Can you still profit while accepting CDCP patients?

As of May 23, more than two million people have received dental care through the CDCP. (iStock)

On the surface, the federal Canadian Dental Care Plan (CDCP) seems simple: uninsured Canadians earning under $90,000 gain access to dental care and dentists gain new patients.
However, it’s not that simple, as the CDCP creates scenarios with nuances.

Bernard Dolansky, senior national partner, transition consultant and salesperson, and Bill Henderson, broker and senior transition sales consultant at Tier Three Brokerage, say that making a profit while accepting CDCP patients hinges on how well a dental practice handles balanced billing. Balanced billing is when dentists charge patients the difference between the CDCP’s reimbursement rate and the dentist’s usual fee.

The CDCP also has income-based co-pays, and reimbursement varies by income bracket. For households earning under $70,000, there is 100 per cent coverage. For incomes between $70,000 and $79,999, the co-pay is 60 per cent, and 40 per cent for those between $80,000 and $89,999.

“Under CDCP, you must collect the co-pay — that’s mandatory. But balance billing is discretionary,” Dolansky said, highlighting the responsibility dentists must exercise to balance their bills.

Dolansky and Henderson examined the CDCP at the Ontario Dental Association Annual Spring Meeting (ODA ASM) 2025 in Toronto.

“One of the slides I presented showed that if a dentist only collected the CDCP co-pay without balance billing — and this applied to their entire practice — they would have to work 50 per cent more just to maintain the same income level,” Dolansky said.

Are dentists balancing their billing?

Survey data from the ODA show that 80 per cent of Ontario dentists who participated in its survey are balancing their billing — sometimes or always — under the CDCP.

“The only provincial association we’re aware of that’s done good research around this is the ODA,” Henderson said, explaining why they cited the association’s figure. “We have separately heard that [the figure for balanced billing] may be lower in Ontario than the national average,” he added.

With a lack of proper national data on how many dentists are truly balancing their billing, those who are not may be faced with risks.

Dolansky described the “great danger” in not balancing billing, as it can “depreciate the value of your practice a great deal.”

“You need to preserve the profits in your practice,” he advised.

As of May 23, the total number of oral health providers participating in the CDCP was 25,668, with Ontario leading at 9,691 participating dentists, followed by 4,422 in Quebec, 3,415 in British Columbia and 2,563 in Alberta — together representing the majority in the country.

According to the federal government, only 17 providers nationwide deregistered from the CDCP and have not submitted any claims since deregistering.

The ‘good news’ and the ‘big picture’

However, the scenario isn’t entirely grim.

“The good news? Hygiene services like scaling are often reimbursed close to 100 per cent,” Dolansky said. “Scaling units, again depending on the provincial fee guide, you’re looking at scaling units close to 100 per cent. Again, provided you collect the co-pay — which, by the way, dentists are legally bound to do when they sign up for CDCP.”

When asked if dentists can still profit while accepting new CDCP patients, Chief Operating Officer Jackie Joachim of ROI Corporation Brokerage advised looking at the “big picture.”

“We believe anything that helps bring a patient into the office to generate revenue cannot be a bad thing,” Joachim said. “However, for those who feel the need to resist, they could look at scheduling CDCP patients during quieter times in the office, such as 1 p.m. to 4 p.m.”

Joachim, however, doubted there are any “valid reasons” for dentists to opt out of the CDCP.

“I would think that owners may not choose to accept based on the type of practice they are operating. If it is a high-end or significantly above fee guide, they may not want to accept or even promote it,” she said.

“I believe those who accept it see it as an opportunity to capture patients that may not come to the office currently,” she added.

There are risks in all scenarios

Henderson explained that dentists really have two choices: either accept the program for current patients or welcome new CDCP patients — with risks in each situation.

Dentists who choose not to participate in the CDCP still face risks — especially in competitive urban markets.

“Even if my practice is full, there’s a real risk I’ll lose existing patients if I don’t accept the plan,” Henderson said. “It’s hard to explain why you’d turn down government-subsidized care.”

He also warned of longer-term concerns, such as reimbursement levels not keeping pace with inflation or rising costs — and the possibility that balance billing could eventually be restricted.

Despite the risks, more dentists are treating CDCP patients.

“The majority of dentists are seeing either new patient flow increases or existing patients who are able to get an improved quality of care, which, of course, is what the program is for,” Henderson said.

Indeed, as of May 23, more than two million people have received dental care through the CDCP and more than four million have been approved as applicants.

(This is part one of a two-part series on the CDCP from a practice management perspective. Here is part two of the series: Will CDCP increase the value of your dental clinic?)