Version 9.0 of the R4+ software includes the following enhancements:
Several changes have been implemented throughout R4+ to support the introduction of Care Package based Treatment which is replacing the 2006 NHS Contract System of Banded based Treatment for Wales. The Care Package model takes effect from April 1st, 2026.
Due to the scale and scope of the changes under the new Contract Model, further changes will be implemented in subsequent releases.
See the following descriptions of the initial functionality provided in Release v9.0.0.
Care Packages are replacing Banded Charges.The Care Package Metric value is derived from the fee(s) associated with the selected package(s) according to the defined conversion rules. NHS Contracts targets are changing to an Annual Contract Value (ACV), which further breaks down into proportional Targets that make up the agreed ACV.
For example, New Patient Urgent Treatment allocates a certain percentage of ACV, New Patient Assessments allocate a different percentage, and all Non-Urgent Care Packages entail another percentage. The targets for each Care Package will likely be a common start value, but they are designed to allow the percentage mix to be altered per contract, allowing for more flexibility between contracts.
When certain items are recorded in the chart, they prompt a specific Care Package type. The R4+ software automatically creates the appropriate Care Packages based on the procedures that are added to the treatment plan.
On the FP17 claim form, the Charge Banding Frame is replaced with a Fee Frame to present the Patient and NHS Charges covered by the Claim.
Note: Within the R4+ software, for the time being, all of the NHS Contract Management, Summary & Activity Reports, remain driven on the old Unit Values. Reporting KPIs will be updated in a future release.
Click the following links for more information:
Any claims that reach completion on or after April 1st, 2026 but accepted prior to April 1st, 2026, will retain the agreed Banded Patient Charge but will generate and transmit as a Care Package. The renumeration received from the DPB will no longer be the expected UDA Value of Treatment and is instead calculated as the remainder of the relevant Care Package (i.e., the Package that the existing treatment is now considered part of under the new Contract).
This is done automatically, so the Banded Patient Charge is generated as normal at Course Completion, but the FP17 Claim will present both the Patient and DPB Costs based on the Transitional Arrangements and include the calculated Care Package(s) for transmission under the new Contract Arrangements as required by the NHSBSA.
The Functionality required under the New Contract Reform requires all Clinical Activity to be Performed in Clinical Chart. From April 1st, 2026, the available functionality in the Treatment Tab has been reduced for new NHS Courses of Treatment. Most of the functions in the Treatment Tab are disabled for Wales, except for the Add New Course and Uncomplete buttons.
You can add a new course to create retroactive courses where needed. Completed courses post April 1st can also be uncompleted in order to permit a Clinician to re-enter the Clinical Chart to make any necessary amendments before recompleting. For example, in situations where a claim was rejected due to a mistake or something missing, the Clinician can correct before preparing a new claim submission.
Any other adjustments have to be made from the Patient Chart.
Note:
-- All Treatment Tab Functionality remains unaffected for Orthodontic courses on or after April 1st, 2026, and all existing Courses of Treatment prior to April 1st, 2026.
-- Only NHS courses of treatment are restricted; private courses of treatment remain fully accessible in the Treatment Tab.
-- Any closed course or new course created after April 1st in the Treatment Tab, but with the Start Date before April 1st, will not be disabled and will allow all of the normal actions in the Tab.
The 6-month automatic recall system is ending, with intervals extended to 18–24 months for stable patients to prioritize access for new patients.
As such, new Assessment DPB Codes are now available under the Examination Category for use in Patient Recalls. The existing Examination DPB Codes are now contributing as part of the New Patient/Initial Assessment Registration Care Package.
Claims will be rejected if certain Care Packages do not have the proper DPB codes mapped, or the ACORN Assessment carried out, etc.
New Patient/Initial Assessment Packages
For New Patient/Initial Assessment Care Packages, you must use the previously existing examination codes, which moving forward are only for new patients:
101 Exam/Report
111 Extensive Exam
121 Full Case Assessment
131 Care & Treatment
The Clinical Data tab must be completed and transmitted on the claim form as well in order to avoid automatic claim rejection. To fill out the Clinical Data, you can either do so from the CDS tab on the FP17 claim form, or you can complete the ACORN assessment from the Patient Chart (Chart > Drop-Down Arrow in the Treatment Plan Header > ACORN Assessment). Select New in the ACORN Assessment window to record a new assessment. You must also select the Acorn Assessment Carried Out option on the claim form.
Recall Assessment Packages
Two new codes are available to handle Recall Assessments:
109 Recall Assessment
110 Recall Assessment (18-24 Month)
For Recall Assessment and Recall Assessment (18-24 Months) Care Packages, you must select the ACORN Assessment Carried Out option on the Clinical Data tab in the claim form in order for the claim to be accepted. Additionally, for Recall packages, you must use the new examination codes to ensure that they are not mischarged to the wrong Package type.
