Bridge owners are frequently faced with the need to replace critical bridge components during strictly limited or overnight road closure periods. This paper presents the development, testing and installation of precast, High Performance Concrete (HPC) bridge elements with field cast Ultra-High Performance Concrete (UHPC) Joint Fill, specifically designed for the Ministry of Transportation of Ontario, to repair deteriorated bridge decks. As this new technology and method of construction moves into main stream, designers and owners need to expand its use into larger and more complex bridge geometries, such as multiple spans with live-load continuity and others. The fundamentals of the technology, material properties, design details, manufacturing, prototyping, load testing, erection and an application utilizing live-load continuity are included. By utilizing the UHPC material’s unique combination of superior properties in conjunction with Glass Fiber Reinforced Polymer (GFRP), precast bridge deck panel design is advanced. Benefits include: reduced joint size and complexity, improved durability, improved continuity, speed of construction, elimination of post-tensioning and extended usage life. This paper further advances the use of this technology through demonstrating the use in developing live load continuity in multiple span bridges.