La. Admin. Code tit. 40 § I-5321

Current through Register Vol. 50, No. 11, November 20, 2024

Section I-5321 - Maximum Allowable Reimbursement

A. Maximum Allowable Reimbursement lists the maximum payment allowed for dental items described by appropriate codes. Payment will be the least of:

1. the seventieth percentile in the current edition of the National Dental Advisory Service (NDAS) Comprehensive Fee Report, utilizing the average of geographic multipliers for Louisiana as published in the NDAS report;

2. a pre-negotiated amount between the provider and carrier/self-insured employer; or

3. the amount indicated in the maximum allowable reimbursement schedule.

La. Admin. Code tit. 40, § I-5321

Promulgated by the Department of Labor, Office of Workers' Compensation, LR 19:1167 (September 1993), amended LR 20:1298 (November 1994), amended by the Workforce Commission, Office of Workers' Compensation, LR 40:379 (February 2014).

AUTHORITY NOTE: Promulgated in accordance with R.S. 23:1034.2.