What oral health providers need to know about the CDCP

Oral health professionals play a vital role in delivering oral health care, and the Canadian Dental Care Plan (CDCP) will allow more Canadian residents to benefit from their care.

On this page

• Participation in the CDCP
• CDCP established fees
• Coordination of benefits

Participation in the CDCP

Oral health providers can now confirm their participation in the CDCP directly with Sun Life.

How to participate in the CDCP as a provider

Participation in the CDCP is done on a voluntary basis. Oral health providers eligible to participate and who can bill for services include:

• dentists
• denturists
• dental hygienists
• dental specialists

Oral health providers are asked to confirm their participation in the CDCP to accept receiving direct payment from Sun Life. This will limit out-of-pocket costs for their CDCP patients which will reduce financial barriers to accessing care for eligible Canadian residents.

Providing services on a claim-by-claim basis

As of July 8, 2024, oral health providers will be able to direct bill Sun Life for services provided on a claim-by-claim basis without formally signing up for the CDCP.

This will make it easier for providers to treat patients and submit CDCP claims to Sun Life for direct reimbursement, whether or not they choose to formally participate. This also means that CDCP clients can see any oral health provider they choose for their care, as long as the provider agrees to direct bill Sun Life for services provided under the plan.

CDCP clients will be responsible for paying any potential remaining amounts directly to their provider. Sun Life will never reimburse a CDCP patient and will only reimburse providers for services covered under the CDCP.

In all cases, by submitting a CDCP claim and accepting payment, providers agree to the terms of the CDCP, either on a claim-by-claim basis or through their formal participation agreement with Sun Life.

Before providing care to CDCP patients, providers will still need to:

1. confirm patient eligibility for the CDCP through their existing patient intake process
2. confirm the patient is covered for select services
3. submit a claim with assignment of benefits (non-assigned claims will be rejected)

CDCP established fees

Oral health providers will be reimbursed according to the CDCP established fees for each service covered under the plan. CDCP fees may differ from those set out in provincial and territorial suggested fee guides, that providers often use to charge for oral health services. However, on average, the CDCP fees for the most frequently used procedure codes are set to cover at least 80% or higher of the provincial or territorial oral health provider associations’ suggested fees.

Full lists of the 2024 CDCP dental benefit grids for each province and territory are now available.

Full 2024 CDCP dental benefit grids

Fees will be reassessed annually to account for new scientific evidence, inflation, and changes in costs over time. The Government will continue to work with oral health provider associations to inform the methodology for determining fees for 2025 and beyond.