When evaluating payment processing companies, one of the most confusing topics for many dental offices is understanding the different pricing models available. Most processors structure their pricing using one of three common approaches: interchange-plus pricing, tiered pricing, or flat-rate pricing. Each model has its own advantages and disadvantages, and understanding the differences can help dental practices make a more informed decision when choosing a payment partner.
For many dentists and office managers, pricing conversations can quickly become complicated because payment processing statements are often difficult to read and filled with industry terminology. While pricing certainly matters, the right solution for a dental office usually depends on a combination of transparency, predictability, operational efficiency, and overall technology value — not simply the lowest advertised rate.
Interchange-plus pricing is often viewed as one of the more transparent pricing models in the payments industry. With interchange-plus, the practice pays the actual interchange cost set by the card brands and issuing banks, plus an additional markup from the processor. The interchange portion varies depending on factors such as card type, rewards level, debit versus credit, and how the transaction is accepted.
Many larger businesses appreciate interchange-plus pricing because it allows them to see the true underlying cost of each transaction. However, for dental practices, interchange-plus can sometimes become difficult to predict and manage because rates fluctuate constantly based on patient payment behavior. While interchange-plus may occasionally produce lower costs for high-volume organizations, statements can often become extremely detailed and difficult for office managers to analyze.
Tiered pricing is another common structure used by traditional processors. Under a tiered model, transactions are grouped into categories such as “qualified,” “mid-qualified,” and “non-qualified,” with different pricing assigned to each category. While this model may initially sound simple, it can sometimes create confusion because the processor determines how transactions are categorized.
In many cases, dental offices may find that a significant percentage of their transactions end up falling into higher-cost categories, making it difficult to fully understand the true effective processing rate being paid. Because of the lack of transparency, tiered pricing has become less popular among businesses seeking more predictable and understandable payment costs.
Flat-rate pricing has become increasingly popular in recent years, particularly with modern payment companies and software-focused providers. Companies like Stripe and Square helped popularize the simplicity of flat-rate pricing by charging a fixed percentage regardless of card type or transaction category.
Many dental practices prefer flat-rate pricing because it is easy to understand and highly predictable. Office managers know exactly what percentage will apply to in-person payments versus online or manually entered transactions, making budgeting and reconciliation much simpler. Flat-rate pricing also tends to pair well with modern payment technology platforms that prioritize ease of use, integrated workflows, and streamlined onboarding.
For dental offices specifically, simplicity and operational efficiency often matter just as much as slight pricing differences between models. Practices that process patient payments through integrated systems like Open Dental, Dentrix, or Eaglesoft frequently value streamlined workflows, automated ledger posting, and patient-friendly payment tools over chasing marginal differences in interchange categories.
Another important consideration is transparency around additional fees. Regardless of the pricing model being used, dental offices should carefully evaluate whether the processor charges monthly fees, PCI fees, annual fees, statement fees, terminal rental costs, gateway fees, or long-term contract penalties. Sometimes a provider advertising a lower rate may ultimately cost more once all fees are considered.
Ultimately, there is no universal “best” pricing model for every dental practice. Larger organizations with sophisticated accounting teams may prefer interchange-plus pricing for maximum transparency. Other practices may value the predictability and simplicity of flat-rate pricing. The most important factor is finding a processor that provides clear pricing, modern technology, reliable support, and workflows designed specifically for dentistry.
At Moolah, we focus on helping dental practices simplify payments through modern, dental-focused technology. Our Crown platform combines integrated payment workflows, wireless smart terminals, payment requests, hosted payment pages, membership management, and patient payment plans into a streamlined solution built specifically for the needs of modern dental offices.
Thank you for scheduling. If you have any questions, please contact us at 800-625-1670.
A credit card surcharge is an additional fee added to a transaction when a patient chooses to pay with a credit card. The surcharge is intended to help offset the cost of credit card processing and applies only to eligible credit card transactions.
No. Debit card transactions may not be surcharged under any circumstances, even if the debit card is processed as a credit transaction or entered manually.
