture—per claspRepair, insertion and adjustment of a denture involving replacement or addition of a new clasp or clasps. 174.45
- 88764 Repairing broken base of a partial dentureRepair, insertion and adjustment of a broken resin partial denture base. 166.95
- 88765 Replacing/adding new tooth on denture—per toothRepair, insertion and adjustment of a denture involving replacement with or addition of a new tooth or teeth to a previously existing denture. 174.45
- 88766 Reattaching existing tooth on denture—per toothRepair, insertion and adjustment of a denture involving reattachment of a pre‑existing denture tooth or teeth. 166.95
- 88768 Adding tooth to partial denture to replace an extracted or decoronated tooth—per toothModification, insertion and adjustment of a partial denture involving an addition to accommodate the loss of a natural tooth or its coronal section. 176.65
20 Item in Subgroup 7 of Group U7
This clause sets out items in Subgroup 7 of Group U7.
- Group U7: Prosthodontics
- Column 1Item Column 2Dental service Column 3Amount of dental benefit ($)
- Subgroup 7 of Group U7—Other prosthodontic services
- 88776 Impression—dental appliance repair/modificationTaking an impression where required for the repair or modification of a dental appliance. 53.35
Division 8—Group U9: General services
21 Item in Subgroup 1 of Group U9
This clause sets out items in Subgroup 1 of Group U9.
- Group U9: General services
- Column 1Item Column 2Dental service Column 3Amount of dental benefit ($)
- Subgroup 1 of Group U9—Emergencies
- 88911 Palliative careInterim care to relieve pain, infection, bleeding or other problems not associated with other treatment. 79.20
22 Items in Subgroup 4 of Group U9
This clause sets out items in Subgroup 4 of Group U9.
- Group U9: General services
- Column 1Item Column 2Dental service Column 3Amount of dental benefit ($)
- Subgroup 4 of Group U9—Sedation
- 88942 Sedation—intravenousSedative drug(s) administered intravenously, usually in increments. The incremental administration may continue while dental treatment is being rendered. 155.25
- 88943 Sedation—inhalationNitrous oxide gas mixed with oxygen is inhaled by the patient while dental treatment is being rendered. 77.60
Schedule 2—Dental cap
Note: See section 15.
1 Dental cap
The dental cap for the 2 year period beginning on the day specified in an item in column 1 of the following table, and ending on the day specified in column 2 of the item, is the amount specified in column 3 of the item.
| Item | Column 1<br>For the 2 year period beginning on… | Column 2<br>and ending on… | Column 3<br>the dental cap is… |
|---|
| 1 | 1 January 2026 | 31 December 2027 | $1,158 |
Schedule 3—Repeals
Dental Benefits Rules 2014
1 The whole of the instrument
Repeal the instrument.