These are the sources behind The Tooth Bill’s rules, coverage statements and prices, with the edition we used and the date we read it. Each page also cites its sources at the claim, so you can check any figure where you see it. How we check explains how rules are read and dated, and how we estimate costs explains the price method.
General information about costs, not dental, medical, insurance, tax or financial advice. Your dentist decides what treatment suits you; your plan’s documents and a pre-treatment estimate decide what it pays.
Rules and regulations
All read 11 November 2026 unless stated. eCFR sections were read in the version “up to date as of 9 November 2026”; US Code sections in the 2024 edition on govinfo.
| Source | What we use it for | Edition |
|---|---|---|
| 42 CFR 411.15(i) | Medicare’s dental exclusion and the dental services tied to covered care that are not excluded | eCFR as of 9 Nov 2026; point-in-time versions from 2023, 2024 and 2025 |
| CY2026 physician fee schedule final rule, 90 FR 49266 | No new dental exceptions for 2026 | 5 Nov 2025 |
| CY2027 physician fee schedule final rule, 91 FR 70992 | No dental section for 2027 | 9 Nov 2026 |
| medicare.gov, dental services; Medicare costs | What Medicare says it covers; 2026 Part B deductible ($283) and standard premium ($202.90 a month) | 2026 amounts |
| medicaid.gov, dental care | Children’s dental under EPSDT and CHIP; no federal minimum for adults | read 11 Nov 2026 |
| 42 USC 1396d(r)(3); 42 USC 1397cc(c)(6) | EPSDT dental services; CHIP dental coverage | US Code, 2024 edition |
| 45 CFR 156.110 and 156.115(d); 45 CFR 156.150(a) | Children’s dental as an essential health benefit; the bar on counting routine adult dental; the stand-alone dental plan cap | eCFR as of 9 Nov 2026 |
| CMS Final 2026 and Final 2027 Letters to Issuers | Children’s dental out-of-pocket cap: $450 one child, $900 two or more, in both years | 2026 and 2027 plan years |
| healthcare.gov, dental coverage | How Marketplace dental plans are sold; adult waiting periods | read 11 Nov 2026 |
| IRS Publication 502 and Publication 969 | What counts as a dental expense; the 7.5% of income floor; HSA and FSA rules | 2025 editions (for 2025 returns) |
| IRS Rev. Proc. 2025-19 and Rev. Proc. 2025-32 | 2026 HSA limits and HDHP figures; 2026 health FSA limit and carryover | 2026 limits |
| CFPB, Medical Credit Cards and Financing Plans | How deferred interest works; the typical medical card rate; deferred interest paid | May 2023 report |
| CFPB, order against GE CareCredit | The 2013 refund order and its findings | 10 Dec 2013 (archived press release) |
| 42 USC 254b; 42 CFR 51c.303(f) | Health centers’ preventive dental services and sliding fee discounts | US Code 2024 edition; eCFR as of 9 Nov 2026 |
| 38 CFR 17.161 and 17.169; va.gov, VA dental care | Who qualifies for VA dental care; the VA Dental Insurance Program | eCFR as of 9 Nov 2026; va.gov page updated 12 Jan 2026 |
| Florida Statutes s. 636.212; Texas Insurance Code ch. 7001; FTC | Discount plans are not insurance; registration in Texas | Florida 2025 Statutes; FTC page dated May 2021 |
| Massachusetts General Laws c. 176X, s. 2 | The state’s dental loss ratio | read 10 Nov 2026 |
Medicaid data
- ADA Health Policy Institute, Dental Care in Medicaid Programs: the data tables and report, published December 2025, data as of August 2025. We use HPI’s level of adult dental benefit for each state (none, emergency-only, limited, enhanced) with HPI’s own definitions, and its share of dentists taking part in Medicaid or CHIP in 2024 (41% nationally). HPI is the ADA’s research arm. Its material is copyrighted, so we describe it in our own words. Read 11 November 2026.
- State Medicaid fee schedules: Virginia’s Cardinal Care Smiles schedule (effective 1 July 2024), Maryland Medicaid’s 2026 CDT fee schedule (dated 18 August 2026) and Wyoming Medicaid’s 2026 dental fee schedule. We use them as a floor (the most the program pays a dentist), never as a market price, and as public sources that print code numbers.
- State Medicaid agencies: each state page and fold-out cites the agency pages, manuals and handbooks it relies on, with their dates. Where an agency page could be read only in an archived copy, the page says so and gives the copy’s date.
National spending, prices and payments
- CMS National Health Expenditure accounts, Table 12, dental services: US dental spending by who paid, 1970 to 2024. Read 11 November 2026.
- BLS consumer price index for dental services, series CUUR0000SEMC02 (CPI-U, US city average, not seasonally adjusted): how dental prices change, and how much they have moved since a published figure’s date. Latest month read: October 2026. BLS did not collect October 2025 data.
- AHRQ Medical Expenditure Panel Survey, 2023: the full-year consolidated file (HC-251) and the dental visits file (HC-248B). A federal household survey of what was actually paid, by patients, insurers and public programs together. Figures are our own weighted tabulation of the public files and are labelled so.
