NDAC 75-02-02-09.3
Limitations on payment for dental services
Cite as N.D. Admin. Code ยง 75-02-02-09.3
1.
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.