Negotiated reimbursement rates for D0120 across 29 states, sourced from CMS Transparency in Coverage data. 468 rate records.
D0120 is the code for a periodic oral evaluation, typically performed on patients who are returning for routine check-ups. This evaluation assesses the overall health of the oral cavity and includes an examination of the teeth, gums, and other oral structures. Documentation should include findings from the examination, any changes in the patient's health status, and recommendations for future care. Reimbursement for D0120 generally varies by payor, with some plans covering it as part of preventive care while others may have limitations on frequency. It's essential to verify coverage specifics with each insurance provider to ensure proper billing.
Reimbursement rates for D0120 vary significantly by state, payor, and provider network. The national average negotiated rate is $64. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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