Updated October 2026
Quick answer: Anthem does not publish a public, statewide dental fee schedule for its commercial PPO networks. Your allowed amounts come from the Network Fee Schedule attached to your participating agreement, at your network level (PPO 100/200/300/Prime/Complete, or the specialist schedule). Anthem's 2026 CDT update notice says that schedule "contains the most commonly utilized procedures and may not contain all ADA codes." For the allowable on a specific CDT 2026 code, it says to contact Anthem Dental Professional Services at 1-866-947-9398 (Anthem CDT 2026 notice). Fees vary by state entity, network level and contract, so verify in your agreement or portal. Any "Anthem fee schedule 2026" figures you find online that aren't from your own contract are not your rates.
Related: our Anthem BCBS fee schedule overview and the BCBS payer hub.
What's public vs. contract-specific
| Item | Public? | Where |
|---|---|---|
| Network structure (PPO 100/200/300/Prime/Complete, specialist, GRID/GRID+) | Yes | Anthem Dental Provider Reference Manual |
| Definitions (Allowable, alternate benefit, denied vs. disallowed) and CDT 2026 code changes | Yes | CDT 2026 notice, effective Jan 1, 2026 |
| Dental clinical policies | Yes | Anthem dental provider page |
| Your dollar allowables by CDT code | No: contract-specific | Your participating agreement and Network Fee Schedule; Professional Services 1-866-947-9398 |
| Changes to your fee schedule | Sent to you | Anthem says it notifies providers of fee schedule changes (manual) |
| Federal machine-readable price files for stand-alone dental | Generally not required | See the FAQ below |
How Anthem's network level determines your fees
Anthem's reference manual covers CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, VA and WI. It describes three participation levels for general dentists. Each level determines which fee schedule applies:
- Participation cascades downward. Joining 100/Prime/Complete also commits you to the 200/Complete and 300/Complete levels. Joining 200/Complete also commits you to 300/Complete. Joining 300/Complete covers only that level.
- Reimbursement is typically the plan payment plus the member payment, up to your contracted allowed amount.
- Specialists in the specialist network participate in all three levels and are paid from the specialist fee schedule.
- Discount Card Program: To join, you must participate at the 200/Complete level and accept the 200/Complete fee schedule. Members pay you that allowed amount directly at the time of service.
- GRID/GRID+ (national network for other Blue plans' members): the fee schedule used is "based on the treating doctor's location and participation in the 100/200/300/Prime/Complete networks." GRID reimbursement equals Prime and GRID+ equals Complete.
Source: Anthem Dental Provider Reference Manual.
Anthem is not one company. Its dental page lists separate Anthem entities by state, along with affiliates such as DeCare Dental, UniCare and Wellpoint (Anthem dental provider page). A schedule from one state or entity doesn't transfer to another.
Step-by-step: how a practice gets its Anthem dental fee schedule
- Find your agreement. Locate the executed participating agreement and its fee schedule exhibit. Note your network level(s) and the effective date.
- Register for Availity Essentials. Availity is Anthem's dental portal for claims, attachments, eligibility and remittances. Dental registration is at Availity.com/dentalproviders, and Availity Client Services is 1-800-282-4548 (Anthem dental page; Availity dental FAQ).
- Call Professional Services. If your schedule is missing, outdated or lacks a code, call Anthem Dental Professional Services at 1-866-947-9398 and ask for the Network Fee Schedule Allowable Amount for the specific CDT codes (CDT 2026 notice).
- Reconcile against remittances. Compare allowed amounts on recent ERAs with your schedule, especially for new CDT 2026 codes.
- Keep fee change notices. Anthem sends fee adjustment notifications and contract amendments. File each with your agreement.
- Dispute underpayments in writing. Anthem's manual allows appeals within 180 days of the claim denial. Include: the patient name and ID; the group number and claim number; the dentist name as shown on the EOB; supporting information. For Prime and Complete, Anthem acknowledges receipt within 3 days and decides within 30 days (manual).
Documentation checklist
- Signed participating agreement plus fee schedule exhibit, with network level(s)
- All fee adjustment notices and contract amendments since signing
- Availity Essentials access for remittances and claim status
- List of CDT 2026 codes you bill that are missing from your schedule
- Sample ERAs/EOBs showing allowed amounts by code
- For disputes: claim number, group number, EOB, and narrative and diagnostics
FAQ
Can I download the Anthem BCBS dental fee schedule for 2026?
Not publicly. Allowed amounts are contract-specific and attached to your participating agreement. Anthem directs dentists to Professional Services (1-866-947-9398) for allowables on specific codes.
Why does my fee schedule not list a CDT 2026 code?
Anthem says the Network Fee Schedule contains the most commonly used procedures and may not include every ADA code. Call Professional Services for the allowable on any code it doesn't list.
Do federal price transparency files show Anthem dental rates?
Usually not for stand-alone dental. CMS lists excepted benefits among plans that do not need to meet Transparency in Coverage requirements (CMS TiC overview). Limited-scope dental under a separate policy is an excepted benefit (45 CFR 148.220). Dental benefits embedded in a medical plan may be treated differently.
Does the fee schedule change if I join GRID or GRID+?
GRID members are paid at Prime levels and GRID+ members at Complete levels. The schedule used depends on your location and network level.
Sources
- Anthem Notice of CDT 2026 Update (effective Jan 1, 2026): https://www.anthem.com/content/dam/digital/docs/provider/commercial/general/P_DENT_00341.pdf
- Anthem Blue Cross and Blue Shield Dental Provider Reference Manual: https://www.anthem.com/content/dam/digital/docs/provider/commercial/general/CA_Dental_10005.pdf
- Anthem dental provider page: https://www.anthem.com/provider/individual-commercial/dental
- Anthem Availity Dental FAQ: https://www.anthembluecross.com/content/dam/digital/docs/provider/commercial/general/ANT.91.18_Availity%20Provider%20Portal%20FAQ_Dental.pdf
- CMS Transparency in Coverage overview (2022): https://www.cms.gov/files/document/transparency-coverage-webinar-naic-06-27-22-508.pdf
- 45 CFR 148.220, Excepted benefits: https://www.law.cornell.edu/cfr/text/45/148.220
See also: BCBS dental timely filing.