Explain the Tarif f-Setting Process of Dental Services in Islamic Republic of Iran

Insurance coverage of dental services through reducing costs and increasing the purchasing power of people, leads insured people to use more of these services than people without insurance coverage. One of the requirements of dental services insurance coverage is to determine the tariff of these services. The aim of this study was to explain the tariff-setting process of dental services in Islamic Republic of Iran in 2020.

Various steps were taken to determine the tariff for dental services: identifying the list of services, determining the professional component, the technical component and the consumables and materials component. The required data were collected through ten meetings with the members of the Supreme Council of Health Insurance (Deputy of Treatment, Medical Council of the Iran, and Basic and Complementary Insurance Organizations), two meetings with specialized dental associations, reports of the Statistics Center of Iran and a review of the actual costs of dental clinics across the country.

The professional component was obtained by the cost of living method and by calculating the number of units of relative value that can be provided during a year and then the expected annual income of a general dentist. The technical component was calculated by determining the annual costs of dental clinics and the consumables and materials component by the costing method based on the actual performance of dental clinics across the country. The obtained results for each stage were presented in various meetings in the Secretariat of the Supreme Council of Health Insurance and were confirmed after the final review.

Tariff-setting of dental services has various advantages such as targeting the insurance coverage process of these services, facilitating the process of monitoring tariffs, cost management by provider centers, facilitating the process of updating the tariff of existing services and facilitating the process of tariff-setting of new services.