Usual & Customary Fee List (dental)
The usual and customary fee list is a provincial or insurer-based schedule that outlines standard dental fees used to determine reimbursement. Insurers use this list to calculate the amount payable for each procedure, regardless of what your dentist charges.
If your dentist charges more than the listed fee, you must pay the difference. Each province updates its fee guide annually, and private insurers typically follow it when determining reasonable reimbursement.
Example:
If the Alberta dental fee guide lists $200 for a filling and your dentist charges $230, your plan reimburses based on $200, leaving you to pay $30.
What to Watch For:
Confirm whether your plan follows your province’s fee guide or its own internal schedule, as differences can affect out-of-pocket costs.
