CDA has been receiving questions from dentists regarding CDCP payments, eligibility requirements, and the April 1, 2026 updates to the CDCP Fee Grids. Based on information provided by Health Canada, the following Q&A is intended to support predictability and consistency for dental practices delivering care under the CDCP.

We will continue to share additional information as it becomes available.

For CDCP claims, is payment amount determined based on the date service is provided or the date the claim is submitted?

CDCP payments are based on the CDCP Fee Grids in effect on the date the service is provided, not the date the claim is submitted.

• Services delivered before April 1, 2026 will be paid according to the fee grids in effect prior to April 1, even if the claim is submitted after that date.
• Services delivered on or after April 1, 2026 will be paid according to the updated fee grids, even if a preauthorization was issued before the fee change.

For treatment plans requiring multiple visits, each service is paid based on its individual date of service.

How do fee changes affect existing preauthorizations? How does the increase to commercial lab fee caps effective April 1 affect existing preauthorizations?

Services are paid according to the fee grids in effect on the date of service. If a preauthorization was issued before a fee increase, it may reflect lower amounts than what will ultimately be paid if the service is performed after the fee increase takes effect. For example, this may occur in cases involving commercial lab fees if a preauthorization is issued prior to lab fee cap increases on April 1, 2026, and services rendered on or after that date.

If a patient loses eligibility temporarily, can [LV1.1]treatment and billing proceed once eligibility is restored?

Members must be eligible on the date the service is rendered in order for services to be covered by the CDCP. Services provided during a period of ineligibility are not eligible for coverage, even if eligibility is later restored.

What happens to a preauthorization if a patient loses eligibility temporarily?

Preauthorizations are valid for up to 12 months, depending on the service. Certain preventative and periodontal services may be eligible for up to 24 months. A preauthorization does not become invalid solely because a member temporarily loses eligibility.

If eligibility is later restored:

• The original approved preauthorization remains valid, provided:
  • The service is delivered within the approval’s validity period
  • The member is eligible on the date of service

A new preauthorization is not required in these circumstances.

That said, obtaining an updated preauthorization may be advisable after an extended period of ineligibility or where there may have been changes to co-payment levels, changes in the CDCP Fee Grids, or CDCP coverage rules that could affect the patient’s treatment.