What to include on a dental invoice
CDT codes and tooth numbers
Pair each procedure with its CDT code and, for restorative work, the tooth number and surfaces treated.
Insurance estimate vs. patient share
Show the full fee, the estimated insurance payment and the patient's responsibility on separate lines.
Provider and practice info
Include the treating dentist, NPI and practice tax ID so patients can file their own claims if needed.
Treatment plan reference
For multi-visit care, note which phase of the treatment plan this invoice covers.
Example dental line items
These sample entries show how to describe dental work clearly. Rates are illustrative only; use your own pricing.
| Description | Qty | Rate | Amount |
|---|---|---|---|
| Periodic oral evaluation (D0120) | 1 | $65.00 | $65.00 |
| Adult prophylaxis cleaning (D1110) | 1 | $120.00 | $120.00 |
| Bitewing X-rays, four films (D0274) | 1 | $85.00 | $85.00 |
| Composite filling, two surfaces, tooth #19 (D2392) | 1 | $245.00 | $245.00 |
| Subtotal | $515.00 | ||
Payment terms for dental invoices
Our suggestion: Patient portion due at checkout; plans available for larger treatment.
Sample terms you can paste into the invoice: “Patient portion is due at the time of service. Payment plans are available for treatment over $1,000.”
Not sure what Net 15 or 2/10 Net 30 mean? Payment terms explained.
Dental invoice FAQ
What are CDT codes on a dental invoice?
CDT codes are the standardized procedure codes used in dentistry, such as D1110 for an adult cleaning. Using them makes it easier for patients and insurers to understand and process the bill.
Can a dental office bill patients before insurance pays?
Many offices collect the estimated patient portion at the visit and reconcile once the claim is processed. Explain clearly that the estimate may change, and refund or bill the difference promptly.
How do I invoice an uninsured dental patient?
List each procedure with its code and fee, and apply any self-pay or membership discount as a separate line. Some practices offer in-house plans, so mention those if they help patients afford care.