Regulation 11 claims are to be used for NHS treatment when providing a patient with a replacement appliance.

Submitting a Claim for a Regulation 11 

When claiming for regulation 11 treatment, the course of treatment must only contain the regulation 11 treatment.

Charting a Regulation 11

1. Open the patient record.
2. Open the Chart tab.
3. Create an NHS course of treatment (COT).
4. Click on the Exemptions option at the bottom of the COT.
5. Select Regulation 11 Replacement Appliance.
   • EXACT will automatically add the patient charge.
6. Select OK.
7. Add the Replacement Appliance service to the COT without any other treatment charted.
   • Examples of these services: 3281, 3282, 3283, 3284 or 3285.
     ⚠️ Please Note: Any treatment being claimed must have the correct dataset assigned to it. The NHS will reject any Regulation 11 claim with the clinical dataset 'Other'.
     💡 Tip: You can check your NHS Datasets, Service Codes and Categories before charting or transmitting your claim.
8. Complete the treatment and TC.

Regulation 11 Patient Charges and Activity

• The patient will pay 30% of the Band 3 charge per appliance, even if they do not normally pay.
  ⚠️ Please note: Upper and lower dentures are considered as two appliances. In cases of undue hardship patients may apply for a refund of charges by completing a Form FP17R11.
• 12 UDAs are awarded for general appliances
• UOAs are not awarded for replacement orthodontic appliances. The orthodontist retains the patient charge and Form FP17O is submitted.

View the NHS website for the most up to date Regulation 11 information.