Dental Fee Schedule Negotiation: The Overlooked Key to Practice Profitability

Dental Fee Schedule Negotiation: The Overlooked Key to Practice Profitability

If you're preparing to open your own dental practice, you’ve probably been knee-deep in everything from equipment quotes to lease negotiations. But there’s one high-leverage strategy that often gets missed—and it could be the difference between scraping by and thriving financially.

Let’s talk about dental fee schedule negotiation.

Yes, negotiating your dental fee schedule before you open your doors.

If you’ll be accepting PPOs, this could shape your profits for the next 20+ years. Yet most dentists either skip it—or worse—don’t know it’s even an option.

Why Fee Schedule Negotiation Matters (a Lot More Than You Think)

Here’s the hard truth: most doctors accept the first PPO rates offered, not realizing those numbers can be challenged. That means two dentists doing the exact same procedures in similar towns could be reimbursed wildly differently.

And over time, that delta adds up. We’re talking six figures a year. Not exaggerating.

We’ve seen this firsthand with clients across the country:

• Doctors A&A renegotiated their PPO fee schedule and now collect $120,000 more annually for the same procedures.

• Doctor P moved his new office just two miles to unlock PPO reimbursements that were 5–10% higher—adding tens of thousands in income, every single year.

The only difference? Strategic dental fee schedule negotiation before they committed to a location.

How PPOs Set the Stage (and Why You Can Push Back)

Let’s zoom out for a moment.

PPOs are massive businesses with one simple goal: pay providers as little as possible. Their default fees are designed to minimize payouts—not to support your practice.

But here’s the silver lining: they’re not legally obligated to offer the same fees to every doctor. That opens the door for negotiation—especially if you’re starting a new practice and haven’t signed anything yet.

That’s where the opportunity lies.

What Are Your Options with PPO Reimbursements?

Let’s break down what this might look like:

Scenario #1 – Fee Boost from Day One
When we helped Doctors A&A expand their office, we simultaneously negotiated their PPO schedule. Despite their initial skepticism (“You can’t even get them on the phone!”), we persisted—because we’ve built the right industry relationships.

The result? We secured raises on 24 codes. That’s $120K more per year. No new procedures, no new marketing. Just smarter reimbursement.

Scenario #2 – Location Intelligence = Instant Raise
Doctor P had his heart set on a particular town. Looked great on paper. But our pre-real estate PPO research revealed that a neighboring area offered dramatically better reimbursement. Same doctor, same procedures—better paycheck.

He moved two miles down the road.

Now? He earns up to 10% more on every PPO procedure.

Imagine the lost income if he hadn’t checked.

Dental Fee Schedule Negotiation Starts Before You Build

Here's the mistake we see all too often: doctors choose their location, sign a lease, then try to improve their PPO rates.

By then, it’s too late.

The most effective dental fee schedule negotiation happens before you:

• Lock in your practice location

• Sign your lease

• Credential with insurance companies

The PPOs know you have options at that stage—and so do we.

Need a Proven Process? You’re Not Alone

This isn’t something you can Google your way through. You need a team that’s done this before—and knows how to bypass the generic contact forms and get to real decision-makers.

Ideal Practices has guided hundreds of startups through PPO negotiations as part of our proven launch process. We know how to:

• Identify towns with better reimbursement before real estate decisions

• Negotiate multiple rounds with major carriers

• Push for fee increases based on custom data (not canned templates)

• Help you avoid rookie mistakes like accepting downgraded codes or missed procedure categories

When You Have the Right Team, It All Changes

Opening your own dental office is one of the most courageous, complex things you’ll ever do. And if you're starting out with student debt, a hefty buildout budget, and PPO reimbursements that barely cover your costs—you'll feel it fast.

But it doesn’t have to be that way.

The right strategy at the right time can change your trajectory:

• Stronger cash flow

• Less stress about overhead

• More freedom to focus on patients, not billing

We’ll show you how to build your dream practice, and get paid what you’re worth.

Want to Dig Deeper?

Grab our free step-by-step guide that breaks down the exact process we use for PPO negotiations:
Download the Dental Fee Schedule Negotiation Blueprint

You deserve to start your practice on solid financial ground—with the reimbursements to match your clinical excellence.

Let’s make that happen, together.

—Stephen Trutter