Combined Dental Agreement (CDA)

Under the nationally-standardised Combined Dental Agreement (CDA), Te Whatu Ora provides funded oral health services for adolescents (aged from school year 9 up to the 18th birthday) and special dental services for children and adolescents.

The current CDA took effect on 1 July 2019. 

Combined Dental Agreement (CDA)

Adolescent oral health services

Adolescent oral health services are for patients from school year 9 up to the 18th birthday who are eligible for free dental care.

Forms for the CDA

You can download claim forms that include all the current codes below. You can also download application forms for treatment requiring prior approval by the Approving Dental Officer (ADO).

Approving Dental Officers’ contacts

Pads of printed forms are available by phoning 0800 855 066, option 6.

 

Enrolment form

An enrolment form must be completed at the patient’s first visit — this must be filled out by both the patient and the dental provider. The enrolment form is unchanged from previous years.

Claim forms

Send in a completed claim summary form along with the individual treatment report(s).

Use the individual treatment report for consultation only services as well as treatment services

Discontinuation of annual consultation only treatment form

The 'annual consultation only treatment report form' (HP5954) has been discontinued. Do not use this form for any services provided after 30 June 2016.

Instead, use the individual treatment report form (HP5953) for consultation only services as well as for treatment services.

High caries treatment planning claim form

This form was previously called the 'oral health services in exceptional circumstances (adolescents) treatment report/claim summary form'.

Special dental services

Special dental services are for children and adolescents under the age of 18 years who are eligible for free dental care.

Send in a completed claim summary form along with the individual treatment report(s).

Decile scores and school numbers

To see the most up-to-date information on decile scores and school numbers for schools in your area, visit the Ministry of Education website.

If the patient is being home-schooled, is at correspondence school, at polytech, is unemployed or is working, use the middle range (decile 4–6) rates.

Submitting claim forms

Download, fill in, print and send completed claim forms to:

Sector Operations Dental Claims
PO Box 1026
Wellington 6140

If you are unable to download forms from the website and you need more forms, call Sector Operations on 0800 855 066, option 2. You will need to provide your payee number. The forms are free.

If you have any questions about the claim form requirements, call Sector Operations:

0800 855 066

Returned claim forms

If your claim form is sent back, we will include a letter explaining why the form was rejected. In most cases, the errors are also highlighted on the claim form.

Contact Sector Operations

If you have any questions about the claim form requirements, call Sector Operations:

0800 855 066