Dentists

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Other than payment to Orthodontic Specialists, all other dental procedures are insured by MSP only when listed in a Dental Payment Schedule and performed in a hospital.

Enrolment

Dental practitioners who are licensed by the College of Dental Surgeons of British Columbia (CDSBC) are eligible to enrol with MSP and obtain MSP billing numbers.

Enrolment status, and, therefore, the possession of an active billing number, is contingent upon the practitioner's continued licensure by the CDSBC. Any change in licensure, such as the renewal of a temporary license or specialty, must be reported to MSP to avoid refusal of claims.

Enroled Dentists

Licensed dentists who register with MSP are called enroled dentists. Like physicians, dentists may choose to be opted-in or opted-out. Extra billing restrictions are identical to those for physicians except that oral and maxillofacial specialists may bill patients directly for the technical component of associated out-of-hospital services (i.e. x-rays, dental laboratory services, prostheses, etc.) except for those patient categories covered under Schedule E of the Dental Payment Schedule.

Dentists Who Are Not Enroled

Not all services provided by dentists in B.C. are billable under MSP. Other than payment to orthodontic specialists, all other dental procedures are covered by MSP only when listed in the Dental Payment Schedules (updated April 2012) and performed in a hospital.

Assignment of a Billing Number

Each practitioner enroled with MSP is assigned a billing number consisting of two numbers:

  • a practitioner number, which identifies the practitioner rendering the service, and
  • a payment number, which identifies the person or group (e.g. clinic, hospital) to which payment is to be made.

The practitioner and payment numbers are usually the same. However, they differ in cases where a practitioner designates another practitioner or a group, such as a clinic or hospital, to receive that practitioner's MSP fee-for-service payments. See Assignment of Payment.

All claims submitted to MSP must include the practitioner number of the practitioner who performed the service; therefore, a practitioner cannot bill under another practitioner's number. The practitioner whose number appears on the MSP claim assumes full responsibility for the service provided.

Applying for a Billing Number

Dentists wishing to obtain a billing number from MSP must follow a clearly defined process.

  1. You must first request licensure from the College of Dental Surgeons.
  2. You must complete and submit the following application form:

Change of Address or License

If you change your address or telephone number, or if there is a change in your specialty or license status, you must advise MSP so that your records can be updated accordingly. Timely notification of changes enables MSP to provide practitioners with accurate and efficient service and helps prevent unnecessary refusal of claims.

De-enrolment and Opting Out

A dental practitioner may:

  • enrol with MSP (if licensed with the appropriate licensing body); or
  • once enroled, opt out of MSP; or
  • once enroled, de-enrol from MSP (cancel the enrollment); or
  • not enrol with MSP.

Notifying Patients

If a dental practitioner intends to require their patients to pay all or a portion of the costs of a service, he or she must inform the patient, prior to rendering the service:

  • that the patient will be required to pay part or all of the cost directly;
  • the amount the patient will be required to pay; and
  • the amount the patient can expect to be reimbursed by MSP.

Billing Codes and Payment Schedule

The Laboratory Services Act (LSA) came into force on October 1, 2015. The LSA replaces the Medicare Protection Act and the Hospital Insurance Act as the authority for insuring laboratory services and consolidates the responsibility for all publicly-funded laboratory services in British Columbia. For information on laboratory service benefits under the Laboratory Services Act, visit the Laboratory Services website.

The Dental Payment Schedules (updated February 1, 2017) lists fees payable for dental services insured under MSP.

For more information on Medical and Health Care Services regulations pertaining to dental and orthodontic services, see Section 19 of the Medical and Health Care Services Regulations of the Medicare Protection Act (PDF, 21KB).

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