Section 535.2 - Definitions.

535.2 Definitions. (Additional statutory authority: Social Welfare Law, Section 368-a) When used in this Part, unless otherwise expressly stated or unless the context or subject matter requires a different interpretation, the terms hereinafter set forth shall be interpreted in accordance with the definitions herein provided.

(a) Reimbursement means State reimbursement.

(b) Maximum reimbursable allowance means that portion of the expenditures for any dental service or procedure which shall be subject to reimbursement.

(c) Dentist includes periodontist, endodontist and oral surgeon.

(d) Attending dentist means that dentist who is primarily and continuously responsible for the service or procedures rendered to a patient.

(e) Consultation means advice and counsel from an accredited specialist called in by the attending dentist in regard to the further handling of the case by the attending dentist.

(f) Referral shall mean the transfer of a patient from one dentist to another for definitive treatment.

(g) Anesthesia time means that time elapsing from the beginning of the administration of the anesthetic agent until the anesthetist is no longer in personal attendance.

(h) The notation T means one time unit for each 15 minutes of anesthesia time during in-hospital oral surgery.

(i) By report means that the maximum reimbursable allowance is determined on an individual basis in consideration of the nature, extent and need for the procedure or service, the time, skill and equipment necessary therefor, and such other factors as may be pertinent.

 

Doc Status: 
Complete