Download Free Dentist Invoice Templates

Download a template, then edit in PDF, Word, Excel, Google Docs or Google Sheets. Print or email when ready.

Sheets, Excel, Word and Doc Templates Coming November 21, 2025.

Custom Dentist Invoice Template

Best for:

Logo, plan fields, claim and preauth.

Editable Dentist Invoice Template

Best for:

Edit procedures, discounts, notes.

Printable Dentist Invoice Template

Best for:

Copay, insurance, CDT, signatures.

Free Dentist Invoice Template

Best for:

Procedure codes, tooth and surface, x-rays.

How to Invoice as a Dentist

Keep it simple from chair to checkout so patients see what they owe and why.

Free Online Invoice Generator

☝️ No sign-in. Save as PDF.

In 5 Steps:

Review today’s charting and confirm completed services against the treatment plan.
Build the invoice with procedure codes, tooth or quadrant, and the date of service.
For lab-heavy cases, create a deposit invoice before you send the case to the lab.
At delivery, add remaining services and apply the deposit to the outstanding balance.
Send the invoice with clear terms, record payment, and file the claim or receipt.

Free Online Invoice Generator

☝️ No sign-in. Save as PDF.

What to Include in a Dentist Invoice

These are the must-have fields for clear, compliant invoices.

Invoice number and date of service
Practice name, address, phone, and email
Provider name, license number, NPI, and tax ID
Patient name and patient ID
Insurance payer name, subscriber ID, and group number
Claim number or preauthorization number, if applicable
CDT procedure codes with plain descriptions
Tooth number, surface, or quadrant
Quantity or units and clinician initials
Lab case ID and lab fee lines
Taxes on retail items and tax rate; check local rules
Payments received, deposits applied, balance due, and due date

Billing Scenarios for Dentists

How to label charges so every invoice makes sense the moment your clients see it.

Crown preparation and temporary; Porcelain crown lab fee

Crown or veneer with outside lab work

This separates clinical work from third-party lab cost so timing and price make sense.

Service total; Deductible applied

Patient has insurance deductible remaining

It shows the full price and the deductible so the higher out-of-pocket is clear.

Emergency exam; After-hours fee

After-hours emergency visit for pain or a broken tooth

It splits urgent care from the premium for late scheduling.

Scaling and root planing x2; Local anesthesia

Deep cleaning across two quadrants with local anesthesia

List retail products on separate lines and apply tax only to those items. Check local rules.

Implant placement; Bone graft with membrane

Implant placement with bone graft and membrane

It lists each surgical step so material-heavy add-ons are not mistaken for the implant itself.

Missed appointment fee; Late cancellation fee

It communicates the policy and protects the value of the reserved slot.

Free Online Invoice

No sign-in. Save as PDF.

Create a Free Account

☝️ Risk-free 30-day trial.

Standard charges and patient fees for dentists

List procedures and treatments, X rays and exams, and insurance copays with professional invoice line items.

Charge or Service

Unit

Taxable

When to use

How to show it

Comprehensive exam & diagnosis

Time

New patient or annual check

Time × hourly rate. Document findings and planned care so treatment, notes, and billing match.

Prophylaxis cleaning

Time

Routine cleaning appointment

Time × hourly rate. Note quadrant or full-mouth to keep scope clear on the invoice.

Bitewing x-rays (2–4)

Item

Decay monitoring or treatment plan

Qty × per-image rate. Attach images in the file and note views taken.

Composite filling - 1 surface

Item

Small cavity, one surface

Qty × unit rate. Include tooth number and surface to avoid confusion later.

Crown prep & seat

Time

Preparing and seating crown

Time × hourly rate. Note tooth number and material selected in case details.

Lab fabrication - porcelain crown

Item

Taxable

Crown made by outside lab

Cost × (1 + markup%). Add the lab invoice number for traceability.

Root canal - single canal

Time

Infection in single-root tooth

Time × hourly rate. Include tooth number and canal count in notes.

Surgical extraction

Time

Impacted or broken tooth removal

Time × hourly rate. Record anesthesia used and any complications.

Custom night guard

Item

Taxable

Grinding/clenching with wear

Qty × unit rate. Include impression date and delivery date for the appliance.

Emergency exam after-hours

Time

Urgent visit outside hours

Time × after-hours rate. Note reason for visit and any immediate care provided.

Save and reuse your dental services and fees

Create a free account and save procedure pricing, exam and X-ray fees, and copays once, so nothing gets retyped.

Create a Free Account

☝️ Risk-free 30-day trial. No card.

Common Dentist Invoicing Mistakes

Real-world billing gets messy fast, but a few simple fixes stop disputes and speed up payment.

Mistake

How to fix it

Missing CDT codes and tooth details causes denials and delays.

Add the correct code for every service and include tooth, surface, or quadrant when required. Support each code with brief notes.

Combining estimate and final charges on one invoice confuses totals and trust.

Keep estimates separate from final invoices and mark each clearly. Convert the estimate to an invoice only after work is done.

Post allowed amounts and write-offs so the math is transparent. Show patient responsibility after adjustments.

List retail products on separate lines and apply tax only to those items. Check local rules.

Vague service descriptions lead to disputes.

Use plain names patients know and avoid clinic shorthand. Tie each charge to a date of service.

Missing payment terms leaves balances hanging.

State the due date, accepted methods, and any payment plan rules. Include a late fee policy if you use one.

Dentists Invoice FAQs

CDT codes, lab pass-throughs, ortho progress payments, cancellations, after hours, insurance write offs, and cosmetic charges. Line items, markup, and terms you can copy, clear answers.

How should I show CDT codes and insurance adjustments on the bill?

List each CDT code, your standard fee, the PPO write off, and patient responsibility. Example: “D1110 Prophylaxis Adult $110, PPO adjustment ($20), patient pays $90.” Use the Dentists Invoice Template to keep this consistent.

Can I pass dental lab fees to the patient?

Yes, if your financial policy allows it. Add a separate line like “Lab fee for crown fabrication $220” and note any markup or pass through. Rules vary—check local rules.

What’s the right way to bill a crown across multiple visits?

Bill the prep and temp at the prep visit, then seat the crown at delivery. Example: “D2392 Build up $180, D2740 Crown porcelain $1,200, temp included, delivery visit no charge except adjustments.”

How do I handle a no show or late cancellation fee?

State your policy up front, then add a clear line when it happens. Example: “Missed appointment fee (less than 24 hours) $50.” Rules vary—check local rules.

How do I bill after hours emergency care?

Use a separate emergency exam line and any palliative treatment. Example: “Limited exam after hours $150, palliative treatment $120.” If an oral surgeon is involved, add their fee on a separate claim or statement.

How should orthodontic treatment be billed over time?

Use progress billing with an initial payment and monthly charges. Example: “Comprehensive ortho total $5,000, initial $1,000, monthly $150 x 27, supplies kit $60.” Note any insurance lifetime maximums.

Can I split a statement between two parents or add secondary insurance?

Yes. Set percentages and list them: “Parent A 60%, Parent B 40%.” For secondary insurance, add “Primary EOB pending, secondary claim to follow,” then post both EOBs before patient balance.

How do refunds or balance bills work after the EOB arrives?

Post the insurer payment and adjustment, then reconcile the patient share. Example: “Insurer paid $340, adjustment ($45), patient paid $400, refund $55.” With PPOs, balance billing limits apply, rules vary—check local rules.