Professional dental services can be expensive to provide, with costs from staffing, overhead, and equipment eating into the bottom line. Dentists cannot afford to leave money on the table, as this represents potential profits to be taken home or invested back into the practice.
However, many practices do just this by not examining or updating their fee schedules on a regular basis. This two-part series will discuss trends in regional fee data and share the latest average fees for the eight regions in the U.S. The purpose of this series is to help dentists examine their fee schedules and consider whether alterations are needed.
Regional differences
One of the many reasons for fee schedule variance among practices is because of differences in geographical regions. As the table below shows, there are large variances in average fee schedules and reimbursements by region, so practices need to keep their fee schedules up-to-date to reflect competitive fees in their geographical region.
For each of these 10 codes, the fee is highest in the Southwest region and lowest in the Midwest region. These differences in fees can be caused by factors such as differences in the cost of living between regions and even competition among dentists.
8 regions
Eight regions are included in the table (see key below). The table examines regional fees for the following 10 diagnostic codes:
- D0150: Routine oral examination -- comprehensive oral evaluation for a new or established patient
- D0210: Complete series or panoramic film: Intraoral - complete series (including bitewings)
- D0274: Bitewings -- four films
- D0330: Panoramic film
- D1110: Prophylaxis -- adult
- D2150: Amalgam -- two surfaces, primary or permanent
- D2620: Inlay -- porcelain/ceramic -- two surfaces
- D2643: Onlay -- porcelain/ceramic -- three surfaces
- D2750: Crown -- resin with high noble metal
- D2950: Core buildup, including any pins
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 |
| D0150 | $106 | $103 | $106 | $105 | $101 | $105 | $104 | $119 |
| D0210 | $148 | $145 | $151 | $149 | $143 | $145 | $142 | $166 |
| D0274 | $74 | $71 | $75 | $73 | $70 | $72 | $72 | $84 |
| D0330 | $125 | $122 | $129 | $127 | $121 | $124 | $123 | $142 |
| D1110 | $109 | $105 | $109 | $108 | $105 | $108 | $108 | $120 |
| D2150 | $206 | $201 | $209 | $208 | $199 | $205 | $202 | $234 |
| D2620 | $1,133 | $1,096 | $1,140 | $1,131 | $1,087 | $1,120 | $1,081 | $1,236 |
| D2643 | $1,227 | $1,197 | $1,252 | $1,229 | $1,186 | $1,212 | $1,182 | $1,354 |
| D2750 | $1,289 | $1,255 | $1,326 | $1,289 | $1,245 | $1,274 | $1,251 | $1,426 |
| D2950 | $317 | $309 | $325 | $318 | $308 | $314 | $307 | $354 |
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.
Part 2 of this series will run on Friday, June 2, and will focus on an additional 10 codes.
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.
