Provincial dental fee increases for 2009

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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 2009 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

2009 effective date

British Columbia

2.7%

Procedure codes

Classification

Percentage cost increase

00000-09999

Diagnostic

Ranges from

0 - 6.1%

10000-19999

Preventive

Ranges from

0 - 3.4%

(excluding hygiene services)

20000-23999

Restorative

- Amalgams

- Composites

 

4.5%

 

4.5%

24000-29999

Restorative

- Crowns

1.1%

30000-39999

Endodontics

0%

40000-49999

Periodontics

4.0% (excludes root planing)

50000-59999

Prosthodontics - Removable

4.0%

60000-69999

Prosthodontics - Fixed

3.8%

70000-79999

Oral surgery

Ranges from

2 - 6 %

 

February 1

 

 

Alberta

6.07%

Overall increase

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

February 1

Saskatchewan 4.95% Overall increase January 1
Manitoba 3.84% Overall increase January 1
Northern Manitoba 4.22%

Overall increase

This guide has adjusted fees that are about 10% higher than those in the Manitoba guide.

January 1
Ontario 2.0%
 Service category  Percentage cost increase

Diagnostic

1.6%

Preventive

1.5%

Restorations:

- Amalgam

- Composite

 

4.0%

3.1%

Crowns

0.0%

Endodontics

0.0%

Periodontics

2.0%

 Fixed

 - Prosthodontics

 

2.0%
 Oral surgery 7.3%
 Other 2.0%
January 1
Quebec 2.6% Overall increase January 1
New Brunswick 3.0% Overall increase January 1
Nova Scotia 2.93% Overall increase February 1
Prince Edward Island 1.92% Overall increase January 1
Newfoundland and Labrador 6.0% Overall increase January 1
Northwest Territories Not available   April 1
Nunavut Not available   April 1
Yukon Not 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 2009 increase over 2008 reimbursment guide

00000-09999

Diagnostic (e.g. examinations)

5.6 %

10000-19999

Preventive (e.g. cleaning, scaling)

5.3%

20000-22999

Restorative – Basic (e.g. fillings)

7.0%

23000-24999 Composite fillings 7.0%
25000-29999 Restorative – Major (e.g. crowns) 7.0%
30000-39999 Endodontics (e.g. root canal treatment) 7.0%
40000-49999 Periodontics (e.g. gum treatment) 7.0 %
50000-59999 Prosthodontics – Removable
(e.g. dentures)
5.0 %
60000-69999 Prosthodontics - Fixed (e.g. bridges) 6.5 %
70000-79999 Oral and maxillofacial surgery 7.0%
80000-89999 Orthodontics 3.0%
90000-99999 Adjunctive general services 5.0 %

Plan sponsors in Alberta

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

Our recommended fee 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 2009’ explains how we reimburse dental services in Alberta.

 

Questions?

Please contact your Sun Life Financial group representative.