Oral Health Fee For Service Scheme (OHFFSS) schedule of fees

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 2024.

Last updated: 06 January 2025
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​​​​​ This information is to be read in conjunction with NSW Health policy directive Oral Health Fee For Service Scheme (PD2024_025), and The Australian Schedule of Dental Services and Glossary, 12th Ed. (Australian Dental Association).

Voucher limits

The maximum amounts payable for authorised vouchers are: 

  • Urgent Care Voucher: $470.00 or as printed on voucher
  • General Care Voucher: $1040.00 or as printed on voucher
  • Denture Care Voucher: $1815.00 or as printed on voucher.

Local health districts and specialty health networks may:

  • raise or lower voucher limits in line with local policy
  • pre-authorise and fund other ADA items not listed in this schedule where it is applicable to an individual patient or model of care.

Actual limits are printed on each voucher.

Schedule of fees

Voucher type

  • U = Urgent care voucher
  • G = General care voucher
  • D = Denture care voucher

Diagnostic services

Description Item Restrictions Fee Ex. GST Voucher type
Comprehensive oral examination011Limit of 1 per provider per patient. Must be at least two years after previous 011.59.80 G
Initial denture exam011Limit of 1 per Denture Voucher.53.85 D
Limited oral examination013Limit of 3 per 3 month period.31.25 U
Intraoral periapical or bitewing radiograph022First exposure per day only.42.10 U, G
Each subsequent exposure (on same day)

022

Limit of 6 total 022 per day.

Limit of 4 per tooth undergoing endodontic treatment per voucher.

34.60

U, G

Panoramic radiograph -per exposure

037

Prior approval required

Radiograph must be taken on-premises at the provider's surgery.

107.05

G


Preventative services

DescriptionItemRestrictionsFee Ex. GSTVoucher type
Removal of plaque and/or stain111Limit of 1 per 6 month period.61.10 G

Removal of calculus - first appointment

114Limit of 1 per 6 month period.101.90 G
Removal of calculus -subsequent appointment115Limit of 2 per 12 month period.66.30 G
Topical application of remineralising and/or cariostatic agents - one treatment121Limit of 1 per 6 month period.39.30 G
Concentrated remineralising and/or cariostatic agents, application - single tooth123Limit of 1 per day.30.75 G

Oral hygiene instruction

141

Where a full appointment of at least 15 minutes is used. Limit of one per 12 month period.

56.20

G

Fissure and/or tooth surface sealing - per tooth

16152.35 G
Desensitising procedure - per appointment16530.75 G

Periodontics

DescriptionItemRestrictionsFee Ex. GSTVoucher type

Treatment of acute periodontal infection –per appointment

213Limit of 2 per 12 month period.79.20 U, G

Clinical periodontal analysis and recording

221

Limit of one (1) per 12 month period.

Evidence of clinical periodontal analysis and recording must be submitted when claiming for 221.

60.15

G

Periodontal debridement –per tooth

222

Limit of 10 per day. Limit of 20 per 12 month period. Item 222 can only be claimed in conjunction with item 221. Item 221 can be claimed on the same voucher or claimed within the previous 12 months.

Prior approval required for treatment above the specified limits.

29.60

G

Oral surgery

The item number and its fee includes anaesthesia, the insertion of sutures, normal post-operative care, suture removal, and the treatment of alveolar osteitis should it arise. All surgical procedures must be supported by an appropriate radiographic image and clinical notes. Surgical extractions (item numbers 322 and 324) are only claimable where a mucoperiosteal flap has been raised.

DescriptionItemRestrictionsFee Ex. GSTVoucher type
Removal of a tooth or part(s) thereof311For first tooth extracted per quadrant per day.149.15 U, G
A subsequent extraction in same quadrant31194.00 U, G
Sectional removal of a tooth or part(s) thereof314For first tooth extracted per quadrant per day.190.65 U, G
A subsequent extraction in same quadrant314125.95 U, G
Surgical removal of a tooth or tooth fragment not requiring removal of bone or tooth division322

For first tooth extracted per quadrant per day. Permanent teeth only.

242.10 U, G
A subsequent extraction in same quadrant322161.10 U, G
Surgical removal of a tooth or tooth fragment requiring bone removal and/or tooth division324

For first tooth extracted per quadrant per day. Permanent teeth only.

