Negotiated reimbursement rates for D0170 across 29 states, sourced from CMS Transparency in Coverage data. 668 rate records.
D0170 is the code for a limited, problem-focused re-evaluation, typically used when a patient returns for follow-up care related to a specific issue. This evaluation assesses the progress of treatment or addresses new concerns that may have arisen. Documentation should include the patient's history since the last visit, current symptoms, and any changes in treatment plans. Reimbursement for D0170 is generally lower than for initial evaluations, and coverage can vary by payor. Some insurance plans may have specific guidelines regarding the frequency of re-evaluations, so billing professionals should verify these details to ensure proper reimbursement.
Reimbursement rates for D0170 vary significantly by state, payor, and provider network. The national average negotiated rate is $43. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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