Orthodontic Fee Schedule and Reimbursement of Cleft Patient Treatment

Abstract

National Health Security Office (NHSO) lump sum pays a service unit for orthodontic treatment 48,000 baht per cleft patient’s lifetime even the orthodontic treatment is ongoing. When some patients have to relocate and be treated at other service units, they are charged for the remaining treatment. This descriptive cross-sectional study aimed to perform costing based orthodontic fee and payment schedule. Itemized full cost was calculated according to activity-based costing. Two workshops with dental personnel of 15 regional hospitals in 9 health regions were conducted to collect data on itemized service time, and the material and non-drug medical supplies of the budget year 2020. The national data on average renumeration per minute of specialist dentist, dental technician and dental assistance; and depreciation cost of building and dental equipment were obtained from the Ministry of Public Health. The indirect cost was added at a 20% of the total direct cost and the future development cost was a 25% addition on the full cost. Itemized dental lab fee (if any) was finally added to be the final fee for reimbursement from the government payer. The study was performed during February to December 2020.

The full cost and final fee of orthodontic treatment were 47,311 and 56,320 baht per patient lifetime. The payments of 3 treatment phases conforming with cost of dentition by age were 3,583 (for primary dentition of pre-school age) 18,158 (for mixed dentition of primary school age) and 34,580 baht (for permanent dentition of secondary school age). If based on final fee, the required budget for reimbursement should increase by 8,320 baht per patient lifetime. According to the 2013 NHSO’s 48,000 baht rate, the payments should be 3,054; 15,475 and 29,471 baht respectively.