Common use of Prosthodontics Clause in Contracts

Prosthodontics. Reimbursement for any type of prosthesis (removable or fixed) includes follow-up examinations and adjustments for the three-month period following the date on which the prosthesis is fitted. For the laboratory expenses included in a procedure, the eligible maximum is 50% of the dental surgeon’s fee for the dental procedure code at issue and in accordance with the maximum set forth in the Fee Guide. Unless otherwise specified, any type of prosthesis is reimbursed only once per five-year period. i) Removable prostheses Complete dentures − Standard complete dentures − Equilibrated complete dentures − Immediate complete dentures (once in a lifetime) − Immediate complete dentures (transitional, once in a lifetime) − Dentures, complete, overdenture, standard − Dentures, complete, overdenture, equilibrated − Partial dentures, acrylic (immediate, transitional or permanent, once in a lifetime) − Partial dentures, cast − Complete denture with partial denture (opposing arch) with cast (standard and equilibrated) − Removable cast partial dentures with precision attachments or semi-precision cast partial dentures − Hybrid partial dentures, cast − Dentures, complementary services − Dentures supported by implants, up to the fee for an equivalent standard denture ii) Fixed prosthodontics and bridges (one procedure per tooth per five-year period) Fixed prosthodontics − Individual crown − Cast post − Crown or veneer repair, chairside − Recementation or removal of inlay, onlay, non-prefabricated crown, veneer or post − Prefabricated post with buildup − Pontics − Fixed bridges, complementary services − Abutments e) Oral surgery