Section 75-02-02-09.3 - Limitations on payment for dental services1. No payment will be made for single crowns on posterior teeth for individuals twenty-one years of age and older except for stainless steel crowns. Payment for other crowns may be allowed by the department for the anterior portion of the mouth for adults if the crown is necessary and has been previously approved by the department.2. No payment will be made for single crowns on posterior teeth for individuals under age twenty-one except for stainless steel crowns. Payment may be made if a dental condition exists that makes stainless steel crowns impracticable and the provider has secured the prior approval of the department.3. Payment will be made for partial dentures for upper and lower temporary partial stayplate dentures. Payment may be made for other types of partial dentures designed to replace teeth in the anterior portion of the mouth if the provider secures prior approval from the department. Replacement of dentures is limited to every five years unless a medical condition of a recipient, verified by a dental consultant, renders the present dentures unusable. This limitation does not apply to individuals eligible for the early and periodic screening, diagnosis, and treatment program.N.D. Admin Code 75-02-02-09.3
Effective September 1, 2003; amended effective October 1, 2012.Amended by Administrative Rules Supplement 2016-360, April 2016, effective 4/1/2016.Amended by Administrative Rules Supplement 368, April 2018, effective 4/1/2018.General Authority: NDCC 50-24.1-04
Law Implemented: NDCC 50-24.1-04