September 2026 Benchmarking Report: The $48K Collections Gap
Collections are rising with patient spending, but only your collection rate shows whether your revenue cycle works. The benchmarks to measure against, and the math on recovering the gap.
An earlier summary of this report listed headline benchmark figures (median and top-quartile collections, overhead and hygienist wage) that came from a projection model, not measured data. We have removed them. We also corrected the ADA gross billings figures, which had been misquoted as $865,660 (general practitioners) and $2,213,040 (specialists), and every calculation built on them, including the headline gap. The analysis below cites its sources directly.
Collections are ticking up, and the reason is unglamorous: patients are spending more on dentistry than they ever have. Consumer dental spending hit a $201 billion annualized rate in September 2025, up 4% year over year, up 3% across the first nine months of 2025, and up 9% from where it sat before the pandemic, according to the ADA Health Policy Institute's Q4 2025 update on the U.S. dental economy. More demand means more production, and more production means more money hitting the bank. That's the top line.
Here's the part that should bother you. A rising collections number tells you almost nothing about whether your revenue cycle is working. Collections went up at practices that fixed their insurance follow-up, and collections went up at practices that did nothing at all except treat more patients. Those are two completely different businesses, and only one of them keeps the gain. If you want to know which one you're running, you have to look at collections as a percentage of what you produced, not as a dollar figure that grew alongside a growing market.
The Number That Actually Moved
Demand is the engine here, and it's been running for three straight years. The $201 billion annualized figure from ADA HPI's economic update is drawn from Bureau of Economic Analysis spending data, which means it's measuring actual household outlays on dental care, not survey sentiment about what people plan to do. When that number climbs 4% in a year, the average practice sees it as more filled chair time, more accepted treatment plans, and a bigger monthly deposit.
Production is tracking with it. The ADA's Survey of Dental Practice puts 2025 average gross billings for general practitioners at $965,660, with specialists at $1,213,040 and average net income for general dentists at $215,320. That GP billings figure is the base you should be measuring your collection rate against. It's also a useful sanity check: if you're producing near that number and your net income is nowhere near $215,320, the leak is either in overhead or in collections, and collections is the cheaper one to fix.