372.00 U, G
A subsequent extraction in same quadrant324245.20 U, G
Incision and drainage of abscess (other than through a root canal or at the time of extraction)392110.05 U, G

Endodontics

All endodontic procedures should be supported by an appropriate radiographic image.
DescriptionItemRestrictionsFee Ex. GSTVoucher type
Pulpotomy414Only claimable for primary teeth anticipated to last more than 12 months.86.45 U, G

Complete chemo-mechanical preparation of root canal – one canal

415Limit of one per tooth per day. Prior approval required.243.35 G
Complete chemo-mechanical preparation -each additional root canal416Prior approval required.115.95 G
Root canal obturation – one canal417Limit of one per tooth per day. Prior approval required.237.10 G
Root canal obturation -each additional canal418Prior approval required.110.95 G
Extirpation of pulp or debridement of root canal(s) - emergency or palliative419156.65 U, G

Restorative services

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.

DescriptionItemRestrictionsFee Ex. GSTVoucher type
Metallic restoration –one surface –direct511Limit of 1 restorative service (511-535) to be reimbursed per tooth per day (see above note).118.45 U, G
Metallic restoration –two surfaces –direct512Limit of 1 restorative service (511-535) to be reimbursed per tooth per day (see above note).145.15 U, G
Metallic restoration –three surfaces –direct513Limit of 1 restorative service (511-535) to be reimbursed per tooth per day (see above note).173.30 U, G
Metallic restoration –four surfaces –direct514Limit of 1 restorative service (511-535) to be reimbursed per tooth per day (see above note).197.55 U, G
Metallic restoration –five surfaces –direct515Limit of 1 restorative service (511-535) to be reimbursed per tooth per day (see above note).225.50 U, G

Adhesive restoration –one surface –anterior tooth –direct

521

Limit of 1 restorative service (511-535) to be reimbursed per tooth per day (see above note). Limit of 5 adhesive single surface restorations (521/531) per day

131.20

U, G

Adhesive restoration –two surfaces –anterior tooth –direct522Limit of 1 restorative service (511-535) to be reimbursed per tooth per day (see above note).159.25 U, G
Adhesive restoration –three surfaces –anterior tooth –direct523Limit of 1 restorative service (511-535) to be reimbursed per tooth per day (see above note).188.60 U, G
Adhesive restoration –four surfaces –anterior tooth –direct524Limit of 1 restorative service (511-535) to be reimbursed per tooth per day (see above note).218.00 U, G
Adhesive restoration –five surfaces –anterior tooth –direct525Limit of 1 restorative service (511-535) to be reimbursed per tooth per day (see above note).256.15 U, G

Adhesive restoration –one surface –posterior tooth –direct

531

Limit of 1 restorative service (511-535) to be reimbursed per tooth per day (see above note). Limit of 5 adhesive single surface restorations (521/531) per day

140.15

U, G

Adhesive restoration –two surfaces –posterior tooth –direct532Limit of 1 restorative service (511-535) to be reimbursed per tooth per day (see above note).175.95 U, G
Adhesive restoration –three surfaces –posterior tooth –direct533Limit of 1 restorative service (511-535) to be reimbursed per tooth per day (see above note).211.50 U, G
Adhesive restoration –four surfaces –posterior tooth –direct534Limit of 1 restorative service (511-535) to be reimbursed per tooth per day (see above note).238.25 U, G
Adhesive restoration –five surfaces –posterior tooth –direct535Limit of 1 restorative service (511-535) to be reimbursed per tooth per day (see above note).275.15 U, G
Provisional (intermediate/temporary) restoration –per tooth

572

Limit of 3 per three month period. Not claimable with endodontic items except 419. Not claimable with restorative item numbers (511-535) on same tooth on same day.

55.40

U, G

Metal band57446.70 U, G
Pin retention -per pin575Limit of 3 per tooth. Limit of 6 per voucher. 31.95 U, G
Cusp capping -per cusp577Limit of 2 per tooth.34.45 U, G
Restoration of an incisal corner -per corner578Limit of 2 per tooth.34.45 U, G
Crown –metallic –with tooth preparation –preformed586Not claimable with restorative item numbers (511-535) on same tooth. No other crown item number to be claimed on the same tooth within six months.292.05 G
Crown -metallic -minimal tooth preparation -preformed587Not claimable with restorative item numbers (511-535) on same tooth. No other crown item number to be claimed on the same tooth within six months.173.30 G
Recementing of indirect restoration596

 

89.95U, G

Prosthodontics

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.

