Bulgaria’s NHIF: dental coverage and reimbursement in 2026

Which dates these rates cover

Bulgaria’s National Health Insurance Fund (NHIF, НЗОК) pays the rates below for care provided from 1 September to 31 December 2026. Article 105(1) of framework contract РД-НС-01-00-5 dated 16 September 2026 sets these amounts in euros. The contract covers 2026–2028, but this price period ends on 31 December 2026.

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Eligibility, contributions and visit fees

NHIF care requires health insurance entitlement and a dentist contracted for the relevant service. Before treatment, check the allowance already used, the insurance booklet or supplement, and any required referral. Patients insured in another country need the corresponding entitlement documents.

For a chemically cured composite filling for an adult in the standard package, the dentist receives 43.63 € from NHIF and 2.05 € from the patient for the procedure. For a child, NHIF pays 45.67 €, with no procedure contribution. The statutory visit fee is separate and applies only when the patient is not exempt. Article 96 and Annex 6 set out the exemptions.

When the annual allowance is exhausted or the patient chooses treatment or materials outside the package, Article 109 allows direct payment. Agree the basis and price before treatment.

For patients, see the 2026 NHIF dental coverage guide. Facility requirements and contractual changes are explained in the NHIF practice-contract guide.

Primary care: children and adults

The examination is separate from the treatment allowance. Pregnancy entitles the patient to one additional comprehensive examination in the calendar year.

Primary dental care

Procedure	Children up to 18	Adults over 18
Comprehensive examination with oral status assessment	Code 10111 NHIF 22.00 € Patient 0.00 €	Code 10112 NHIF 22.00 € Patient 0.00 €
Additional comprehensive examination during pregnancy	Code 10311 NHIF 22.00 € Patient 0.00 €	Code 10312 NHIF 22.00 € Patient 0.00 €
Chemically cured composite filling	Code 30111 NHIF 45.67 € Patient 0.00 €	Code 30112 NHIF 43.63 € Patient 2.05 €
Primary tooth extraction with anaesthesia	Code 50811 NHIF 18.35 € Patient 0.00 €	Not included
Permanent tooth extraction with anaesthesia	Code 50911 NHIF 45.67 € Patient 0.00 €	Code 50912 NHIF 43.63 € Patient 2.05 €
Treatment of pulpitis or periodontitis in a primary tooth	Code 33211 NHIF 24.58 € Patient 2.40 €	Not included
Treatment of pulpitis or periodontitis in a permanent tooth	Code 33311 NHIF 79.27 € Patient 3.07 €	Not included

Children up to 18: one comprehensive examination and up to four treatment procedures per year. No more than two of these may treat pulpitis or periodontitis in permanent teeth (Article 104).

Adults over 18: one comprehensive examination and up to three treatment procedures per year, fillings and/or permanent tooth extractions. From 1 November 2026, § 6 adds a fourth treatment for 2026, which must be performed on or after that date.

For example, one examination and three eligible adult fillings give 152.89 € from NHIF and 6.15 € from the patient for those procedures. With an eligible fourth filling from 1 November, the totals become 196.52 € and 8.20 €. Visit fees and private services are separate.

For an adult with a retained milk tooth, do not use the permanent-tooth extraction item solely because of the patient's age. The adult primary package does not include extraction of a milk tooth, as NHIF confirms in its reply.

Paediatric dental specialists

These codes apply to a provider contracted for specialist paediatric dentistry. Rates differ from primary care: NHIF pays 48.51 € for a filling and 88.24 € for pulpitis or periodontitis treatment in a permanent tooth.

Changing dentist or seeing a specialist does not create another annual allowance. Check all care already used under Article 104.

For repeat pulpitis or periodontitis treatment, check the exceptions in Article 98, the clinical indication and the remaining annual allowance. In its reply concerning a child's repeat treatment, NHIF permits it when the contracted volume is not exhausted. This does not unconditionally authorise repeat reporting of any procedure on the same tooth.

For an older record or question labelled only “code 333”, identify the full current code and package. Permanent-tooth pulpitis or periodontitis treatment is 33311 in standard primary care and 33321 in specialist paediatric care. Fully funded groups and general-anaesthetic care have separate codes.

Specialist surgical care

A consultation referral, form МЗ 119А, is required to a contracted provider with the relevant surgical specialty. Article 104(3) does not impose a volume limit on these referred surgical procedures. Clinical indications, documentation and provider requirements still apply.

