Attached please find your copy of the new NIHB Dental Benefit Grid for Denturists in Prince Edward Island.
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1 March 1, 2009 TO: Registered NIHB Denturists in Prince Edward Island Dear Provider: Attached please find your copy of the new NIHB Dental Benefit Grid for Denturists in Prince Edward Island. The NIHB Regional Dental Benefit Grid for Prince Edward Island is effective March 1, The Health Information and Claims Processing System (HICPS) has been changed to reflect the new rates indicated in your copy of the grid. Should you have any questions, please contact the First Canadian Health NIHB Toll-Free Inquiry Centre at Sincerely, Dr. Gregory W. Jones D.D.S Regional Dental Officer, Atlantic Region Non-Insured Health Benefits cc: Prince Edward Island Denturists Association Aussi disponible en français au numéro
2 PRINCE EDWARD ISLAND NIHB REGIONAL DENTAL BENEFIT GRID Denturists EFFECTIVE DATE March 1, 2009 Dental services provided through the NIHB Dental Program will be reimbursed in accordance with the terms and conditions outlined herein. Predetermination is required for specific procedures identified in this document with a P, or procedures that are I.C. Please review carefully before treatment. Post treatment approval will be considered, except in those cases specified in the NIHB Dental Practitioner Information Kit.
3 PRINCE EDWARD ISLAND NIHB DENTURISTS DENTAL BENEFIT GRID Code Service Fee L PD Eligibility Examinations Oral Exam $ /arch/60months Emergency/Specific Nature $ /12 month period Prosthodontics Removable The fee paid for dentures includes 3 months post-insertion care including adjustments and modifications. FNIHB does not cover any other denture procedures (e.g. adjustments) during this period. For immediate dentures, an additional reline is permitted. Complete Dentures c. maxillary $ P c. mandibular $ P c. maxillary and mandibular $1, P Complete Dentures - Immediate c. maxillary $ P c. mandibular $ P c. maxillary and mandibular $1, P Complete and Partial Dentures Combined c. upper/p. lower $1, L P c. lower/p. upper $1, L P Partial Dentures Cast Frame Free end-standard p. maxillary $ L P p. mandibular $ L P p. maxillary and mandibular $1, L P Tooth borne-standard p. maxilary $ L P p. mandibular $ L P p. maxillary and mandibular $1, L P Partial Dentures Cast Frame - Immediate w/clasps Free end-standard p. maxillary $ L P p. mandibular $ L P Tooth borne-standard p. maxillary $ L P p. mandibular $ L P Partial Dentures Acrylic Base - with clasps p. maxillary $ P p. mandibular $ P p. maxillary and mandibular $1, P Partial Dentures Acrylic Base - w/o clasps p. maxillary $ P p. mandibular $ P p. maxillary and mandibular $ P Effective Date: March 1, 2009 P.E.I. - Denturists 1
4 Code Service Fee L PD Eligibility Partial Dentures Acrylic Base - Immediate w/clasps p. maxillary $ P p. mandibular $ P Partial Dentures Acrylic Base - Immediate, w/o clasps p. maxillary $ P p. mandibular $ P Relines Lab Processed with functional impression c. maxillary $ c. mandibular $ c. maxillary and mandibular $ p. maxillary $ p. mandibular $ p. maxillary and mandibular $ Processed c. maxillary $ c. mandibular $ c. maxillary and mandibular $ p. maxillary $ p. mandibular $ p. maxillary and mandibular $ Rebases Lab Processed with functional impression c. maxillary $ c. mandibular $ c. maxillary and mandibular $ p. maxillary $ p. mandibular $ p. maxillary and mandibular $ Repairs and Additions 1/prosthesis/12 months w/o impression c. maxillary $54.00 L c. mandibular $54.00 L p. maxillary $54.00 L p. mandibular $54.00 L w/ impression c. maxillary $81.00 L c. mandibular $81.00 L p. maxillary $81.00 L p. mandibular $81.00 L add.teeth/clasp p. maxillary $90.00 L p. mandibular $90.00 L Tissue Conditioning c. maxillary $ c. mandibular $ p. maxillary $54.00 Effective Date: March 1, 2009 P.E.I. - Denturists 2
5 Code Service Fee L PD Eligibility p. mandibular $54.00 Adjustments (more than three months after insertion) c. maxillary $ c. mandibular $ p. maxillary $ p. mandibular $40.50 Adjunctive Service Out of Office (house or institution) $45.00 Laboratory Procedures In Office I.C Commercial I.C. Effective Date: March 1, 2009 P.E.I. - Denturists 3
Attached please find your copy of the new NIHB Dental Benefit Grid for Denturists in Nunavut.
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