Note: When undertaking a recall, the 109 code should be more commonly used, with 110 only being used where the patient was previously told to return between 18-24 months from their last appointment.
Periodontal Packages
For Periodontal Care Packages, you must chart the appropriate examination codes to use for the Course of Treatment.
The available Periodontal DPB codes are as follows:
1011 Periodontal Treatment
1021 Chronic Periodontal Treatment
1022 Sextant fee [Periodontal]
1041 Splinting Perio, Compromised Teeth
Additionally, you must transmit the BPE examination data along with the claim, which comes from the Basic Periodontal Exam recorded in the Clinical Chart.
The "further treatment within 2 months" rule which allowed Clinicians to provide additional treatment without a new patient charge or claim continuation UDAs has now been retired and removed from April 1st, 2026.
Treatments that traditionally maintained a UDA Banding but were considered free to the Patients continue under the new Contract, but they are now counted under the Miscellaneous Care Package.
Where these are used in isolation or in tandem under the Package, the existing Charge Exempt state is maintained with the DPB covering the full cost of the Package. However, if they are mixed with treatment that is considered chargeable under the package, the Patient will receive a charge as the charged treatment takes precedence within the same Care Package. This involves Treatments under Denture Repair, Arrest of Bleeding, Removal of Sutures, Bridge Repair or Antibiotic Prescriptions.
The following changes come into effect from April 1st, 2026:
Urgent courses of treatment, which previously incurred a fixed 1.2 UDA with a Band 1 Urgent Patient Charge, are now being replaced with Unscheduled Care.
In the R4+ software, the option in the Create Plan window has changed from Urgent treatment to Unscheduled care, and the Charge band information on the claim is changing from Urgent - 1.2 UDA to Unscheduled Care - Notional UDA.
The allowed items for Unscheduled Care courses of treatment remain the same as those that were allowed under Urgent Treatment. The Patient will still receive a Band 1 Urgent Charge. However, the UDA Cost is no longer fixed and is instead calculated using the individual NHS Contracts Notional UDA Multiplier held in COMPASS, as used in New Patient Payments.
As R4+ does not hold this information, subsequent claims will present the charge as “Notional UDA” with the Claim Response being automatically settled, regardless of what the received payment values are in the Monthly Schedules. This may be improved upon in the future as more details are made clear from the NHSBSA.
Note: The Activity Report will be missing these Claims entirely for the moment, but this will be addressed with other Reporting KPI updates in a future release.
Fissure Sealant only Treatments will now incur a Band 2 Charge.
On FP17 claims, in the CDS tab under Chart Calculated Values, Denture Reline/Rebase has been removed and split into two options: Denture Relines/Rebase and Denture Additions. These will be calculated as normal in the claim as you complete new dental courses of treatment.
The following changes come into effect from April 1st, 2026:
In cases where a patient does not have a fixed address, there is a new No Fixed Abode option available in the Patient Tab, in the Home Address section. When selected, the address is set to No Fixed Abode with the postcode automatically entered as ZZ99 3VZ.
When you accept a course of treatment and select an Ethnic Group, the available options have changed. The Patient Record (Patient > Schemes Tab) and subsequent FP17 claims have been updated with revised as well as new Ethnicity options. All NHS claims require that a valid Ethnicity Group be selected for the Patient.
The new Ethnicity options include:
White: Gypsy or Irish Traveller
Other Ethnic Group: Arab
Ethnicity Not Stated
Patient Ethnicity Unknown
Note: Any existing Patient who was previously set as White British, White Irish, Other Write Background, Any Other Ethnic Group or Patient Declined will be reset to allow for prompted reselection. This is to ensure accuracy is maintained in transmitted FP17 claims.
Under Patient Record > Scheme Tab > NHS Number, a new No NHS Number drop-down list is available beneath the NHS number field.
The values for the new dropdown list are:
Non-registered UK resident (1111111111)
Non UK resident (2222222222)
Data sharing consent not given (3333333333)
NHS number not found (4444444444)
Claims cannot be marked as Ready To Send if the patient record does not include an NHS number or have one of the No NHS Number options selected.
NHS England & Wales: April 2026 Fee UpdateNHS England & Wales: April 2026 Fee Update
The 2026 NHS Dental Fees take effect from April 1st, 2026. This is a fee increase of 1.66% across all Treatment Bands in England with Wales retaining the 2025 Fees for Orthodontic courses only.
See the Version 9.0.0 Release Notes for more information.