Resolve Dental Consultancy
Fee Guide & Price List Template 2026
Fee Guide & Price List Template 2026
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Complete Fee Schedule with ADA Item Numbers for Australian Private Dental Practices
- Examination, Diagnosis & Preventive (011–114)
- Restorative — Fillings (511–535)
- Endodontics — Root Canal Treatment (411–419)
- Crowns, Bridges & Veneers (613–671)
- Oral Surgery & Extractions (311–381)
- Periodontics — Gum Treatment (221–232)
- Prosthodontics — Dentures (711–752)
- Orthodontics (811–891)
- Dental Implants (687–888 and All-on-4)
- Cosmetic & Whitening (take-home, in-chair, composite bonding, smile design)
- Mouthguards & Splints (141–156)
- Administration & Cancellation (FTA fees, deposits, records transfer)
- Template A — Waiting Room Price List: A clean, summary-format price list for display at reception or in the waiting room — covering the 10 most common services with spaces for your fees, HICAPS and CDBS notes, and a "fees correct as at" date
- Template B — New Patient Treatment Plan Fee Disclosure Statement: A professional fee disclosure statement to attach to every written treatment plan — covering health fund rebate disclaimers, payment terms, cancellation policy, and a contact prompt for fee questions before the appointment
- Practice Managers responsible for maintaining the fee schedule and ensuring consistency between the software, treatment plans, and patient communications
- Practice Owners who want a documented, reviewable fee schedule rather than fees that exist only in the practice management software
- New practices setting up their fee structure from scratch
- Any practice that has not formally reviewed its fees in the past 12 months
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This template covers everything a dental fee guide needs — item numbers, descriptions, fees, health fund notes, and the important disclaimers. We customised it with our branding and it now sits in our new patient welcome pack and on the front desk. Looks very professional. Highly recommend.
We'd had complaints from patients about fee transparency for years. This template gave us a clear, well-structured fee guide that explains our fees in plain language alongside the ADA item numbers. Since introducing it, the number of fee-related complaints has dropped significantly and patients seem much more comfortable with the payment conversation.
We needed to update our patient-facing fee guide and this template saved us hours. The layout is clean and professional, the ADA item number structure is already in place, and it was straightforward to update with our current fees. Patients have commented that it's much clearer than our previous version. Great value.
Good, well-structured template that covers the key fee categories. We added a few items specific to our practice but the base structure was exactly right. Looks polished and professional once customised. Worth the price for the time it saves.
The template is well-designed and easy to customise with your own branding. We added our logo and colours and it now looks like a professional practice document rather than something we threw together. It sits in our new patient welcome pack and at the front desk. Several patients have commented on how clear and professional it is.