Table of Allowances
A fixed schedule of maximum dollar amounts a dental insurer will pay for each covered procedure, regardless of the dentist's actual fee.
Full Definition
A table of allowances is a benefit structure in which the dental plan assigns a specific dollar amount to each covered D-code; the insurer pays that fixed sum and the patient is responsible for any difference between it and the dentist's fee. Unlike UCR (Usual, Customary, and Reasonable) fee structures, the table of allowances does not adjust to regional fee averages. Editors drafting or reviewing patient benefit booklets, explanation-of-benefits documents, or fee analysis reports must distinguish this structure from percentage-based co-insurance plans. The term may also appear as 'schedule of allowances' or 'indemnity schedule'. Confusion with a fee schedule (the dentist's own charge list) is a common editorial error.
Usage
Usage note: Capitalise all major words when used as a proper noun referring to a specific plan document: 'Table of Allowances'. Use lowercase when used generically.
In Context
- "Under this plan's table of allowances, the maximum payable for a porcelain crown is $800, regardless of the provider's submitted fee." — Patient benefit booklet
- "The billing coordinator used the table of allowances to calculate the patient's estimated out-of-pocket costs before treatment began." — Financial consultation script