Dental good faith estimates for self-pay patients
When a dental office must give an uninsured or self-pay patient a good faith estimate under the No Surprises Act, what it must include, and the deadlines.
Checked November 12, 2026
Under the No Surprises Act, a dental office must give a written good faith estimate of expected charges to patients who are uninsured or who choose not to use their insurance. In 2023, CMS confirmed to the ADA that the rule covers dental providers.
Who needs one
- Patients with no dental coverage.
- Patients with dental coverage who choose not to send the claim to their plan. They count as self-pay for that service.
- Patients whose plan doesn't cover the service at all, with no other coverage for it. They count as uninsured for that service.
Patients who are using a stand-alone dental plan for the service generally don't need one, because CMS treats them as insured. The office's own estimate letter is still good practice for them.
When it's due
- Service scheduled 3 or more business days ahead: within 1 business day of scheduling.
- Service scheduled 10 or more business days ahead: within 3 business days of scheduling.
- Patient asks for an estimate: within 3 business days of the request.
- If anything changes, such as the services or the providers, a new estimate is due at least 1 business day before the visit.
What it must include
- The patient's name and date of birth.
- The main service in plain language, and its date if scheduled.
- An itemized list of what's expected, grouped by provider, with expected service codes, diagnosis codes and charges for each.
- Each provider's name, NPI and tax ID, and where the services will be done.
- A list of related services that will be scheduled separately, with the disclaimer the rule requires above it.
- Disclaimers that the estimate isn't a contract, that charges can differ, and that the patient can start the dispute process if the bill is far higher.
If another provider will be part of the care, such as an oral surgeon or an anesthesia provider, the office that schedules the main service must ask them for their estimate within 1 business day and include it.
Telling patients they can ask
The office must tell self-pay patients that good faith estimates are available, in plain language, on its website, in the office and wherever scheduling happens, and when they schedule or ask about cost.
When the bill is higher
If the final bill from a provider is at least $400 more than that provider's estimate, the patient can dispute it through the federal patient-provider dispute process, within 120 calendar days of getting the bill. Keep every estimate: the office must give a patient a copy of any estimate issued in the last 6 years on request.
A plan of care that repeats, like a series of visits, can be covered by one estimate of up to 12 months. After that, a new one is due.
Sources
Read November 11, 2026. Where a source describes one insurer's plans, we say so.
Get the patient's share in dollars, from the benefits page
Every estimate starts with what the plan will pay. Tabruns reads the coverage, deductible, yearly maximum, waiting periods and frequency limits from the insurer's portal and works out what the patient owes. Patient details stay on the office computer.
Not ready? Try the free patient portion calculator.