- HRSA Uniform Data System, 2025 national data: how many health center patients received dental care.
- KFF, Medicare Advantage report of 5 June 2026: the share of individual Medicare Advantage enrollees in plans offering some dental benefit. KFF is an independent health policy research group; its work is copyrighted and paraphrased.
Plan documents used as examples
We show how real plans handle coinsurance, maximums, waiting periods, the missing tooth clause and cheaper-alternative payments from these documents, each named with its year, form and page. They are examples, not a description of every plan. All read 11 November 2026.
- 2026 federal employees’ dental plan (FEDVIP) brochures: GEHA Connection Dental Federal, the MetLife Federal Dental Plan and Delta Dental’s Federal Employees Dental Program, the copies posted by BENEFEDS, the program’s enrollment portal for the Office of Personnel Management. They also print many of the code numbers on our pages.
- CMS Exchange public use files, plan year 2026: our count of the stand-alone dental plans sold on HealthCare.gov in 30 states. States with their own exchange are not in the files.
- Delta Dental of Iowa, Individual Platinum Prime member policy, form INDPLATPR-012027, for 2027: an individual policy’s full contract text.
- Cigna Dental 1000: the Colorado evidence of coverage extract (form CO DE003 1-2025), which contains a missing tooth clause, and the plan’s summary of benefits (form 888306, 8/25).
What a procedure is
One or two plain sentences only, from public health sources: MedlinePlus pages on dental crowns, root canals, tooth extraction, impacted teeth, cavities, dentures and orthodontia; the FDA on dental implants and clear aligners; and NIDCR on gum disease. Read 11 November 2026, each with the review date the page shows.
Published price sources
No public, free, primary list of dental prices exists, so cost pages show figures from several publishers side by side, never averaged. We look for at least three per procedure; where we find fewer, the page says so, and a lender’s figure is never shown alone. We don’t use lead-generation, find-a-dentist or affiliate sites, or insurance and loan referral marketplaces, as sources. Each one is named on the page with its date and what it measures. This is who they are and why each might lean. Figures read 11 November 2026 unless the page says otherwise.
| Publisher | Who they are | What their figures measure | Why they might lean |
|---|---|---|---|
| CareCredit | A medical credit card issued by Synchrony Bank: a lender | National averages and ranges from the Synchrony Average Procedural Cost Study, a survey of practices it commissions from ASQ360 Market Research (2023, 2024 and 2026 editions) | Sells financing for the same treatments; never shown alone |
| Delta Dental | Insurer (Delta Dental Plans Association) | Its own claims data, often average out-of-network charges, with the data year named | Sells plans; out-of-network fees run higher than in-network ones |
| Humana | Insurer | Its own pricing tool, for Orlando, Florida | Sells plans; one metro area |
| MetLife | Insurer | Some figures from its data for one Philadelphia zip code; others unsourced or second-hand | Sells plans; shows its plan’s value |
| Cigna, Guardian, Ameritas | Insurers | Cost pages, often without a stated source or repeating another publisher’s figure | Sell plans; used only where the figure is their own, labelled |
| Dental Economics | Dental trade journal | A phone survey of 278 practices in six large metro areas on implant prices (September 2025, published 1 February 2026) | Large cities only; prices quoted by phone |
| Pearl | Cost guide from a company that sells software to dental offices | Modelled national and state estimates it says are based on ADA fee survey data; method not published | Method unclear and pages carry template errors: a weak source, never alone |
| CostHelper | Consumer cost site | Editorial estimates plus prices readers report | Ad-funded; dates unclear, some figures old |
| Penn Dental Medicine | University of Pennsylvania dental school clinics | Implant price ranges in Philadelphia | Promotes its own clinic’s fees; one city |
| Align Technology | Maker of Invisalign | A survey of its own doctors about their fees; no dollar price | Sells the product |
A few other publishers appear on a single page, such as Healthline, WebMD, Oral-B, the American Association of Orthodontists and the Academy of General Dentistry. Each is named on that page with what kind of publisher it is, the date, and why it might lean. Dental chains’ own prices are never a price source. Lenders and plans are named only as the publishers of figures and terms; we never link to an application or sign-up page.
What we don’t use
- The ADA’s Survey of Dental Fees: sold; we have not bought it.
- FAIR Health’s figures: its consumer site’s terms bar copying for commercial use, so we link to its dental cost lookup instead.
- Pages we couldn’t open: some cost pages refuse automated reads. Figures we saw only in search results are not published.
- Dental practice blogs, chains’ marketing, lead-generation, find-a-dentist and affiliate sites, forums, Reddit, YouTube and “best dental insurance” lists: never a source for a rule, a coverage statement or a figure.
Code numbers are from the CDT Code, maintained by the American Dental Association; the descriptions on our pages are our own. If you publish a source we cite and something here is out of date, or you know a primary source we should read, please tell us.
Sources on this page checked on 11 November 2026.