Yes. Credit card surcharges may not exceed the merchant’s actual cost of accepting credit cards and are capped at a maximum of 3% of the total transaction amount, in accordance with card-network rules and applicable law.
Yes. Card networks require clear and transparent disclosure of any credit card surcharge. Practices must notify patients through appropriate signage at the practice entrance, point of sale, and anywhere payments are accepted. If payments are accepted online, the surcharge must also be clearly disclosed on the practice’s website.
Yes. Some U.S. states and territories prohibit or restrict credit card surcharging. Practices are responsible for understanding and complying with their state’s specific requirements before implementing a surcharge.
No. While Moolah provides tools and general guidance to support credit card surcharging, compliance with all applicable laws and card-network rules is the responsibility of the merchant. Moolah does not provide legal advice and assumes no liability for a merchant’s compliance.
Most major credit card networks permit surcharging when done in accordance with their rules, but additional requirements or restrictions may apply. Practices should ensure they have completed all required network notifications and disclosures prior to enabling surcharging.
Failure to comply with surcharging rules may result in card-network fines, required refunds, or other enforcement actions. Practices should ensure they fully understand all applicable requirements before applying a surcharge.
Flex does not currently offer built-in support for credit card surcharging. If a practice chooses to enroll in a surcharge plan, payments would need to be processed through Moolah’s payment platform, which is designed to support surcharging and integrates directly with Open Dental.
If you are considering introducing a credit card surcharge for your patients, it is important to understand that there are specific rules and regulations that must be followed when enrolling in and operating under a surcharge plan.
This article provides a general overview of common surcharging requirements. This content is provided for informational purposes only and does not constitute legal advice. It is the responsibility of each merchant to review, understand, and comply with all applicable laws, card-network rules, and regulatory requirements, including notification timeframes, signage requirements, surcharge percentage limits, and jurisdictions where surcharging is prohibited.
If you are unsure about the laws or regulations applicable to your practice, you should consult with qualified legal counsel. Moolah assumes no liability for a merchant’s compliance or non-compliance with credit card surcharging rules or regulations.
Transparent Communication
Card networks, including Visa, Mastercard, Discover, and American Express, require merchants to clearly and transparently disclose when a credit card surcharge is applied.
Practices must clearly notify patients of a credit card surcharge through appropriate signage placed at the practice entrance, at the point of sale or terminal, and anywhere payments are accepted. If payments are accepted online, surcharge disclosures must also be clearly visible on the practice’s website. All disclosures must inform patients that the surcharge applies only to credit card transactions.
Surcharge Limits
Credit card surcharges must comply with both card-network rules and applicable law. The surcharge amount may not exceed the merchant’s actual cost of accepting credit cards and may not exceed 3% of the total transaction amount.
Card-network rules cap credit card surcharges at 3%, meaning that if a merchant’s processing costs exceed this amount, the excess portion cannot be passed on to the patient.
Network and State Restrictions
The major credit card networks, such as Visa and Mastercard, impose specific requirements related to surcharge limits, advance notification, and disclosure.
In addition, several U.S. states and territories regulate or prohibit credit card surcharging. At the time of writing, credit card surcharging is prohibited in Connecticut, Maine, Massachusetts, and Puerto Rico. Other states, including Colorado, Minnesota, Mississippi, New Jersey, and New York, impose restrictions on surcharge amounts or require specific disclosures.
If your practice operates in a state that restricts or prohibits credit card surcharging, you must fully understand and comply with those requirements before implementing a surcharge.
Debit card transactions may never be surcharged, even if the debit card is processed as a credit transaction.
Applicability
Credit card surcharges may be applied only to credit card transactions. Other payment types, including debit cards and alternative payment methods, are not eligible for surcharging.
Regulatory Compliance
Merchants are responsible for maintaining ongoing compliance with all applicable card-network and legal requirements. This includes meeting advance notification obligations, using compliant signage and disclosures, adhering to surcharge percentage limits, and respecting jurisdiction-specific restrictions.
By following these guidelines, dental practices can implement credit card surcharging in a way that aligns with card-network rules and promotes transparency with patients. Clear and upfront communication helps maintain patient trust and supports a positive payment experience.