Description Item Restrictions Fee Ex. GSTVoucher type
Recementing crown or veneer651117.15U, G
Recementing bridge or splint - per abutment652 Limit of 4 per day. 114.45U, G
Removal of bridge or splint656210.15U, G
Complete maxillary denture711975.90D
Complete mandibular denture712975.90D
Metal palate or plate716 Prior approval required. Additional to 711, 712 and 719. Laboratory casting invoice required. Maximum amount payable $481.05. As per lab invoice. Maximum amount payable $481.05D
Complete maxillary and mandibular dentures7191730.40D
Partial maxillary denture – resin base721 This item refers to denture base only. Specify number of teeth using item 733. 446.50 D
Partial mandibular denture – resin base722This item refers to denture base only. Specify number of teeth using item 733. 446.50D
Partial maxillary denture – cast metal727 Prior approval required. This item refers to denture base only. Specify number of teeth using item 733. 1307.15D
Partial mandibular denture – cast metal728 Prior approval required. This item refers to denture base only. Specify number of teeth using item 733. 1307.15D
Retainer – per tooth731Additional to items 721, 722, 727 and 728 45.00D
Occlusal rest732 Additional to items 721, 722, 727 and 72822.00 D
Tooth/teeth (partial denture)733Maximum of 12 teeth per denture base. 37.00D
Immediate tooth replacement – per tooth7369.25 D
Resilient lining737

This will only be paid with:

  • a new denture
  • together with 743 for an existing complete denture
  • together with 744 for an existing partial denture
 193.50D
Wrought bar738 180.15 D
Adjustment of pre-existing denture741Will not be paid for full or partial dentures within 12 months of their provision or relining. Upper/lower and partial/complete must be specified in the invoice. 53.45 U, G, D
Relining - complete denture – processed 743Will not be paid within 2 years of provision or relining (except for immediate dentures which can be relined once within 2 years of their provision – please specify immediate denture reline on the voucher) unless requested by the LHD. Upper/lower must be specified in the invoice. Use with 737 for soft relines. 340.50D
Relining – partial denture – processed744Will not be paid within 2 years of provision or relining (except for immediate dentures which can be relined once within 2 years of their provision – please specify immediate denture reline on the voucher) unless requested by the LHD. Upper/lower must be specified in the invoice. Use with 737 for soft relines. 290.25 D
Cleaning and polishing of pre-existing dentures753 Domiciliary visits only. Limit of 1 per 2 year period per denture 43.40 D
Reattach pre-existing clasp to denture761Limit of one per denture. 147.65D
Replacing/adding clasp to denture762 Limit of one per denture.

 

 154.15 D
Repair broken denture base of complete denture763 Limit of one per denture. 147.65 D
Repairing broken base of a partial denture764Limit of one per denture. 147.65 D
Replacing first tooth on denture765Limit of one per denture. 154.15 D
Reattaching existing tooth on denture - per tooth766 Limit of one per denture. 133.36 D
Any repair or tooth replacement in addition to other repairs, alterations or other modifications for same denture on same day767 Limit of 5 per denture. Upper/lower must be specified. 60.80 D
Adding tooth to partial denture to replace an extracted or decoronated tooth768Limit of one per denture. 155.90D
Tissue conditioning preparatory to impressions – per application771Limit of one per day per denture. Upper or lower must be specified. 70.80 D
Impression – dental appliance repair/modification776

Limit of one per dental appliance repair/modification.

47.05D
Identification777Limit of 1 per denture. 37.60D

General services

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.

DescriptionItemRestrictionsFee Ex. GSTVoucher type

Palliative care

911

Limit of 2 per 6 month period. Not to be claimed with an extraction, endodontic or restorative treatment on same tooth.

77.75

U, G

Travel to provide services

916

Limit of 1 per patient per day. Limit of 1 per location per day. Not claimable by providers operating a mobile dental clinic.

75.90

U, G

Travel to provide services

916

Limit of 1 per patient per day. Limit of 1 per location per day. Not claimable by providers operating a mobile dental clinic.

68.25

D

Splinting and stabilization - direct - per tooth

981110.05 U, G
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Current as at: Monday 6 January 2025
Contact page owner: Centre for Oral Health Strategy