The follow-up code relates to the listed incision or extraction of a deeply fractured or destroyed tooth. A routine primary-care extraction uses another code and rate.

Specialist surgical care

Procedure	Children up to 18	Adults over 18
Comprehensive specialist examination	Code 102214 NHIF 23.19 € Patient 0.00 €	Code 102224 NHIF 23.19 € Patient 0.00 €
Incision into connective tissue spaces with anaesthesia	Code 520214 NHIF 21.26 € Patient 1.53 €	Code 520224 NHIF 18.96 € Patient 3.83 €
Extraction of a deeply fractured or extensively destroyed tooth with anaesthesia	Code 510214 NHIF 51.56 € Patient 2.56 €	Code 510224 NHIF 46.40 € Patient 6.90 €
Follow-up after incision or complex extraction	Code 544214 NHIF 5.00 € Patient 0.41 €	Code 544224 NHIF 5.00 € Patient 0.41 €

Complete dentures: clinical work and device

For a fully edentulous upper and/or lower jaw, regardless of age, the package allows one upper and one lower restoration over four consecutive years from the procedure, including follow-up within two months of fitting. This is not an annual renewal.

Separate clinical work (832/833) from manufacture of the medical device (834/835). Reporting manufacture also requires reporting the corresponding restoration procedure under Article 113(2). If both lines are eligible and approved, they total 177.94 € per jaw or 355.88 € for both. This is not the dentist’s net income: the device and laboratory relationship are separate costs and arrangements. The patient contribution for these tariff items is 0.00 €.

The listed patient contribution is zero. These codes do not extend coverage to partial dentures, implants or any chosen technique outside the package.

Under Article 86(5), the patient must be told whether the provider also reports fabrication to NHIF, as recorded in the Annex 5 declaration. Do not present the combined amount as device coverage when fabrication is not reported under the contract. Covered clinical work alone does not establish coverage of the device.

Full payment for the Article 102 groups

Article 102 covers people accommodated in medico-social service homes; children in the specified special schools and homes for children deprived of parental care, including after age 18; and people held in custody. Verify the precise category and evidence. Exemption from the statutory visit fee alone does not establish eligibility for these tariff groups.

Use their distinct codes and full-payment rates. Do not simply add the standard NHIF and patient amounts: a primary-care filling with anaesthesia here is 59.91 €.

Article 102: primary care

Procedure	Children up to 18	Adults over 18
Comprehensive examination with oral status assessment	Code 101111 NHIF 22.00 € Patient 0.00 €	Code 101121 NHIF 22.00 € Patient 0.00 €
Additional comprehensive examination during pregnancy	Code 103111 NHIF 22.00 € Patient 0.00 €	Code 103121 NHIF 22.00 € Patient 0.00 €
Chemically cured composite filling with anaesthesia	Code 301111 NHIF 59.91 € Patient 0.00 €	Code 301121 NHIF 59.91 € Patient 0.00 €
Primary tooth extraction with anaesthesia	Code 508111 NHIF 18.35 € Patient 0.00 €	Not included
Permanent tooth extraction with anaesthesia	Code 509111 NHIF 45.67 € Patient 0.00 €	Code 509121 NHIF 45.67 € Patient 0.00 €
Treatment of pulpitis or periodontitis in a primary tooth with anaesthesia	Code 332111 NHIF 37.10 € Patient 0.00 €	Not included
Treatment of pulpitis or periodontitis in a permanent tooth with anaesthesia	Code 333111 NHIF 92.45 € Patient 0.00 €	Not included

Article 102: surgical care

Procedure	Children up to 18	Adults over 18
Comprehensive specialist examination	Code 1022114 NHIF 23.19 € Patient 0.00 €	Code 1022214 NHIF 23.19 € Patient 0.00 €
Incision into connective tissue spaces with anaesthesia	Code 5202114 NHIF 22.80 € Patient 0.00 €	Code 5202214 NHIF 22.80 € Patient 0.00 €
Extraction of a deeply fractured or extensively destroyed tooth with anaesthesia	Code 5102114 NHIF 54.60 € Patient 0.00 €	Code 5102214 NHIF 54.60 € Patient 0.00 €
Follow-up after incision or complex extraction	Code 5442114 NHIF 5.40 € Patient 0.00 €	Code 5442214 NHIF 5.40 € Patient 0.00 €

General anaesthesia under Article 103

This regime applies to insured people with mental illnesses under Articles 94 and 103. It does not cover every requested sedation or general anaesthetic. The required clinical grounds, documents, referral and provider contract must be in place. Article 104(2) sets no volume limit for the covered dental procedures under general anaesthesia.

