How is the Maximum Plan Allowance (MPA) – Delta Dental Allowed Amount – calculated?
A. The Maximum Plan Allowance (MPA) is the amount which equals the lesser of the covered charge for a service, supply, or any dental procedure covered under the dental plan or an amount which Delta Dental establishes annually as its maximum allowable fee for the same service, supply, or procedure. For all dental procedures covered under the plan, the maximum allowable fee is established by Delta Dental of South Dakota for a covered dental procedure that is dentally necessary and dentally appropriate. It is developed from various sources, such as contracts with dentists, input from our dental consultants, the simplicity or complexity of the procedure, the billed charge for the same procedures by dentists in South Dakota, and a leading economic indicator. For services billed by dentists outside of South Dakota, the maximum allowable fee is based on information from that state’s Delta Dental member company.
