When is the last time you examined or updated your fee schedule? As noted in part 1, hopefully, it was recently. If not, this series can help you examine your fee schedule and consider if alterations are needed.
Regional differences
As the table shows, there are large variances in average fee schedules and reimbursements by geographical region. Your fees may or may not be competitive for your region. This is a guide to help you keep your fee schedule current.
As noted in part 1, the fees are generally highest in the Southwest region and lowest in the Midwest region.
8 regions
Eight regions are included in the table (see key below). The table examines regional fees for the following 10 diagnostic codes:
- D2954: Prefabricated post and core in addition to crown
- D2962: Labial veneer (porcelain laminate) -- laboratory
- D3310: Endodontic therapy -- anterior (excluding final restoration).
- D3320: Endodontic therapy -- bicuspid (excluding final restoration)
- D3330: Endodontic therapy -- molar (excluding final restoration)
- D4341: Nonsurgical periodontics -- periodontal scaling and root planing -- four or more teeth per quadrant
- D5110: Complete denture
- D5120: Complete denture
- D9110: Palliative (emergency) treatment of dental pain -- minor procedure
- D9940: Occlusal guard, by report
This table includes fees broken down into 90th percentile. This means 90% of the dental practices in the region charge less than this amount for this particular procedure. All data were collected without practice identifying information and are compliant with HIPAA and the Health Information Technology for Economic and Clinical Health (HITECH) Act.
| Fees by region for 10 common diagnostic codes | ||||||||
| Code | Southeast | Mid-Atlantic | Northeast | North Central | Midwest | South Central | Northwest | Southwest |
| D2954 | $402 | $392 | $412 | $403 | $390 | $400 | $386 | $440 |
| D2962 | $1,264 | $1,224 | $1,273 | $1,250 | $1,197 | $1,244 | $1,215 | $1,392 |
| D3310 | $851 | $822 | $855 | $846 | $794 | $832 | $826 | $964 |
| D3320 | $989 | $954 | $985 | $986 | $927 | $970 | $949 | $1,110 |
| D3330 | $1,174 | $1,139 | $1,172 | $1,165 | $1,121 | $1,154 | $1,148 | $1,294 |
| D4341 | $293 | $288 | $299 | $297 | $284 | $295 | $291 | $327 |
| D5110 | $2,000 | $1,926 | $2,015 | $1,992 | $1,901 | $1,971 | $1,950 | $2,227 |
| D5120 | $2,005 | $1,928 | $2,017 | $1,999 | $1,905 | $1,976 | $1,953 | $2,238 |
| D9110 | $154 | $149 | $157 | $155 | $148 | $153 | $155 | $178 |
| D9940 | $745 | $713 | $752 | $750 | $716 | $732 | $708 | $817 |
Mid-Atlantic: North Carolina, Virginia, Maryland, New Jersey, Pennsylvania, West Virginia, and Kentucky
Northeast: Maine, New Hampshire, Vermont, Massachusetts, Connecticut, Rhode Island, and New York
North Central: Ohio, Indiana, Michigan, Illinois, Wisconsin, Minnesota, and Missouri
Midwest: Iowa, Nebraska, South Dakota, North Dakota, Wyoming, and Montana
South Central: Texas, Oklahoma, Kansas, Colorado, and New Mexico
Northwest: Washington, Oregon, and Idaho
Southwest: California, Arizona, Nevada, and Utah
Conclusion
Economic and geographical influences can be difficult to predict at an individual practice level, so it is important to be aware of regional fees when undertaking practice fee negotiations.
Dentists should update their fees regularly to ensure that they are getting the revenue they need from insurers and patients to support their practice and continue to provide excellent care. With a decrease in fees charged, practices must work harder or find other ways to make up for the lost revenue.
Alitta Boechler is the director of digital marketing at Sikka Software. You can contact her at [email protected]. For ZIP code-specific fee data, dentists can check out store.sikkasoft.com or the mobile app at www.practicemobilizer.com.
Please note that the data should be used for comparison only and may have changed, depending on when you are accessing this column.
The comments and observations expressed herein do not necessarily reflect the opinions of DrBicuspid.com, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.
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