Provincial dental fee increases for 2010

#203

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It’s that time of year when most provincial and territorial dental associations release their annual fee guides. Typically there is an increase across the board for dental services performed by general practitioners. The information in provincial fee guides helps us establish reimbursement levels for the dental services your plan members receive.

 

This chart summarizes fee guide increases announced for 2010 by the provincial dental associations (except for the Alberta Dental Association and College, which doesn’t publish an annual fee guide).

 

Province Percentage cost increase Details of increase 2010 effective date
British Columbia 2.42%

Procedure codes

Classification

Percentage cost increase

00000-09999

Diagnostic

3.0%

10000-19999

Preventive

1.4%

 

20000-23999

Restorative

- Amalgams

- Composites

 

2.8%

1.6%

24000-29999

Restorative

- Crowns

3.3%

30000-39999

Endodontics

3.6%

40000-49999

Periodontics

2.7%

50000-59999

Prosthodontics - Removable

3.2%

60000-69999

Prosthodontics - Fixed

3.1%

70000-79999

Oral surgery

3.2 %

80000-89999

Orthodontics

2.8%

February 1

 

Alberta

6.0% *

Overall increase

* For more information please refer to the information following this chart.

February 1

Saskatchewan 4.07% Overall increase January 1
Manitoba 3.36% Overall increase January 1
Northern Manitoba 4.36% Overall increase
This guide has adjusted fees that are about 10% higher than those in the Manitoba guide.
January 1
Ontario 2.43%

Service category

Percentage cost increase 

Diagnostic

2.4%
Preventive 2.5%
Restorations:
-Amalgam
-Composite

3.5%
2.3%
Crowns 3.5%
Endodontics 1.9%
Periodontics 1.3%
Fixed
-Prosthodontics

1.3%
Oral surgery 2.3%
Other 1.5%
January 1
Quebec 2.9% Overall increase January 1
New Brunswick 2.0% Overall increase January 1
Nova Scotia 2.04% Overall increase February 1
Prince Edward Island 2.07% Overall increase January 1
Newfoundland and Labrador Not yet available January 1
Northwest Territories Not yet available April 1
Nunavut No changes for Nunavut in 2010 April 1
Yukon Not yet available April 1

 

How we reimburse dental expenses in Alberta

Since the Alberta Dental Association and College doesn’t publish a dental fee guide, insurers must establish their own reimbursement levels for dental services in Alberta.

At Sun Life Financial, we use our own Alberta-based claims data from the two most recent consecutive calendar years to determine appropriate fee increases for each category of dental service.

Our application of these reimbursement levels may not always result in full reimbursement of the charges by some dentists in Alberta, nor will they necessarily match the reimbursement levels set by other carriers.

For group contracts that provide benefits on a current fee guide basis, the following reimbursement levels will apply:

 

Procedure codes Classification

2010 increase over

2009 reimbursement guide

00000-09999 Diagnostic (e.g. examinations)  6.0 %
10000-19999 Preventive (e.g. cleaning, scaling) 5.4%
20000-22999 Restorative – Basic (e.g. fillings) 7.3%
23000-24999 Composite fillings 7.3%
25000-29999 Restorative – Major (e.g. crowns) 6.5%
30000-39999 Endodontics (e.g. root canal treatment) 4.5%
40000-49999 Periodontics (e.g. gum treatment) 5.0%
50000-59999 Prosthodontics – Removable
(e.g. dentures)
8.0 %
60000-69999 Prosthodontics - Fixed (e.g. bridges)  6.5 %
70000-79999 Oral and maxillofacial surgery 10.0%
80000-89999 Orthodontics 0.0%
90000-99999 Adjunctive general services 10.0%

 

Plan sponsors in Alberta

Dental fees in Alberta vary significantly because the province doesn’t publish a provincial dental association fee guide. 

Our recommended reimbursement guide is developed to cover fees that are representative of what the majority of patients are charged.  However, did you know that our dental claims system allows you the flexibility to amend your plan so that dental claims can be reimbursed at a higher or lower level than the options provided in our Alberta reimbursement guide? Please contact your Sun Life Financial group representative to explore your choices.

We are also including a communication for your plan members. ‘Making the most of your dental benefits 2010’ explains how we reimburse dental services in Alberta.

 

Questions?

Please contact your advisor.