Dental Supplement

General Anaesthetic (GA) and IV sedation in Dental Office
Limited coverage for GA/IV sedation in office is available under fee code 92215
(previous code used was 92444). Refer to the detailed information and restrictions
noted under fee code 92215 in the Schedule of Fee Allowances – Dentist. Eligibility for
this service must be confirmed prior to treatment. See the Eligibility Information section
on page (v).
General Anaesthetic (GA) and IV Sedation in a Private Facility
The Ministry does not cover GA and IV sedation facility fees. Effective April 2003, the
management of all private facility fees was transferred to the Provincial Health Services
Authority (PHSA) Children’s and Women’s Health Centre (CWHC). For specific
information on coverage of facility fees, contact CWHC at 1-604-875-2345.
Access to Additional $1000 of Basic Dental Services When Treatment is
Completed in an Approved Private Facility Or Hospital
If your client is found eligible and dental treatment is performed under GA/IV sedation in
hospital through the Medical Services Plan (MSP) or in an approved facility through the
above noted agency, access to an additional $1000 of basic dental treatment is
available. You must ensure you have noted on your claim form that treatment was
performed under GA or IV sedation in an approved private facility or hospital. The name
of the private facility or hospital is also required.
The additional $1000 over the client’s limit is a once yearly supplement but can be
utilized over multiple GA/IV sedation appointments should more than one appointment
be necessary. An example would be if a child has a GA and uses up their $1400
biennial limit plus $100 of the additional limit and then a second GA is necessary, the
patient would have access to the remaining $900 that year.
Note: The eligible dental services will be paid at rates in accordance with the Schedule
of Fee Allowances – Dentist. All rules, frequency and financial limits associated
with each service still apply. There is no provision to exceed time and financial
limited services (i.e.: 2 year filling limits). The additional $1000 of basic dental
services is not available when treatment is done in office.
Crown and Bridge Supplement
Specific and comprehensive information regarding allowable services along with their
associated fees, rules and restrictions and billing information can be found under
Part E - Preamble - Crown and Bridgework Supplement and Part F - Schedule of Fee
Allowances - Crown and Bridgework.
October 1, 2012
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