Dental Care: The New Rates
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By 2018, some dental care rates will change. Prices for dental prostheses will be capped while those for conservative care, such as the treatment of cavities, will be revalued.
The new fee schedule for dental care will come into effect on January 1, 2018. Health Minister Marisol Touraine has decided to approve the arbitration award proposed by Bertrand Fragonard, Honorary President of the Court of Auditors. “She announced on March 9, 2017.
This text is binding on liberal dental surgeons following the failure of negotiations between health insurance and their representative unions. By the end of January 2017, the dentists had slammed the door of the talks which had begun at the end of September 2016, it is recalled.
“One French out of five gives up dental care for financial reasons”, the objective of this plan is “to reduce the rest to the charge of patients,” said Marisol Touraine. If usual scales do not change, such as consultation (23 euros), scaling (28.92 euros) or dental X-rays, several price changes will take place over the next four years.
Positive impact on the rest
Between 2018 and 2021, the Arbitration Regulation proposes a gradual upgrading of frequent oral care, such as the treatment of caries, in return for a fixed price for prosthetic care.
“We are in favor of this step-by-step rebalancing of the cost of conservative care and of reducing the cost of prostheses, and there will be a real impact on the rest,” said Agnès Boccognano, health director at Mutualité French. “Interest is primarily in public health but also in economic terms.To prevent prevention, it is possible to intervene before the destruction of the teeth, especially in patients who are giving up care because of the cost, so they will avoid prosthetic care Heavy and expensive later, “says Agnès Boccognano.
Here are the main changes for patients:
Limitation of crown tariffs
Arbitration limits the tariff of dental prostheses, with a progressive reduction over four years. The prices are differentiated according to the types of crowns. A ceramic-metallic crown will be billed 550 euros maximum in 2018, 530 euros in 2019, then 510 euros from 2020.
The price of a crown entirely made of ceramic will be capped at 590 euros in 2018. It will then drop to 550 euros by 2020. Nevertheless, these prices will be higher in the departments where the tariffs are generally more substantial (Essonne, Hauts Seine, Paris, Yvelines as well as in Guadeloupe, Guyana and Martinique). In these areas, the ceramic-ceramic crown will increase from 700 euros in 2018 to 610 euros in 2021.
Conversely, for the 5.52 million beneficiaries of the CMU-C (complementary universal health insurance), the ceilings that already existed will be revalued. For example, the maximum tariff for the metal crown will increase from 230 to 250 euros. A decree, which could take place in the coming weeks, will allow the ceilings to be extended to the beneficiaries of the complementary aid (ACS), 1.12 million people .
Increase in the bases of reimbursement
The patient will benefit from an increase in the reimbursement base of crowns and the most common prosthetic procedures. This amount will increase from 107.5 euros to 112.50 euros in 2018 and 120 euros in 2019.
Not reimbursed until now, the transitional crown will be assumed on the basis of 25 euros, from 2018. For this act, the invoice may not exceed 25 euros for the beneficiaries of the CMU-C and 60 euros for Patients.
Another novelty: the reimbursement base will also increase for inlay and 3-sided onlay, techniques for reconstituting a tooth whose caries is very extensive. This will be 120 euros from 2019, against 40.97 euros before.
Upgrading Conservative Care Conservative
care will be upgraded to strengthen prevention. To treat a certain type of decayed tooth, dental surgeons will be able to claim 67 euros in 2018, against 41 euros currently.
An order must create an oral follow-up examination, 100% reimbursed, for young people at the age of 21 and 24 years.
For people with diabetes, a periodontal assessment of 35 euros will be created to “detect the pathologies of the gum and bone”. In case of problems, the treatment costs can be up to 390 euros.
Finally, consultations for people with severe physical and / or psychological disabilities will be revalued (60 euros or 90 euros with sedation). These consultations require a longer time and are often more complex.
In total, “the revaluation of acts for dental surgeons amounts to 273 million euros, an average gain of 7,600 euros of additional fees per liberal dental surgeon by 2021”, estimates the ministry of the health. The cost for complementary healthcare is estimated at 150 million euros over the four years.
In order to obtain their upgradings, dentists will have to meet the expenditure targets set by the compulsory health insurance scheme and effectively implement the rate reductions set out in the Arbitration Rules.
Control is provided under a “safeguard” mechanism. Balance meetings will be set up at the end of the first quarter and then in November of each year. If non-compliance with the objective is established, upgrades are suspended. Billing prices lower than those of the initial schedule will then apply on 1 January of the following year.