IAB Dental Reimbursement Rates
This is only a partial list which includes the Top 50 Dental Reimbursements and codes.
| Procedure Description | Reimb Amount | Waiting Period |
|---|---|---|
| Prohylaxis -Adult | $29 | No Waiting Period |
| Periodic Oral Exam | $10 | No Waiting Period |
| Limited Oral Exam | $10 | No Waiting Period |
| Intraoral-Periapical-First Film | $5 | No Waiting Period |
| X-rays-Bitewing Four Films | $15 | No Waiting Period |
| X-rays-Bitewings Two Films | $9 | No Waiting Period |
| Extraction - Erupted Tooth | $29 | 90 Days |
| Prohylaxis - Child | $20 | No Waiting Period |
| Topical Application Flouride | $8 | No Waiting Period |
| Resin Based Composite - One | $28 | 90 Days |
| Limited Oral Exam-Problem | $10 | No Waiting Period |
| Intraoral - Periapical 0 Each Add Film | $3 | 90 Days |
| X-Rays - Panoramic Film | $29 | No Waiting Period |
| Intraoral-Complete Bitewings | $36 | No Waiting Period |
| Sealant - Per Tooth | $13 | 90 Days |
| Periodontal Scaling & Root | $48 | 90 Days |
| Amalgam - Two Surfaces | $30 | 90 Days |
| Resin Based Composite - Two | $36 | 90 Days |
| Amalgam - One Surface | $22 | 90 Days |
| Resin Based Composite - One | $28 | 90 Days |
| Crown-Porcelain Fused to Hi Noble | $176 | 12 Month |
| Surgical Removal of Erupted Tooth | $49 | 90 Days |
| Core Buildup, Including any Pins | $38 | 12 Month |
| Periodontal Maintenance | $31 | 90 Days |
| Resin Based Composite - Two | $36 | 90 Days |
| Topical Application of Flouride w/cleaning | $11 | No Waiting Period |
| Resin Based Composite - Three | $46 | 90 Days |
| RC Ther-Molar Exc Final | $231 | 90 Days |
| Amalgam - Three Surfaces - Primary | $36 | 90 Days |
| Analgesia, Anxiolysis, Inhalation | $13 | 90 Days |
| Resin Based Composite - Three | $46 | 90 Days |
| Full Mouth Debridement to Enable | $48 | 90 Days |
| Topical Application with Flouride | $25 | No Waiting Period |
| Crown-Porcelain Fused to Noble Metal | $176 | 12 Month |
| Prefab Stainless Steel Crown Primary | $38 | 12 Month |
| RC Ther-Bicuspid Exc Final Restoration | $176 | 90 Days |
| Resin Composite 4+ Surfaces | $56 | 90 Days |
| Pulp Cap Indirect | $13 | 90 Days |
| Removal Impacted Tooth | $121 | 90 Days |
| Prefabricated Post and Core | $53 | 12 Month |
| Root Canal Therapy | $147 | 90 Days |
| Removal Impacted Tooth-Partial Bony | $89 | 90 Days |
| Recement Crown | $13 | 12 Month |
| Initial Oral Exam | $15 | No Waiting Period |
| Crown - Porcelain Fused to High | $155 | 12 Month |
| Resin Based Composite - Four+ Surfaces | $56 | 90 Days |
| Palliative Treatment | $18 | No Waiting Period |