Wales Care Packages - Complete Reference (as of March 2026)
Sources: CCN84, CCN86, CCN87, CCN88, CCN89, Vignettes V2 (March 2026)
Note: CDS validation rules will not be enforced until the new Dental Services Portal goes live. Some rules below are marked accordingly.
Package Summary
| Code | Package | Fee | Patient Charge (50%) | Lab Fees | Multiples | Separate Claim |
|---|---|---|---|---|---|---|
| 9201 | Urgent Care | £75.00 | £37.50 | No | No | Yes (standalone) |
| 9212 | New Patient Assessment (18+) | £54.41 | £27.21 | No | No | Yes |
| 9212 | Initial Assessment (Under 1) | £80.00 | £0.00 | No | No | Yes |
| 9212 | Initial Assessment (1-4 yrs) | £75.00 | £0.00 | No | No | Yes |
| 9212 | Initial Assessment (5-12 yrs) | £70.00 | £0.00 | No | No | Yes |
| 9212 | Initial Assessment (13-17 yrs) | £60.00 | £0.00 | No | No | Yes |
| 9213 | Simple Restorative (Caries) | £72.06 | £36.03 | No | No | No |
| 9214 | Extended Restorative | £137.50 | £68.75 | No | Yes (1-3) | No |
| 9215 | Periodontal | £97.06 | £48.53 | No | No | No |
| 9216 | Anterior RCT | £182.35 | £91.18 | No | Yes (1-6) | No |
| 9217 | Posterior RCT | £365.44 | £182.72 | No | Yes (1-8) | No |
| 9218 | Crown/Bridge/Inlay/Onlay/Veneer | £280.88 | £140.44 | Yes | Yes (1-14) | No |
| 9219 | Denture | £172.79 | £86.40 | Yes | No | No |
| 9220 | Stabilisation | £150.00 | £75.00 | No | No | Yes |
| 9221 | Miscellaneous | £50.00 | £25.00 | Yes | No | No |
| 9222 | Recall (Adult) | £50.00 | £25.00 | No | No | No |
| 9222 | Recall (Child) | £55.00 | £0.00 | No | No | No |
| 9223 | Recall 18-24 months | £0.00 | £25.00 | No | No | Yes |
| 9203 | Warranty - Permanent Restorations | £0.00 | £0.00 | No | No | Yes |
| 9204 | Warranty - Root Fillings | £0.00 | £0.00 | No | No | Yes |
| 9205 | Warranty - Crown/Bridge/Inlay/Onlay/Veneer | £0.00 | £0.00 | No | No | Yes |
Patient charge: 50% of package fee, capped at £384 per course of treatment (lab fees additional). Children are exempt from patient charges.
Claim Rules
Separate Claim Packages (CCN89)
The following must always be submitted as separate claims with no other care packages:
- 9201 - Urgent Care — Fully standalone. Cannot appear with any non-urgent code. Rejected with error 212 if any of 9202, 9212-9222 present.
- 9212 - New Patient Assessment — Must be the only package on the claim. Rejected with error 215 if other packages present. Requires ACORN data. Cannot be claimed if patient seen in previous 36 months.
- 9220 - Stabilisation — Must be separate claim (added by CCN89). Reason: stabilisation is carried out before other packages, and extractions need separate CDS validation from Simple/Extended Restorative. Requires ACORN data. Expected ACORN = Red.
- 9223 - Recall 18-24 months — Separate claim. No fee (covered by 3% capitation). Patient charge of £25 applies for non-exempt.
- 9203/9204/9205 - Warranty items — Separate claims.
Combinable Packages
All other non-urgent packages can be freely combined on the same claim:
- 9213 (Simple Restorative), 9214 (Extended Restorative), 9215 (Periodontal)
- 9216 (Anterior RCT), 9217 (Posterior RCT)
- 9218 (Crown/Bridge), 9219 (Denture)
- 9221 (Miscellaneous)
- 9222 (Recall) — can be combined with any treatment package above
Per CCN87: "That is the only restriction on combinations of non-urgent care packages on the same claim" (referring to 9212 being the only restriction).
Transitional Rule (CCN88)
9212 must NOT be on a separate claim until the new Dental Services Portal goes live. During the transitional period, 9212 can be on the same claim as other packages.
Multiple Instances (stacking)
Packages that allow multiples use <noins> to indicate quantity:
9213/9214 - Simple Restorative / Extended Restorative
Covers teeth needing fillings, pre-formed crowns, extractions. Stack as follows:
| Teeth | 9213 | 9214 (qty) |
|---|---|---|
| 1-4 | Yes | 0 |
| 5-8 | No | 1 |
| 9-12 | Yes | 1 |
| 13-16 | No | 2 |
| 17-20 | Yes | 2 |
| 21-24 | No | 3 |
| 25-28 | Yes | 3 |
9216 - Anterior RCT
Covers 1-2 teeth per instance. Stack: qty = ceil(teeth / 2). Max 6 instances (12 teeth).
