Dentists: 98% Include Lab Fees

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Dentists include lab fee in total fee for serviceThe overwhelming majority of dentists – fully 98% – include dental lab fees in their total fee. Only 2% bill patients separately for the lab fee.

Dentists have historically included lab bills in their total fee, making the profession relatively unique.

With costs rising across the board – and the price of gold skyrocketing – this means that sometimes dentists take a loss on the lab fees.

“Sometimes you win and sometimes you lose," said one dentist. "In the end it averages out to what it should be."

Billing separately sounds great to some

  • “We include lab fees, but we have been thinking to start billing separately.” (General dentist)
  • “We should be able to bill separate. Some insurance plans barely cover the lab fee. It is a joke.” (Maryland dentist)
  • "How do you go about changing this?"

Is the high price of gold costing you money?

  • “It would be great to add gold fees since the price is going up like crazy!” (Florida dentist)

Ups and downs

  • “Sometimes you win and sometimes you lose. In the end it averages out to what it should be.” (Connecticut dentist)

Pluses and minuses

  • “I believe either option is acceptable. If you are thoughtful and fair, you should be able to elaborate your rationale for your selected practice. My sense is that the typical patient may not be able to grasp the overhead & mark-up issues related to most prosthetic procedures. Nickel & dimers may find this an effective point of attack.” (Michigan dentist)

Big cases may get a separate lab bill

  • “On big cases-over 6 units, I will include a separate lab fee in addition to my normal crown fee. Especially on full mouth reconstructions, because the lab fees are so high. I try to recoup at least 50-75% of my lab fee. I have good results.” (Massachusetts dentist)
  • “On more complex cases I bill lab fees separately, and give an estimate of the cost.” (California dentist)
  • “On some large cases I do set a fee and have the patient pay the lab.” (Florida dentist)

Patients do not want a separate lab fee

  • “It is hard to quote a fee accurately when separating the lab fee, and in these difficult economic times, people get really upset at surprises.” (Tennessee dentist)
  • “Never give patients a separate fee for the lab bill. Patients do not value our time enough as it is. It only sets us up to have to justify our fees or encourages patients to try negotiate a lower fee."
  • “Do you want the patient to be able to argue about how we base your fee?” (Michigan dentist)

Lab fees are included because they have always been included

  • “The vast majority of dental insurance plans prohibit billing dental laboratory fees separately. This is due to the fact that traditionally, dentists have never billed patients separately for lab fees. When dental insurance was invented, that same established custom was followed by the developers of insurance billing codes. To this day, the majority of dentists do not bill separately for lab fees. Any attempt to do so would be quite a shock to patients who are used to the customary way to do business."

Dental insurance companies make the rules

  • “I give the client options of materials to be used based on their conditions. They select the type of crown and my office fees correspond to the type of material that was used. Our insurance companies request the lab fees in order for the client to be reimbursed.” (General dentist)
  • “I have seen slimy tactics by discount and DMO and PPO plans to jack up the amount patients pay by including lab fees, local anesthesia fees, sterilization fees, impression fees, temporary crown fees, ETC ad nauseum… in order to cover their losses by participation. One insurance rep called these the 'how to screw your patient fees.'” (Texas dentist)

More questions

  • “I would like to ask, what is the average fee a dentist charges to a patient for a case that incurs a $150 lab bill?” (General dentist)
  • "5X is the average FFS…so how do we do quality dentistry if we reduce the quality of the lab….?"
  • “Who on earth bills separately for lab fees?” (Georgia dentist)
  • “We get charged taxes. Can we charge taxes for crowns and other lab services?” (California dentist)


Note: Survey sample included 173 respondents.

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