This page outlines the Schedule of fees for OHFFSS providers. Fees have been indexed in alignment with movement in the Department of Veteran's Affairs Fee Schedules of Dental Services. These fees will be effective as of 1 July 2023.
This information is to be read in conjunction with NSW Health policy directive
Oral Health Fee For Service Scheme (PD2024_003), and The Australian Schedule of Dental Services and Glossary, 12th Ed. (Australian Dental Association).
The maximum amounts payable for authorised vouchers are:
Local health districts and specialty health networks may:
Actual limits are printed on each voucher.
Limit of 1 per provider per patient. Must be at least two years after previous 011.
Limit of 4 per tooth undergoing endodontic treatment per voucher.
Radiograph must be taken on-premises at the provider's surgery.
The item number and its fee includes include anaesthesia, the insertion of sutures, normal post-operative care, suture removal, and the treatment of alveolar osteitis should it arise. All surgical procedures should be supported by an appropriate radiographic image and clinical notes may be requested.
When placing separate restorations on the same or different surfaces of the same tooth at the same visit, the restorations should be itemised separately. For each tooth restored, the reimbursed fee will represent a fee equivalent to the maximum number of surfaces restored. For example, if two separate one-surface restorations are placed on two different surfaces on the same day, these should be itemised as separate restorations, and providers will be reimbursed for a two-surface restoration. If multiple restorations are placed on the same surface on the same day, that surface can only be counted once. When two materials are used in the same restoration, the predominant material type should be used for claiming the restoration.
The fee associated with item numbers for new complete or partial dentures includes any reasonable adjustments following provision of the denture. At least three or more denture adjustments must be provided, as necessary, following the issue of a denture.
This will only be paid with:
Limit of one per dental appliance repair/modification.
A kilometre allowance may be paid to, dentists and dental prosthetists, in addition to a fee for item 916 if you are required to travel from your normal place of business to visit an entitled person at home or in an institution. Prior approval is required to claim the allowance and the per kilometre fee is to be determined in negotiation with the Local Health District (LHD). The allowance will not be paid for the first 10 kilometres travelled. The allowance will be paid on the basis of the distance travelled, including between patients, not the number of entitled persons attended. To claim the allowance the number of kilometres must be identified on the OHFFSS voucher against each individual patient.