9217 - Posterior RCT
Covers 1-2 teeth per instance. Stack: qty = ceil(teeth / 2). Max 8 instances (16 teeth).
9218 - Crown/Bridge/Inlay/Onlay/Veneer
Covers 1-2 teeth per instance. Stack: qty = ceil(teeth / 2). Max 14 instances (28 teeth). For bridges, only retainers count as units (not pontics).
CDS Validation (enforced when new Dental Services Portal goes live)
9201 - Urgent Care
Must have one or more of: existing urgent codes, 9155 (Arrest bleeding), 9224 (Assessment/Advice), 9225 (Acute Mucosal), 9226 (Recement), 9227 (Dry/infected socket), 9228 (Extirpation).
- 9224, 9225: only with 9201
- 9155, 9226, 9227: only with 9201 or 9221
- 9228: only with 9201 or 9220
- If only code is 9155: no patient charge
9212 - New Patient Assessment
Must have: ACORN data (9179, 9320, 9323, 9326-9332).
9213/9214 - Simple/Extended Restorative
Must have one or more of: 9338 (Pre-formed crowns), 9229 (Composite), 9230 (Amalgam), 9231 (GIC), 9373 (Non-surgical extraction), 9374 (Surgical removal).
- 9229, 9230: only with 9213, 9214, or 9203
- 9231: only with 9213, 9214, 9220, or 9203
- 9373, 9374: only with 9213, 9214, 9220, 9203, 9204, or 9205
9215 - Periodontal
Must have: 9339 (Advanced Perio Root Debridement) + BPE scores (9342-9347).
- 9339: only with 9215
9216 - Anterior RCT
Must have: 9371 (Endodontics Non-molar).
- 9371: only with 9216 or 9204
9217 - Posterior RCT
Must have: 9370 (Endodontics Molar).
- 9370: only with 9217 or 9204
9218 - Crown/Bridge/Inlay/Onlay/Veneer
Must have one or more of: 9308 (Crowns), 9313 (Veneers), 9314 (Inlays), 9336 (Onlays), 9395 (Bridge Retainers). May also have: 9233 (Temp Crown), 9234 (Temp Bridge) — not counted in tooth total.
- New codes 9395 (Bridge Retainers) + 9396 (Bridge Pontics): if one present, both must be present
- All these codes: only with 9218 or 9205
9219 - Denture
Must have one or more of: 9309 (Upper Acrylic), 9310 (Lower Acrylic), 9311 (Upper Metal), 9312 (Lower Metal).
- These codes: only with 9219
9220 - Stabilisation
Must have: ACORN data (same as 9212). Expected ACORN = Red. May have: 9231 (GIC), 9228 (Extirpation), 9373 (Non-surgical extraction).
- Patient must have 7+ carious teeth, at least 2 with caries in/near pulp
- Requires decayed teeth counts: 9320 (Permanent), 9323 (Deciduous)
9221 - Miscellaneous
Must have one or more of: 9154 (Denture repair), 9155 (Arrest bleeding), 9157 (Bridge repair), 9156 (Removal sutures), 9158 (Issue prescription), 9159 (Ortho appliance repair), 9385 (Denture addition), 9384 (Denture reline), 9235 (Denture ease), 9376/9377 (Bite raising appliance), 9381/9382 (Splinting), 9383 (Crown refix), 9226 (Recement), 9236 (Biopsy), 9237 (Study models), 9238 (Pericoronitis), 9239 (ANUG), 9227 (Dry socket), 9240 (Trauma).
- If only charge-exempt items (9154-9159): no patient charge
- If only 9158 (prescription): no fee either
9222 - Recall
May have 9179 (ACORN) — expected every 12 months.
9223 - Recall 18-24 months
May have 9179 (ACORN) — expected every 12 months.
Warranty Rules
- Care package treatment: 24-month warranty from completion
- Urgent care: 12-month warranty
- Warranty exemptions:
- Endo needed after crown/bridge where reasonable pulp tests done prior
- External trauma (blow to face — not biting/parafunctional)
- Temporary procedures for some new urgent patients
Other Key Rules
- Max 4 examinations (9212 + 9222 combined) per 12 months. Rejected with error 411 if exceeded.
- Max 2 periodontal packages per financial year per patient.
- Crown/Bridge packages capped at 10% of ACV — Health Board permission needed to exceed.
- Urgent (9201): only for patients NOT seen by the contract in previous 36 months. Historic patients use relevant non-urgent package instead.
- Incomplete treatment (9164): uses new
<noins>value 0. Assessment/Recall cannot be classed as incomplete if no other package claimed. - 9240 (Trauma Related Injury): new code, can be submitted with any care package.
- 9172 (NICE Recall Interval): only required on the final claim of a multi-claim course of treatment.
- Late submission: all claims for a financial year must be received within 20 days of year end (by 20th April).