901 and 902 are hourly anaesthesia rates, not a case price. The daily limit per patient is 180 minutes in outpatient care, exceptionally 240 minutes with documented grounds, and 360 minutes in hospital care. Code 903 is for 24-hour active observation when necessary afterwards. Do not automatically add every line to each case.

Article 103: primary care

Procedure	Children up to 18	Adults over 18
Comprehensive examination with oral status assessment	Code 101112 NHIF 32.18 € Patient 0.00 €	Code 101122 NHIF 32.18 € Patient 0.00 €
Additional comprehensive examination during pregnancy	Code 103112 NHIF 32.18 € Patient 0.00 €	Code 103122 NHIF 32.18 € Patient 0.00 €
Chemically cured composite filling	Code 301112 NHIF 59.93 € Patient 0.00 €	Code 301122 NHIF 59.93 € Patient 0.00 €
Primary tooth extraction with anaesthesia	Code 508112 NHIF 28.15 € Patient 0.00 €	Not included
Permanent tooth extraction with anaesthesia	Code 509112 NHIF 59.93 € Patient 0.00 €	Code 509122 NHIF 59.93 € Patient 0.00 €
Treatment of pulpitis or periodontitis in a primary tooth	Code 332112 NHIF 43.18 € Patient 0.00 €	Not included
Treatment of pulpitis or periodontitis in a permanent tooth	Code 333112 NHIF 141.60 € Patient 0.00 €	Not included

Article 103: specialist care

Procedure	Children up to 18	Adults over 18
Comprehensive specialist examination	Code 102212 NHIF 32.18 € Patient 0.00 €	Code 102222 NHIF 32.18 € Patient 0.00 €
Comprehensive examination with oral status assessment	Code 101212 NHIF 32.18 € Patient 0.00 €	Not included
Additional comprehensive examination during pregnancy	Code 103212 NHIF 32.18 € Patient 0.00 €	Not included
Chemically cured composite filling	Code 301212 NHIF 60.41 € Patient 0.00 €	Not included
Primary tooth extraction with anaesthesia	Code 508212 NHIF 28.38 € Patient 0.00 €	Not included
Permanent tooth extraction with anaesthesia	Code 509212 NHIF 60.41 € Patient 0.00 €	Not included
Treatment of pulpitis or periodontitis in a primary tooth	Code 332212 NHIF 43.54 € Patient 0.00 €	Not included
Treatment of pulpitis or periodontitis in a permanent tooth	Code 333212 NHIF 142.76 € Patient 0.00 €	Not included
Incision into connective tissue spaces with anaesthesia	Code 520212 NHIF 35.96 € Patient 0.00 €	Code 520222 NHIF 35.96 € Patient 0.00 €
Extraction of a deeply fractured or extensively destroyed tooth with anaesthesia	Code 510212 NHIF 79.54 € Patient 0.00 €	Code 510222 NHIF 79.54 € Patient 0.00 €
Follow-up after incision or complex extraction	Code 544212 NHIF 9.47 € Patient 0.00 €	Code 544222 NHIF 9.47 € Patient 0.00 €

Medical assessment and imaging

Assessment codes require the relevant NHIF procedure and documents, including Articles 111 and 112. They are not a routine extra examination for every treatment.

Dental radiographs and panoramic imaging follow Article 110 and the applicable framework contract for medical activities. Their prices are outside this dental tariff.

From treatment to payment

NHIF pays for eligible care that has been performed, reported and approved. Article 106 excludes payment for care that breaches contracted volumes and values.

1. Check entitlement and code. Verify the patient’s remaining allowance, provider contract and tariff category. Article 98 also sets a 12-consecutive-month period for performed and reported procedures, with its stated exceptions; a new annual allowance does not override that rule.
2. Record the care. Complete the required documents and submit to Bulgaria’s national health information system (НЗИС). Check identifiers and the national reference number. Match denture device and clinical procedure lines.
3. Report monthly. Article 113 requires electronic reporting with a qualified electronic signature by the third working day of the following month. Correct errors within the permitted deadlines.
4. Invoice approved care. The monthly notice is sent by the 15th. Submit the electronic invoice within two working days of that notice and no later than the 19th (Article 115). Follow the objection and review procedure for rejected items.

Current amendments, annexes and instructions are on NHIF’s 2026–2028 dental contract page. The relevant regional fund handles questions about individual claims.