LAC 40:I.5321
LAC 40:I.5321. Maximum Allowable Reimbursement
Cite as La. Admin. Code tit. 40, pt. I, § 5321
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.