Usual and customary fee

The ADA explains that dental plans may use the terms usual, customary and reasonable (UCR) to decide how much of a treatment fee they will pay. It says the words are not interchangeable and that UCR is a misleading acronym, because it is actually three different concepts. Usual fees are determined by the dentist. The fee a plan decides is customary may be lower than the fees local dentists usually charge. This is why a patient may be told a plan pays only part of a bill. See fee schedule and explanation of benefits. Definitions differ among plans, so check the plan documents.