Louisiana Administrative Code
Title 40 - LABOR AND EMPLOYMENT
Part I - Workers' Compensation Administration
Subpart 2 - Medical Guidelines
Chapter 53 - Dental Care Services, Reimbursement Schedule and Billing Instructions
Section I-5321 - Maximum Allowable Reimbursement
Universal Citation: LA Admin Code I-5321
Current through Register Vol. 50, No. 9, September 20, 2024
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.
AUTHORITY NOTE: Promulgated in accordance with R.S. 23:1034.2.
Disclaimer: These regulations may not be the most recent version. Louisiana may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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